chf

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Anonymous
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44235
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chf
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2010-10-22 15:58:23
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chf
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  1. define heart failure
    hearts inability to pump adequate amts of blood to meet the metabolic needs of the body
  2. CHF is which side of the heart

    (congestive heart failure)
    left sided heart failure or left ventricular failure
  3. Cor pulmonale is which side of the heart
    right sided heart failure or right ventricular failure
  4. results in pulmonary edema (fluid in the lungs)
    CHF
  5. risk factors of CHF
    • hypertension
    • diabetes
    • smoking
    • obesity
    • high fat diet
    • fam history or heart disease
  6. term is used to describe right heart enlargement, also pumps against pulm arteries
    cor pulmonale
  7. 5 types of causes of cor pulmonale
    • massive pulm embolism
    • ards
    • copd
    • bilateral pneumotoraces
    • pulm hypertension
  8. normal range or pulm artery pressure
    25/10 mmHg
  9. which results in more dramatic symptoms? left or right heart failure
    CHF
  10. how much ventricular volume is being ejected during a contraction of the ventricles
    70%
  11. in a pt w/ severe heart failure, ejection fraction may fall to as low as
    20%
  12. myocardial fibers are stretched by increasing end-diastolic ventricular pressure and volume, the fibers contract with greater response. (acts like a rubber band) what do you call this type of response
    frank-starling response
  13. release of norepinephrine by the sympathetic nervous system causes
    • increase hr
    • increase in force of contraction
    • improved cardiac output
  14. increase in size of an organ or structure is called:
    hypertrophy
  15. enlargement of the heart is called:
    cardiomegaly
  16. difficulty in breathing while laying down is called:
    orthopnea
  17. chemicals that alter the force of contractility of the heart is called:
    inotropes
  18. alteration of blood flow away from the kidneys and cutaneous tissues toward the brain and the heart during heart failure results in
    increased systemic vascular resistance due to increase sodium and h20 reabsorption
  19. right heart failure leads to
    • portal hypertension
    • liver engorgement
    • reduced lymph duct drainage
  20. left hear failure leads to
    • pulm congestion, esp towards the upper lung zones
    • pulm hypertension
  21. an enzyme released by the kidneys that causes the release of angiotensin I is called:
    renin
  22. a vasopressor substance produced when renin is released by the kidneys is called:
    angiotensin
  23. physiologically INACTIVE form of angiotensin
    angiotensin I
  24. physiologically ACTIVE form of angiotensin
    angiotensin II
  25. reduces blood pressure, causes vasodilation is called;
    angiotensin converting enzyme also a angiotensin II blockers
  26. hormone that functions in the regulation of metabolism of sodium, chloride, and potassium is called:
    aldosterone
  27. a hormone produced by stretch receptor cells in the atria is called:
    atrial natriuuretic peptide (ANP)
  28. increased aldosterone causes the kidneys to retain
    sodium (na)
  29. increased blood pressure causes increased levels of ANP to stimulate the kidneys to :
    excrete sodium
  30. renin causes release of:
    angiotensin I
  31. angiotensin I is converted to:
    angiotensin II in the pulm circulation
  32. angiotensin II stimulates sodium reabsorption, causes:
    vasoconstriction and stimulates aldosterone secretion
  33. aldosterone induces:
    kidneys to further retain sodium
  34. Atrial natreiretic peptide ANP stimulates the kidneys to:
    excrete Na
  35. right heart failure results in what type of edema:
    peripheral edema - increased cap blood pressure and inc systemic venous blood press
  36. left heart failure results in what type of edema:
    pulmonary edema - increased pulm blood press

    -fluid accumulates around the alveoli, small airways and pleural spaces (goes back to the lungs)
  37. typical signs and symp associated with CHF
    • dyspnea
    • adventitious b/s (ins-exp)
    • cough
    • reduced exercise tolerance
    • anxiety
    • delirium
    • orthopnea
    • diaphoresis
    • cyanosis
    • cool skin
    • comp tachycardia
  38. typical signs and symp associated with right side failure
    • distended jugular viens
    • abdominal distention
    • peripheral edema
  39. xray that shows a butterfly of batwing is which type of heart failure
    CHF
  40. x ray that shows cardiomegaly, an enlargement of the heart is which type of heart failure
    cor pulmonale (right side)
  41. lab findings for cor pulmonale:
    • increased hematocrit
    • increased hemoglobin
  42. lab findings for chf
    • elevated atrial natriuretic peptide (ANP)
    • --kidneys to excrete sodium
  43. hemodynamic values for CHF
    • 1- INCREASED Pulm Cap Wedge Pressure (PCWP)
    • >25 mmHg pulm edema

    note: wedge is always a picture on the left side

    • 2. pulm art pressure PAP may be normal
    • - will increase as severity of CHF increases

    • 3. central venous pressure CVP may be normal
    • - will inc as severe changes
  44. hemodynamic values for Cor Pulmonale
    PCWP normal

    • 1- PAP elevated
    • 2- CVP elevated
  45. 5 vasodilators to treat CHF
    • morphine
    • adrenergic blockers
    • angiotensin II blockers
    • calcium channel blockers
  46. perpheral vasodilator
    reduces anxiety

    is what type of drug?
    morphine
  47. decreases the vasoconstrictive effects of norepineephrine

    is what type of drug?
    adrenergic blockers
  48. reduces blood pressure, causes vasodilation
    ace inhibitor

    is what type of drug?
    angiotensin II blockers
  49. diltiazem, cardizem

    inhibit the action of vasoconstriction machanisms
    help control tacharrhmias

    what type of drugs?
    calcium channel blockers
  50. what type of oxygen therapy to treat CHF
    • CPAP
    • BIPAP
    • Intubation and controlled mechanical vent w/ addition of PEEP

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