Failing Pump Facts
What is B-type natriuretic peptide?
BNP is a hormone the heart releases when it’s overloaded with fluid.
BNP >100 pg/ml indicative of HF
What does a "sympathomimetic" medication do and what does a "sympatholytic" medication do?
"sympathomimetic" medication: mimic effects of sympathetic nerves (increased HR, speed of contraction and force of myocardial contraction)
EPINEPHRINE & DOPAMINE&DOPUTAMINE
"sympatholytic" medication: blocks the effect of sympathetic nervous system (decreases HR, speed of electrical signal and force of myocardial contraction) BETA- BLOCKERS-- LOL
Define 'stroke volume' and 'cardiac output'
Stroke volume= the amount (ml) of blood ejected from the ventricle with each beat.
Cardiac output= the amount (ml) of blood pumped by the heart in 1 minute
Increased afterload has what effect on the workload of the heart?
Increases the work load of the heart
Sympathetic Nervous system stimulation to the heart has what effect on the heart rate
Increases heart rate.
Describe how cardiac output is determined.
HR x Stroke volume
Compare/Contrast the effects of coumadin and eliquis.
Coumadin: anticoagulant needed regular monitoring of PT/INR.
Eliquis: antiplatelet requiring no regular monitoring of PT/INR
What is a normal ejection fraction?
67% (55–70% → Normal)
What ejection fraction indicates HF?
Compare/Contrast the effects of Digoxin; Metoprolol
Digoxin: - chronotropic and +inotropic , - dromotropic (increases cardiac output by +inotropic effect increasing stroke volume)
Metoprolol: -chronotropic , - inotropic, - dromotropic (decreases cardiac output)
explain the effect of digoxin on stroke volume using the words "inotropic", "dromotropic" and "chronotropic".
Digoxin exerts a +inotropic effect (increased force of contraction) and increased stroke volume. It also exerts a - chronotropic and - dromotropic effect which is why you check apical pulse before giving.
A client has heart failure and is experiencing dyspnea, crackles, fatigue and cyanosis. What side of the heart has failed?
Left-Sided heart failure causes respiratory symptoms because blood backs up into the pulmonary circulation.
Right-sided heart failure causes ascites, dependent edema as blood backs up into systemic circulation.
What is the physiologic cause of the heart sounds S1 and S2? "lubb-dupp"
closing of the heart valves as the pressure in the ventricles and atria increases during atrial systole and ventricular systole
Define cardiac cycle
The cardiac cycle is one complete heartbeat — including when the heart muscle relaxes and fills with blood (diastole) and when it contracts and pumps blood out (systole).
What are the ventricles doing during atrial contraction?
Relaxing.
This coordinated contraction and relaxation allows for blood to fill the chambers and is essential to maintaining cardiac output.
A drug, like atropine, that blocks the parasympathic (aka vagal) receptors on the heart has what effect on the heart rate?
Increases heart rate (+ chronotropic effect). It is therefore the drug of choice in treating symptomatic bradycardias.
A patient with hypertension is prescribed Lisinopril 10 mg PO.
The medication available is Lisinopril 5 mg per 2 mL.
How many mL should the nurse administer?
4 ml