Term
| Considerations for Cardiac Catheterization |
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Definition
general bed rest from 6, 8 to 12 hours
Extremity Kept Straight
****ASSESS INSERTION SITE (MOST IMPORTANT)***
2nd assess distal to intertion site. |
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Term
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Definition
| dysrhythmias, escemia, sites of a MI, hypotrophy |
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Term
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Definition
| More people die from it than next 7 leading causes, 1 in 5 with Heart failure will die within a year of diagnosis |
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Term
| Indications of Pump Failure |
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Definition
insufficient Cardiac Output
decreased profusion to tissues
hypoxia, lack of nutrients, accumulation of waste products causing more damage around the body |
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Term
| Key Features of Left Side Heart Failure from decreased Cardiac Output |
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Definition
| Fatigue, Weakness, oliguria during day, noctuuria at night, angina, confusion, restlessness, dizziness, tachycardia, palpitations, pallor, weak peripheral pulses, cool extremities |
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Term
| Key Features of Left Side Heart Failure from Pulmonary Congestion |
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Definition
| Hacking cough that is worse at night, dyspnea/breathlessness, crackles or wheezing in lungs, frothy pink tinged sputum, tachypnea, S3/S4 summation gallop |
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Term
| Key Features of Right Sided Heart Failure from Systemic Congestion |
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Definition
| Jugular Vein Distention, Enlarged Liver and Spleen, Anorexia, Nausea, Dependent Edema in legs and sacrum, Distended Abd, Swollen hands & fingers, Polyuria at night, Weight Gain, Increased B/P from excess volume or decreased b/p from failure |
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Term
25% of heart failure begins on
75% of heart failure begins on |
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Definition
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Term
| Right side failure can result from Left Side failure or Pulmonary Congestion |
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Definition
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Term
| Type of Heart Failure usually from increased metabolism such as raging fever, tachycardia, thyroid disease |
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Definition
| High Output Heart Failure |
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Term
| Classification of Heart Failure STRUCTURAL damage of heart from past MI causing necrosis of muscle. |
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Definition
Class A - no damage but risk for it.
Class B thru D increases with amount of damage to the muscle |
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Term
| FUNCTIONAL Classification of Heart disease according to the ability to do things (ADLs) |
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Definition
+1 - minimal symptoms risk for increasing
+4 - client is sedentary b/c of breathlessness |
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Term
| Patients with heart failure experience decreased cardiac output - the ________ mechanism will occur (what is it also) |
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Definition
| Hormonal/Compensatory Mechanism - Activation SNS - speeds up heart rate. |
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Term
| Explain what the SNS does to increase heart rate |
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Definition
increase HR
Activate ReninAngiotensin System - produces a hormone that causes vassoconstriction to make a smaller amount of blood go further,
Manipulates ADH conserving fluid - increasing circulating volume |
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Term
| Myocardial Hypotrophy occurs when |
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Definition
| heart works harder and starts to enlarge to keep up with increased workload. It requires more oxygen |
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Term
| ____ failure revolve around systemic congestion b/c blood comes from Vena Cava backs up = congestion |
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Definition
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Term
| How does right side heart failure usuaslly manifest first? |
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Definition
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Term
| Right Sided Heart Failure Results |
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Definition
| Enlarged Liver/Spleen, Anorexia, Nausea, Vomiting, Distended Abd, Dependent Edema, Enlarged Scrotum, increased B/P |
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Term
| Causes of Right Side Heart Failure |
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Definition
Hypertension = 75% of time
Myocardia Infarction - 1/3rd of time structural Heart Changes = Valvular Dysfunction b/c of pressure or volume overload (MV Damage) |
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Term
| Left Side heart Failure effects |
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Definition
Impaired Tissue profusion b/c systemic and decreased cardiac output,
Excessive Fatigue - b/c decreased Cardiac Output and poor O2, Fluid in lungs - b/c of pressure in lungs forcing fluid in perpheral supporting lung tissues |
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Term
| Complaints of LS Heart Failure |
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Definition
| Activity intolerence - b/c of imbalanced O2 needed and available (IT HAS NOTHING TO DO WITH MUSCLE ABILITY), SOB, Tachycardia, palpitations, dysrhythmias, cough - usually at night, Orthopnea |
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Term
Right Side Heart Failure Results in
resulting in |
