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Details Title: Gerontological Nursing Description: Gero Final Total Flash Cards: 20 Created: 05/07/2005 18:30:04	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term Heart Failure Dilated Cardiomyopathy Definition -the combo of symptoms related to the hearts inability to meet the demands of the body; NOT the disease, just the sx -heart function is impaired due to pump failure and associated w/vent. dilation and hypertropy Term Acute Heart Failure Chronic Heart Failure Definition - usually short term fluid overload symptoms - evolves overtime and will get remodeling/structural and neurohormonal changes Term Compensated Decompensated Definition - stable heart failure symptoms and the body/heart is used to/adjusted to the decreased pumping ability - get worsening heart failure symptoms (esp. at rest!) and the body poorly tolerates the decreased pumping ability Term Left-sided Heart Failure Definition - get LOW OUTPUT symptoms! have decreased CO; blood doesn't get out of the heart good enough and will pool in the pulmonary vasc.; get dyspnea and fatigue Term Right-sided Heart Failure Definition - "LOW VOLUME" symptoms; usually follows left-sided hf; since prob with right side of heart pumping, blood backs up in systemic vasc. and may be JVD, peripheral edema, and hepatic congestion Term In heart failure, the _____ is activated leading to 1. 2. 3. Definition SNS (symp. nervous system) 1. increased HR 2. increased contraction force 3. peripheral vasoconstriction Term Initially in HF, there is a decrease in ________ (3 things) as the ______ is activated Definition 1. decrease in CO 2. decrease BP 3. decreased renal blood flow RAAS is activated Term as there is continued peripheral vasoconstriction, there is _____ absorption of sodium and water Definition increased Term Some examples of neurohormonal changes Definition increased sodium retention, increased thirst, increased afterload d/t vasoconstriction, destoyed cardiac myocytes, arrhythmias Term ANP and BNP (what are they and what do they do?) Definition atriatic neuropeptide and B type neuropeptide they increase natriuresis and diuresis, balances vasoconstriction, and is less potent than other neurohormones causing sodium and water retention Term volume overload symptoms Definition weight gain, nocturia (d/t inc. kidney perfusion), gi complaints like bloating, rales, edema, JVD, ascites, elevated liver fxn tests, S3 sound heard, cough, dyspnea, orthopnea (harder to breath laying down) Term low output symptoms Definition fatigue/weakness, SOB/orthopnea, anxiety/agiation (d/t release of epi and NE), decreased UO (low kidney perfusion), severe lightheadedness, general discomfort d/t low skin perfusion, hypotension, tachycardia, worsening labs (BUN, creatinine, hyponatremia), Cheyne-stroke Term ACE INHIBITORS -what are they used for -how do they work Definition -first line drugs to stop RAAS and for patients with <40% EF (may be with or without symptoms) - these drugs prevent conversion of angiotensin I to II and therefore decrease vasoconstriction by increasing vasodilation, which decreased the hearts workd load to overcome the pressure (afterload) when pumping blood out of heart Term Examples of ACE Inhibitors Definition Captopril, Enalapril, Lisinopril Term ARB's -what are they -what do they do Definition Angiotensin Receptor Blockers -prevent angiotensin II from attaching to cell surface, therefore preventing vasoconstriction, so decrease afterload -good for pt who can't take ACE inhibitors d/t to coughing or angioedemea (these cause less cough) Term Side Effects of ACE Inhibitors Definition hypotension, worsening kidney fxn, hyperkalemia, cough, angioedema (anaphylactic rxn to drug so stop drug immediately!) Term Side Effects of ARB's Definition lightheadedness/dizzy, dec. kidney fxn, hyperkalemia, headache, cough Term Examples of ARB's Definition Candesartan, Losartan, Valsartan Term Vasodilators -what do they do -side efx -good for who? Definition -they will reduce elevated pressures (afterload and/or preload!) -hypotension, HA, nausea -good, esp. in combo therapy, for those who can't take ACEI d/t too much hypotension or renal insufficiency Term Digoxin -what is it -what does it do -how do you dose it -sx of overdose Definition -its an oral inotrope -decreases HR, sx, and hospitalization (does NOT help them live longer!!!) -keep dig level between 0.5-1.5 ng/ml -GI complaints, confusion, fatigue, halo vision, bradycardia