NUR 114 Exam #4 | 246 Verified Questions And
Answers | Updated Study Tests
what is heart failure? ANS a clinical syndrome characterized by symptoms of fluid overload and poor
tissue perfusion that both result in *decreased cardiac output*
HF is a chronic, _____________ condition that is managed with? ANS progressive.
It is managed with lifestyle changes and medications to prevent episodes of acute decompensated heart failure
which race has a higher incidence of HF, African Americans or Caucasians? ANS African Americans
Frank-Starling Law ANS the greater the stretch, the stronger is the heart's contraction.
*associated with HF*
how many classifications of HF are there? ANS four; A-D, with D being the final and worst. D indicates
end-stage HF
what marker tells us "how much fluid is on board" ANS BNP - should be less than 100.
what is the normal ejection fraction percentage in a healthy heart? ANS 55%-65%
what are the s/s of right sided heart failure? ANS 1. JVD
2. Dependant Edema
3. Hepatomegaly
4. Ascites
5. Weight gain
6. Polyuria (nocturia)
,Edema usually affects the feet and ankles and worsens when? ANS the patient stands or sits for long
periods of time
*telling patient to elevate the legs can help decrease edema*
what are the s/s of left sided HF? ANS 1. dyspnea / DOE
2. cough (dry, nonproductive initially)
3. pulmonary crackles
4. decreased O2 sat
5. S3 (ventricular gallop)
6. orthopnea
7. oliguria
8. frothy sputum
*L*eft = *L*ung issues
what are some potential complications of HF? ANS - poor perfusion
- dysrhythmias
- thromboembolism
- pericardial effusion / cardiac tamponade
- pulmonary edema
what tests might be done to diagnose HF? ANS - BNP is a key diagnostic factor. Levels greater than 100
indicate high cardiac filling.
electrolytes, urinalysis, BUN, serum creatinine, ECG, echocardiogram, ABG's, CXR, and a variety of other
tests may be used
the goals of medical management of HF may include? ANS relieving patient symptoms, improving
functional status, and quality of life, and to extend survival
what are some lifestyle recommendations for a patient with HF? ANS - restriction of dietary sodium
,- avoidance of smoking (including passive)
- avoid excessive fluids and alcohol
- weight reduction if indicated
- regular exercise
Name the medications that may be used for treatment of HF? ANS - Ace inhibitors
- ARBS
- Beta blockers
- Diuretics
- Digitalis
- Hydralazine and Dinitrate
nursing considerations for ACE Inhibitors ANS - They decrease secretion of aldosterone, decreasing
retention of sodium and water
- they may be the first medication prescribed for patients in *mild* failure
- started at a low dose that is gradually increased
- may be d/c if potassium levels remain greater than 5.5 or if the serum creatinine rises
- may cause hypotension, hyperkalemia, cough, or angioedema
- if angioedema occurs, d/c the medication immediately
- *prevents progression and relieves symptoms*
nursing considerations for beta-blockers ANS - the therapeutic effects of these drugs may not be seen for
weeks or months
- side effects are most common in the initial few weeks of treatment
- they are started at a low dose and titrated up every few weeks with close monitoring
- contraindicated for patients with history of COPD or asthma
- may cause bradycardia, hypotension, dizziness, fatigue
- *relieves symptoms*
Nursing considerations for Lasix (loop diuretic) and HCTZ (thiazide diuretic) ANS - monitor serum
potassium closely
, - both a loop and a thiazide diuretic may be used in patients with severe HF who are unresponsive to a single
diuretic
-loop diuretics are administered IV for exacerbations of HF when rapid diuresis is needed
- will *decrease s/s*
- monitor kidney function
what is spironolactone's drug category? ANS aldosterone antagonist
Hydralazine and Isosorbide ANS medications used to treat HF. Will dilate the blood vessels. Observe for
symptomatic hypotension
Nursing considerations for digitalis ANS - It is a positive inotropic drug
- decreased the s/s of HF
- improves cardiac contractility
- can result in bradycardia or digitalis toxicity
- patients with renal dysfunction and older patients should receive smaller doses of digoxin
- can cause hypokalemia
- hold with an apical pulse of less than 60
what are the s/s of dig toxicity? ANS anorexia, nausea, visual disturbances (yellow halos), confusion,
bradycardia
Digoxin Level
(Therapeutic) ANS 0.6-1.2
what is the antidote for digoxin toxicity? ANS Digibind
*patient education that was performed MUST be documented* ANS *patient education that was performed
MUST be documented*
A patient newly diagnosed with heart failure is advised to avoid foods high in sodium. The nurse knows the
teaching has been effective when the client chooses which food option for a snack?