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Definition
Systemic Congestion and Fluid Retention
Dependent Edema in legs, feet, hands |
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Term
Pitting Edema is a Result of
Non Pitting Edema is usually a result of |
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Definition
Right Side Heart Failure
kidney overload - general fluid overload |
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Term
| Urination problems with Right side heart failure are |
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Definition
| Oliguria during day, and polyuria at night |
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Term
| Most reliable indicator of fluid status b/c of dependent edema |
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Definition
| weight gain - daily weights |
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Term
| What Lab Test is for Heart Failure? |
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Definition
| There are no lab assessments for heart failure. You will begin to see alterations in values b/c liver not functioning as effectively, kidneys wont be either b/c of fluid imbalances, |
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Term
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Definition
| Chest X-Ray - shows cardiac enlargement |
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Term
A cough only at night could indicate
what causes this |
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Definition
Left Side Heart Failure
Paroxysmal Noctural Dyspnea (PND)
lay down and fluid returns causing more back up in heart results in PND |
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Term
| No pain but 6 mo later development of heart failure b/c they weren't treated for |
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Definition
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Term
| How could you diagnose a silent heart attack? |
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Definition
| ECG would show previous damage |
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Term
| Pulmonary Artery Catheter measures |
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Definition
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Term
| If heart failure is present what would a pulmonary artery catheterization show |
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Definition
| Elevated in Pulmonary VEIN as Right Side of heart pumps to lungs that are congested and it will be decreased in Pulmonary ARTERY where it returns to left side of heart |
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Term
Nursing Diagnosis for Heart Failure
and why with each |
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Definition
| *Impaired Gas Exchange b/c lungs filling with fluid ventilation profusion imbalance patient still breathing air but profusion of blood to lungs has decreased *Decreased Cardiac Output r/t contractility, preload & afterload, *Activity Intolerence r/t imbalance of O2 suppy and demand |
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Term
Nursing Diagnosis
IMPAIRED GAS EXCHANGE for Heart Failure
interventions |
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Definition
| Evaluate respiratory status, Titrate O2, High Fowlers, Coughing, Turning, Deep Breathing (to expand alveoli) |
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Term
Nursing Diagnosis for Heart Failure
DECREASED CARDIAC OUTPUT
interventions |
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Definition
| medications - reduce afterload, reduce preload and improve contractility |
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Term
| The goal of Decreased Cardiac Output is: And how do you do that? |
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Definition
Optimize Cardiac Output
interupt poor circulation by regulating amount of blood coming into the heart, regulating blood leaving the heart and the workload of the heart. Optimize the Stroke Volume |
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Term
| Stroke Volume is dependeent on the __ |
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Definition
| Preload, afterload and contractility |
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Term
| Amount of blood coming into the heart |
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Definition
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Term
| How does drugs that decrease preload work to help heart failure |
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Definition
| optimize the ventricular muscle stretch and ability of heart to contract by not over filling |
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Term
| Interventions for Heart Failure |
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Definition
Low Sodium Diet
Fluid Restriction
Diuretics
Venous Vassodilators |
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Term
| What is the amount for a low sodium diet? What foods? |
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Definition
< 5 g daily
cooking from scratch, no processed or canned foods |
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Term
| What is the fluid restriction for heart failure |
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Definition
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Term
| Diuretic works to improve heart failure how? |
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Definition
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Term
| What are the venous vassodilators for heart failure |
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Definition
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Term
| What is an education for Nitrates? |
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Definition
| Don't wear patch at night because of tolerance build up |
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Term
| Heart Failure - when to contact dr? |
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Definition
weight gain of 1 to 2 pounds overnight or 3 to 5 pounds a week
decrease exertion tolerance, cough, increased edema |
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