Overview
How low does the Ejection Fraction have to be to be considered systolic heart failure?
40% or less
Where does right-sided heart failure affect?
Right = Rest of the body (extremities liver, etc.)
What organ does left-sided heart failure typically affect?
Lungs (Left = Lungs)
What two side effects from Ace-inhibitors does a nurse need to be aware of? And report to a physician
1. Nonproductive cough (5-35% of patients develop this from increased bradykinin levels)
2. Increased potassium levels
What must be checked before giving the medication digoxin?
Apical pulse. Must be 60 bpm
Systolic heart failure occurs when the heart muscle is too weak to contract properly, meaning it can't pump enough blood out during a heartbeat. There is a problem with the heart's contraction phase and the heart can't pump enough blood out of the ventricle.
Why does right-sided heart cause spleen and liver enlargement (hepatosplenomegaly)?
Right-sided heart failure causes venous congestion, which causes fluid to back up into the liver and spleen causing enlargement.
What is pink frothy sputum referred to as?
Pulmonary Edema
What is the is the drug suffix for Angiotension Receptor Blockers (ARBs)
-Sartan
What electrolyte imbalance does dogoxin cause?
Hypokalemia
What is diastolic heart failure?
Diastolic heart failure happens when the heart muscle becomes stiff and can't relax adequately between beats, preventing it from filling with enough blood to pump out effectively, so basically it can’t fill enough.
Why does right-sided heart cause ascities?
What type of lung sounds would you expect with a patient with left-sided heart failure?
Crackles or rales
What are two reasons we would hold a beta blocker?
Heart rate below 60 bpm
Systolic BP less than 100-110 (depends on facility)
What is a very common warning sign of digoxin toxicity
"Green halos" seen around lights
How does the body compensate during heart failure?
(3 ways, know these)
1.Frank-Starling mechanism
2.Neuroendocrine Responses
3.Myocardial Hypertrophy
What lab value is most commonly used to diagnose heart failure?
Brain natriuretic peptide (BNP)
How can we help a patient who is suffering from orthopnea or nocturnal paroxysmal dyspnea?
Have them sleep sitting up.
What is the does loop and thiazide diuretics both cause?
Hypokalemia
What is the antidote to digoxin?
Digibind (it "binds" to the digoxin)
Why does heart always lead to fluid overload?
The Renin-Angiotensin- Aldosterone System (RAAS)
Aldosterone tells the kidneys to reabsorb sodium, which then reabsorbs water, causing fluid overload. This mechanism does not want to shut off due to poor cardiac output. Medication is needed.
What are the common symptoms of left-sided heart failure?
Swelling of legs and hands, weight gain, edema, jugular vein distention (JVD), fatigue, irregular heart weight, hepatosplenomegaly, ascites.
What are the common symptoms of left-sided heart failure?
Dyspnea, rales (crackles), orthopnea, weakness/fatigue, nocturnal paroxysmal dyspnea, tachycardia, pink frothy sputum, and weight gain.
Hyperkalemia
What mechanism does digoxin do to improve cardiac output.
Strengthens contraction (positive inotropy)
Decreases heart rate to allow better filling of chambers, which increases preload (negative chronotropy)