NR324 CH 34 HEART FAILURE (VERIFIED
SOLUTIONS)
right sided vs left sided heart failure - ANSWER-
Nitropress (sodium nitroprusside) - ANSWER-• Arterial BP monitoring is recommended
during drug infusion.
• Record baseline BP and continuously monitor during administration.
• Too rapid rate of IV infusion can reduce BP too quickly and cause hypotension.
• Headache, dizziness, nausea, agitation, and restlessness can occur.
• Monitor thiocyanate (drug by-product) levels if infusion is greater than 3 mcg/kg/min,
as toxicity can occur.
Dopamine - ANSWER-• Monitor IV site for signs of extravasation.
• Tissue necrosis with sloughing can occur with drug extravasation.
• High dosages may produce ventricular dysrhythmias.
Infusion pumps - ANSWER-• To control the rate and assist with titration, use an infusion
pump whenever you are giving IV vasodilators and inotropes.
• Ideally, pumps that contain drug libraries can help to avoid rates and dosages that are
out of the safe range for the drug being given.
CHF is also known as - ANSWER-Left-sided heart failure
Captopril - ANSWER-• Excessive hypotension and hyperkalemia may occur.
• Monitor patient for first-dose hypotension (first-dose syncope).
• Skipping doses or discontinuing the drug can result in rebound hypertension.
• Angioedema, a rare adverse effect, can develop suddenly and can be life-threatening.
VAD (ventricular assist device) - ANSWER-implanted mechanical device that partially or
completely replaces the pumping action of a failing heart
Spironalactone (Aldactone) - ANSWER-• Monitor potassium levels during treatment.
, • Use with caution in patients taking digoxin, since hyperkalemia may reduce the effects
of digoxin.
• Instruct patient to avoid foods high in potassium (e.g., bananas, oranges, dried
apricots).
• Assess male patients for gynecomastia, a common side effect of long-term use of
spironolactone.
HLA (human leukocyte antigen) - ANSWER-Protein in a plasma membrane that
identifies the cell as belonging to a particular individual and acts as an antigen in other
organisms.
Carvedilol (Coreg) - ANSWER-• Overdosage can produce profound bradycardia,
hypotension, bronchospasm, and cardiogenic shock.
• Obtain standing BP 1 hr after dosing to assess tolerance.
• Abrupt withdrawal may result in sweating, palpitations, and headaches.
Digoxin - ANSWER-• Monitor for signs of hypokalemia and hyperkalemia, since these
can increase or decrease the effects of digoxin, respectively.
• Monitor for early signs of toxicity: anorexia, nausea and vomiting, fatigue, headache,
depression, visual changes.
• Monitor for late signs of toxicity, such as dysrhythmias (e.g., bradycardia,
atrioventricular block).
Diastolic failure - ANSWER-inability of the ventricles to relax and fill during diastole
50% of patients with HF have HFpEF
Hypertension is the most important cause
Diastolic failure is characterized by high filling pressures because of stiff ventricles.
Decreased filling of the ventricles results in decreased stroke volume and CO. The end
result of diastolic failure is the same as systolic failure (e.g., pulmonary congestion
heart transplantation - ANSWER-
paroxysmal nocturnal dyspnea - ANSWER-
Pulmonary edema - ANSWER-fluid in the air sacs and bronchioles
Systolic failure - ANSWER-The left ventricle loses its ability to contract normally. The
heart can't pump with enough force to push enough blood into circulation.
The hallmark of systolic failure is a decrease in the EF. Normal EF is 55% to 60%
SOLUTIONS)
right sided vs left sided heart failure - ANSWER-
Nitropress (sodium nitroprusside) - ANSWER-• Arterial BP monitoring is recommended
during drug infusion.
• Record baseline BP and continuously monitor during administration.
• Too rapid rate of IV infusion can reduce BP too quickly and cause hypotension.
• Headache, dizziness, nausea, agitation, and restlessness can occur.
• Monitor thiocyanate (drug by-product) levels if infusion is greater than 3 mcg/kg/min,
as toxicity can occur.
Dopamine - ANSWER-• Monitor IV site for signs of extravasation.
• Tissue necrosis with sloughing can occur with drug extravasation.
• High dosages may produce ventricular dysrhythmias.
Infusion pumps - ANSWER-• To control the rate and assist with titration, use an infusion
pump whenever you are giving IV vasodilators and inotropes.
• Ideally, pumps that contain drug libraries can help to avoid rates and dosages that are
out of the safe range for the drug being given.
CHF is also known as - ANSWER-Left-sided heart failure
Captopril - ANSWER-• Excessive hypotension and hyperkalemia may occur.
• Monitor patient for first-dose hypotension (first-dose syncope).
• Skipping doses or discontinuing the drug can result in rebound hypertension.
• Angioedema, a rare adverse effect, can develop suddenly and can be life-threatening.
VAD (ventricular assist device) - ANSWER-implanted mechanical device that partially or
completely replaces the pumping action of a failing heart
Spironalactone (Aldactone) - ANSWER-• Monitor potassium levels during treatment.
, • Use with caution in patients taking digoxin, since hyperkalemia may reduce the effects
of digoxin.
• Instruct patient to avoid foods high in potassium (e.g., bananas, oranges, dried
apricots).
• Assess male patients for gynecomastia, a common side effect of long-term use of
spironolactone.
HLA (human leukocyte antigen) - ANSWER-Protein in a plasma membrane that
identifies the cell as belonging to a particular individual and acts as an antigen in other
organisms.
Carvedilol (Coreg) - ANSWER-• Overdosage can produce profound bradycardia,
hypotension, bronchospasm, and cardiogenic shock.
• Obtain standing BP 1 hr after dosing to assess tolerance.
• Abrupt withdrawal may result in sweating, palpitations, and headaches.
Digoxin - ANSWER-• Monitor for signs of hypokalemia and hyperkalemia, since these
can increase or decrease the effects of digoxin, respectively.
• Monitor for early signs of toxicity: anorexia, nausea and vomiting, fatigue, headache,
depression, visual changes.
• Monitor for late signs of toxicity, such as dysrhythmias (e.g., bradycardia,
atrioventricular block).
Diastolic failure - ANSWER-inability of the ventricles to relax and fill during diastole
50% of patients with HF have HFpEF
Hypertension is the most important cause
Diastolic failure is characterized by high filling pressures because of stiff ventricles.
Decreased filling of the ventricles results in decreased stroke volume and CO. The end
result of diastolic failure is the same as systolic failure (e.g., pulmonary congestion
heart transplantation - ANSWER-
paroxysmal nocturnal dyspnea - ANSWER-
Pulmonary edema - ANSWER-fluid in the air sacs and bronchioles
Systolic failure - ANSWER-The left ventricle loses its ability to contract normally. The
heart can't pump with enough force to push enough blood into circulation.
The hallmark of systolic failure is a decrease in the EF. Normal EF is 55% to 60%
