Heart Failure
3 Typical Causes of Left Sided HF
○Hypertension
○Coronary artery disease
○Valvular disease
Popping, discontinuous sounds caused by air moving into previously deflated airways; sounds like hair being rolled between fingers near the ear
Fine Crackles
Metoprolol
Carvedilol
Atenolol
O2 Concentration: 24-44%
Nasal Cannula
produced and released by the ventricles as they stretch in response to fluid overload from HF
B-type natriuretic peptide (BNP)
3 Typical Causes of Right Sided HF
○Left ventricular failure
○Right ventricular MI
○Pulmonary hypertension
Lower-pitched, coarse, rattling sounds caused by fluid or secretions in large airways; likely to change with coughing or suctioning
coarse crackles
Assess heart rate (HR) and blood pressure (BP) before administration of these medications because they cause a decrease in HR and cardiac output and suppress renin activity
Beta Blockers
Flow Rate: minimum 5L/min
O2 Concentration: 40-60%
Simple Facemask
an early indicator of decreased compliance of the heart and occurs before the BNP rises; “early warning detector” that lets the primary health care provider know that the heart is experiencing early signs of decreased compliance long before symptoms occur
Microalbuminuria
Signs of this type of heart failure include: edema, ascites, JVD, extreme fatigue with activity, irregular heart rate, nocturia
Right Sided HF
Squeaky, musical continuous sounds associated with air rushing through narrowed airways
Wheeze
First Drugs Used to Manage Hypertension
Diuretics
Can deliver FiO2 >90%
10-15 L/min
bag must be inflated
NonRebreather
Common Risk Factors of Primary Hypertension
○Obesity
○Smoking
○Stress
○Family history
Signs of this type of heart failure include: dyspnea, fatigue, weakness, arm heaviness, rales or crackles, increased HR, nagging cough, cyanosis
Left Sided
Lower-pitched, coarse continuous snoring sounds
Rhonchi
Types of Diuretics
• Potassium-sparing: spironolactone
• Loop: furosemide; bumetanide
• Thiazide: hydrochlorothiazide; chlorothiazide
Noninvasive Positive-Pressure Ventilation (NPPV)
CPAP
BiPAP
What are some examples of health promotion/disease prevention for the cardiac system
weight reduction
low sodium diet
physical activity
smoking cessation
stress reduction
This type of HF is caused by increased metabolic needs or hyperkinetic conditions (septicemia, high fever, anemia, hyperthyroidism)
High Output Failure
Loud, rough, grating, scratching sounds caused by the inflamed surfaces of the pleura rubbing together; often associated with pain on deep inspirations
Pleural Friction Rubs
Side Effects of Thiazide & Loop Diuretics
-hypokalemia
-renal failure
-tinnitus & hearing loss
-glucose control can be affected
-uric acid retention
If oxygen is being delivered at 4L or higher, we need to ensure we are using
humidification
What is the Cardiac Conduction System
SA node (pacemaker of heart)
AV node (gatekeeper of heart; allow atria to empty)
Bundle of His
Bundle Branche
Purkinje Fibers