Flashcards
Heart Failure
Cards in this deck (22)
- 1What is HF?the inability for the heart to pump enough blood to meet metabolic needs of tissues
- 2Types of HFSystolic & Diastolic
- 3CausesIschaemic heart disease, HTN, MI, Infections
- 4What is Systolic HF and the risk factorsimpaired pumping ability of the ventricle > reduced CO
LV ejection is <40%
risk factors: HTN, ischaemic heart disease - 5What is Diastolic HF and Risk factorsventricles are unable to relax to allow ventricular filling during diastole
Risk Factors: HTN, diabetes, CHD, vascular disease - 6Class 1cardiac disease is present, doesn't hinder PA; symptoms aren't exercise related
- 7Class 2cardiac disease is present + slightly limits PA; symptoms occur when PA
- 8Class 3cardiac disease = some PA limitation; less than ordinary activity --> symptoms
- 9Class 4cardiac disease disables pt from continuing PA; symptoms occur @ rest and discomfort increases w PA
- 10What systems are activated?RAA and SNS
long term activation of both systems leads to disease progression - 11Non pharmacological treatmentpt education
weight loss
regular exercise
fluid restriction (1-2L)
avoid smoking
alcohol restriction (0-2/day) - 12pharmacological treatmentACE Inhibitors
Diuretics
Digoxin
Beta Blockers
A-II inbitors - 13Treatment - systolic (First line)ACE Inhibitors
MOA: slow disease progression
improve exercise tolerance
Effects: vasodilation, increase secretion of Na+ & H20
AE; renal function decreases, K+ in the body increases - 14Second LineA-II Inhibitors (startans)
AEs: Monitor renal function and K+ levels
Effects: slows disease progression, reduce preload and afterload - 15Natriuretic Peptidespeptide hormones created in the heart, brain and organs
Effects: vasodilation, diuresis, reduce sympathetic activity
broken down by the enzyme - neprilysin - 16SacubitrilMOA; inhibits neprilysin and breakdown of natriuretic peptides > prolonged effects
treats: systolic HF
Caution: Never mix w ACE > risk of angioedema - 17Loop and Thiazide DiureticsThiazide diuretics are only used as first line treatment if pts: >65 years old due to increase risk of new onset diabetes
Thiazide + Frusemide = increase Na+, h20 and K+ excretion - 18spironolactonecompetitive antagonist for aldosterone
MOA: increase Na+ and h20 excretion; reduces K+ excretion
AEs; fibrosis > hypertrophy and arrithmyias
dosage: 25mg/day - 19Beta BlockersB1 selective: Bisoprolol, Metoprolol
Carvedilol: Non-selective
Nebivolol: B1 selective > vasodilation (only use in pts >70)
Dosage: - 20Dosages (HF)Metoprolol: Controlled release tablet, start at 23.75mg/day; after 2 weeks increase dosage
Bisoprolol: Adult, oral, initially 1.25 mg once daily for 1 week
Spironolactone: initially 25 mg once daily; if CrCl <30/50ml then initial is 12.5mg/day - 21DigoxinMOA: Slows HR + increased force of contractions
Inhibits Na/K+ pump
AEs: toxicity, hypokalaemia, nausea, vomiting, diarrhoea, bradycardia - 22Medications to avoidNSAIDS
Corticosteroids
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- Nursing Flashcards on Heart Failure , created by monique wigan on 17/09/2021.
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- monique wigan
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