NSG-432 exam 2 test questions and
answers
Main causes of heart failure
- CAD
- prior MI's
- stenosis/ regurgetation
- prolapsed valve
- hypertension
- A fib
Right sided heart failure s/s
- generalized edema (peripheral)
- splenomegaly/ hepatomegaly (liver first then spleen)
Which valves are you concerned about in right HF
tricuspid and pulmonic
Valvular stenosis
hardening and narrowing of the valves
Regergetation of tricuspid valve
right ventricle pump has it back up into the right atrium, some can exit out of the pulmonic valve
What does incompitent tricuspid valve mean
regurgitation
Percutaneous transluminal balloon valvulplasty
balloon for stenosis, causes stretch of the valve
Left sided valved
mitral and aortic
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,2 Chapter 14: Voting and Apportionment
s/s of left HF
- frothy pink sputum
- dyspnea
- hypotension
- fatigue/ activity intolerance
Preferred patient position in left sided HF
sitting up- semi-fowlers
Diagnostics for HF
- EKG
- X-ray (look for heart silhouette, how big)
- BNP (over 100, cause of RAAS)
- CMP (includes LPTs)
- ultrasound (ECHO- see how much blood is being pumped, see valves, see heart muscles)
Medications for heart failure
- Diuretics
- morphine (vasodilation, and anxiety/discomfort)
- digoxin
- positive inotropes (dopamine/dolout/epi- increase contractility)
-Nitro
AD
What will the intake restrictions be in heart failure
fluid/sodium
Devices for heart failure
- BCMO; VAD
- IAMP
- ECMO
VAD
- device for HF
- pumps out blood for you
- bridge to transplant: will most likely get this if they cant have transplant
ECMO
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, - device in HF
- big machine acting as your lungs
- pulls blood out
- machine oxygenates your blood for you and puts it back in your body generally done as a last resort
What is the overall goal intervention for heart failure
transplant!
Interventions during HF
- oxygen
- low sodium diet
- activity and when to rest (PT and OT)
- high fowlers position
- monitor I&Os (catheter)
- daily weights!!
What is a concerning daily weight change
3-5 labs over a week and 3 lbs over 2 days
Patient teaching in heart failure
- importance of daily weights
- low sodium diet
- when to escalate care (unstable chest pain)
- activity and rest
Unstable chest pain
chest pain that doesnt go away with rest/nitro
How do you know if heart failure treatment is working?
- increased output
- decreased edema
- increased activity tolerance
- increased SpO2
- lung sounds
- decreased BNP
- LFTs return to normal
- BP
- if they were tachy: decreased HR
AD
Copyright © 2021 Pearson Education, Inc.
answers
Main causes of heart failure
- CAD
- prior MI's
- stenosis/ regurgetation
- prolapsed valve
- hypertension
- A fib
Right sided heart failure s/s
- generalized edema (peripheral)
- splenomegaly/ hepatomegaly (liver first then spleen)
Which valves are you concerned about in right HF
tricuspid and pulmonic
Valvular stenosis
hardening and narrowing of the valves
Regergetation of tricuspid valve
right ventricle pump has it back up into the right atrium, some can exit out of the pulmonic valve
What does incompitent tricuspid valve mean
regurgitation
Percutaneous transluminal balloon valvulplasty
balloon for stenosis, causes stretch of the valve
Left sided valved
mitral and aortic
Copyright © 2021 Pearson Education, Inc.
,2 Chapter 14: Voting and Apportionment
s/s of left HF
- frothy pink sputum
- dyspnea
- hypotension
- fatigue/ activity intolerance
Preferred patient position in left sided HF
sitting up- semi-fowlers
Diagnostics for HF
- EKG
- X-ray (look for heart silhouette, how big)
- BNP (over 100, cause of RAAS)
- CMP (includes LPTs)
- ultrasound (ECHO- see how much blood is being pumped, see valves, see heart muscles)
Medications for heart failure
- Diuretics
- morphine (vasodilation, and anxiety/discomfort)
- digoxin
- positive inotropes (dopamine/dolout/epi- increase contractility)
-Nitro
AD
What will the intake restrictions be in heart failure
fluid/sodium
Devices for heart failure
- BCMO; VAD
- IAMP
- ECMO
VAD
- device for HF
- pumps out blood for you
- bridge to transplant: will most likely get this if they cant have transplant
ECMO
Copyright © 2021 Pearson Education, Inc.
, - device in HF
- big machine acting as your lungs
- pulls blood out
- machine oxygenates your blood for you and puts it back in your body generally done as a last resort
What is the overall goal intervention for heart failure
transplant!
Interventions during HF
- oxygen
- low sodium diet
- activity and when to rest (PT and OT)
- high fowlers position
- monitor I&Os (catheter)
- daily weights!!
What is a concerning daily weight change
3-5 labs over a week and 3 lbs over 2 days
Patient teaching in heart failure
- importance of daily weights
- low sodium diet
- when to escalate care (unstable chest pain)
- activity and rest
Unstable chest pain
chest pain that doesnt go away with rest/nitro
How do you know if heart failure treatment is working?
- increased output
- decreased edema
- increased activity tolerance
- increased SpO2
- lung sounds
- decreased BNP
- LFTs return to normal
- BP
- if they were tachy: decreased HR
AD
Copyright © 2021 Pearson Education, Inc.