Answers | Updated Study Tests
what is heart failure? ANS a clinical syndrome characterized by symptoms of fluid overload and poor
tissue perfusion that both result in *decreased cardiac output*
HF is a chronic, _____________ condition that is managed with? ANS progressive.
It is managed with lifestyle changes and medications to prevent episodes of acute decompensated heart failure
which race has a higher incidence of HF, African Americans or Caucasians? ANS African Americans
Frank-Starling Law ANS the greater the stretch, the stronger is the heart's contraction.
*associated with HF*
how many classifications of HF are there? ANS four; A-D, with D being the final and worst. D indicates
end-stage HF
what marker tells us "how much fluid is on board" ANS BNP - should be less than 100.
what is the normal ejection fraction percentage in a healthy heart? ANS 55%-65%
what are the s/s of right sided heart failure? ANS 1. JVD
2. Dependant Edema
3. Hepatomegaly
4. Ascites
5. Weight gain
6. Polyuria (nocturia)
,Edema usually affects the feet and ankles and worsens when? ANS the patient stands or sits for long
periods of time
*telling patient to elevate the legs can help decrease edema*
what are the s/s of left sided HF? ANS 1. dyspnea / DOE
2. cough (dry, nonproductive initially)
3. pulmonary crackles
4. decreased O2 sat
5. S3 (ventricular gallop)
6. orthopnea
7. oliguria
8. frothy sputum
*L*eft = *L*ung issues
what are some potential complications of HF? ANS - poor perfusion
- dysrhythmias
- thromboembolism
- pericardial effusion / cardiac tamponade
- pulmonary edema
what tests might be done to diagnose HF? ANS - BNP is a key diagnostic factor. Levels greater than 100
indicate high cardiac filling.
electrolytes, urinalysis, BUN, serum creatinine, ECG, echocardiogram, ABG's, CXR, and a variety of other
tests may be used
the goals of medical management of HF may include? ANS relieving patient symptoms, improving
functional status, and quality of life, and to extend survival
what are some lifestyle recommendations for a patient with HF? ANS - restriction of dietary sodium
,- avoidance of smoking (including passive)
- avoid excessive fluids and alcohol
- weight reduction if indicated
- regular exercise
Name the medications that may be used for treatment of HF? ANS - Ace inhibitors
- ARBS
- Beta blockers
- Diuretics
- Digitalis
- Hydralazine and Dinitrate
nursing considerations for ACE Inhibitors ANS - They decrease secretion of aldosterone, decreasing
retention of sodium and water
- they may be the first medication prescribed for patients in *mild* failure
- started at a low dose that is gradually increased
- may be d/c if potassium levels remain greater than 5.5 or if the serum creatinine rises
- may cause hypotension, hyperkalemia, cough, or angioedema
- if angioedema occurs, d/c the medication immediately
- *prevents progression and relieves symptoms*
nursing considerations for beta-blockers ANS - the therapeutic effects of these drugs may not be seen for
weeks or months
- side effects are most common in the initial few weeks of treatment
- they are started at a low dose and titrated up every few weeks with close monitoring
- contraindicated for patients with history of COPD or asthma
- may cause bradycardia, hypotension, dizziness, fatigue
- *relieves symptoms*
Nursing considerations for Lasix (loop diuretic) and HCTZ (thiazide diuretic) ANS - monitor serum
potassium closely
, - both a loop and a thiazide diuretic may be used in patients with severe HF who are unresponsive to a single
diuretic
-loop diuretics are administered IV for exacerbations of HF when rapid diuresis is needed
- will *decrease s/s*
- monitor kidney function
what is spironolactone's drug category? ANS aldosterone antagonist
Hydralazine and Isosorbide ANS medications used to treat HF. Will dilate the blood vessels. Observe for
symptomatic hypotension
Nursing considerations for digitalis ANS - It is a positive inotropic drug
- decreased the s/s of HF
- improves cardiac contractility
- can result in bradycardia or digitalis toxicity
- patients with renal dysfunction and older patients should receive smaller doses of digoxin
- can cause hypokalemia
- hold with an apical pulse of less than 60
what are the s/s of dig toxicity? ANS anorexia, nausea, visual disturbances (yellow halos), confusion,
bradycardia
Digoxin Level
(Therapeutic) ANS 0.6-1.2
what is the antidote for digoxin toxicity? ANS Digibind
*patient education that was performed MUST be documented* ANS *patient education that was performed
MUST be documented*
A patient newly diagnosed with heart failure is advised to avoid foods high in sodium. The nurse knows the
teaching has been effective when the client chooses which food option for a snack?
