Heart Failure

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In the latest textbooks, the terminology has changed. It used to be called Congestive Heart Failure (CHF), but the new term is just Heart Failure (HF). In this study guide we will use the term heart failure.

 

1) Review and redefine the terms preload, after load, cardiac output, stroke volume, and Starling’s law of the heart.

 

2) How do the baroreceptors in the carotid arch influence hormone secretion in heart failure?

 

3) Explain the role of these hormones in heart failure:

Adrenalin

Aldosterone

Antidiuretic Hormone

Rennin

Angiotensin

 

4) What is the physiology that causes the primary symptoms of dyspnea, edema, and fatigue in heart failure?

5) Why does paroxysmal nocturnal dyspnea (PND) occur primarily at night?

 

6) Contrast the etiology of left and right sided heart failure.

7) Differentiate Cor Pulmonale from right sided heart failure.

 

Comparison of heart, kidney, and liver failure symptoms

Symptom heart kidney liver
Ascitesedema
hypertension
breath
Change sensorium
hepatomegaly
puritis
anemia
Diagnostic labs
acidosis
anorexia
Diet
hepatomegaly
Treatments

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Dysrhythmia

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Fill in the chart

 

Arrhythmia  What’s wrong on the EKG? Treatment or medication What should the nurse do?
Normal sinus rhythm  

 

Sinus bradycardia  

 

Sinus tachycardia  

 

PAC  

 

 

A trial fibrillation  

 

 

Atrial flutter  

 

 

First degree heart block  

 

 

Second degree heart block (Mobitz type II)  

 

 

Second degree heart block (WenckebachMobitz type I)  

 

 

Third degree heart block  

 

 

PVC  

 

 

Ventricular tachycardia  

 

 

Ventricular fibrillation  

 

 

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Basics of the Cardiac System

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1) What are some non-pathological reasons for bradycardia?  Pathological?

Non-pathological:

Pathological:

2) What are some non-pathological reasons for tachycardia?  Pathological?

Non-pathological:

Pathological:

3) Cardiac Output =    Heart Rate   x       Stroke Volume     

a) ↓HR x ↑SV = ___ CO

b) ↑HR x ↑SV = ___ CO

c) ↑HR x ↓SV = ___ CO

HINT: Think about when the heart is beating WAAAY too fast. Does the heart have time to refill between each beat?

d)Normal CO is how many Liters/minute?                            

4) You already know many factors that affect Heart Rate.  What are the 3 factors that affect SV?

1.

2.

3.

5) Think about and describe some examples of how the 3 factors that determine SV would affect CO.

CARDIAC CONDUCTION SYSTEM (helps you understand some dysrhythmias)

How many bpm is the base rate for each node?

Sinoatrial (SA) node → Atrioventricular (AV) node → Bundle of His → Purkinje fibers

ADULT CARDIAC ISSUES (PRIMARILY ACQUIRED)

6) What’s the difference between Atherosclerosis and Arteriosclerosis? What can be a resulting symptom or problem of each?

Atherosclerosis:

Arteriosclerosis:

7) Cardiac Ischemia

Partial/temporary loss of blood flow

If it is severe enough to cause PAIN, it is                             

If it is severe enough to cause CELL DEATH, it is                                      

8) Heart Failure

Left Failure: Where is the blood backing up?  So what are the symptoms?  What is causing the blood to back up?  So what are some causes?

 

 

Right Failure: Where is the blood backing up?  So what are the symptoms? What is causing the blood to back up? So what are some causes?

 

 

 

9) What are some treatments for Angina? MI? Heart Failure?

Angina:

 

MI:

 

Heart Failure:

 

EXTRA CREDIT: Which chamber of the heart is the largest?  Why do you think that is?

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