Flashcards Cardiac Hypertension and Heart Failure

Hypertension

High blood pressure caused by factors such as water retention, narrowing of blood vessels, sudden constriction of blood vessels, or excess salt retention.

Water retention

Retention of excess water in the body, contributing to hypertension.

Vasoconstriction

Narrowing of blood vessels, leading to increased blood pressure.

Vasospasm

Sudden constriction of blood vessels, causing increased blood pressure.

Salt retention

Retention of excess salt in the body, contributing to hypertension.

Lifestyle modifications

Behavior and habit changes to lower blood pressure, including maintaining a normal BMI, adopting a healthy diet, reducing sodium intake, increasing potassium intake, becoming more physically active, and moderating alcohol use.

Thiazide diuretic

Medication that removes excess water from the body, commonly used to treat hypertension. Side effects may include low sodium levels (hyponatremia) and low potassium levels (hypokalemia).

Angiotensin converting Enzyme (ACE) inhibitor

Medication that dilates blood vessels, used to treat hypertension. Side effects may include dry cough and angioedema. Not safe for use during pregnancy.

Angiotensin 2 receptor blockers (ARB)

Medication that dilates blood vessels, used to treat hypertension. Side effects are fewer compared to ACE inhibitors. Not safe for use during pregnancy.

Calcium Channel Blocker

Medication that decreases contractions of blood vessels, used to treat hypertension. Side effect may include peripheral edema.

Congestive Heart Failure (CHF)

Condition where the heart is not pumping blood effectively. Diastolic CHF is caused by a stiff and noncompliant heart, often due to hypertension. Systolic CHF is caused by an enlarged and weak left ventricle, often due to damage or irregular rhythm.

Ejection fraction

Measurement of the percentage of blood leaving the heart with each contraction. Normal ejection fraction indicates diastolic heart failure, while reduced ejection fraction indicates systolic heart failure.

Nursing implications

Actions that nurses should take to manage and support patients with congestive heart failure, including smoking cessation, alcohol reduction, sodium restriction, fluid restriction, and obesity avoidance.

Diuretics

Medications that increase urine production, commonly used to treat congestive heart failure. Furosemide (Lasix) is a diuretic that should be monitored for potassium levels.

Beta Blocker

Medication that decreases the sympathetic response of the heart, used to treat congestive heart failure.

Entresto

New medication for congestive heart failure that combines an angiotensin receptor blocker (ARB) with a neprilysin inhibitor. Sacubitril inhibits neprilysin, which decreases B-type natriuretic peptide (BNP) levels and improves heart function.

Spironolactone

Medication that works on the aldosterone in the Renin system to decrease water retention, commonly used to treat congestive heart failure.

Digoxin

Medication that increases contractility of the heart and slows the heart rate by inhibiting sodium-potassium ATPase. It has a narrow therapeutic range and signs of toxicity include blurred vision, halos around light, and yellow vision. The antidote for digoxin toxicity is Digoxin Immune Fab.

Atropine

Medication used for bradycardia (slow heart rate).

Conduction Arrhythmias

Abnormal heart rhythms such as atrial fibrillation, atrial flutter, and supraventricular tachycardia that are caused by conduction abnormalities.

Class 1 Antiarrhythmics

Medications that stabilize the membrane and depress the action potential phase, commonly used to treat conduction arrhythmias. Procainamide is an example of a sodium channel blocker used in ACLS protocol to treat supraventricular tachycardia, ventricular tachycardia, atrial fibrillation, and atrial flutter.

Class 2 Antiarrhythmics

Medications that slow down conduction and lengthen the interval, reducing adrenergic activity in the heart and decreasing heart excitability.

Class 3 Antiarrhythmics

Medications that slow down potassium channels, prolonging the action potential. Amiodarone is an example that can affect thyroid function and has the potential to cardiovert, so it should not be given in new atrial fibrillation without prior anticoagulation.

Class 4 Antiarrhythmics

Medications that block calcium channels, decreasing SA and AV node conduction. They significantly reduce afterload but have little effect on preload. They should not be given to people with heart block as they can cause severe hypotension and heart block.

Coronary Artery Disease

Condition where the coronary arteries are narrowed or blocked, leading to decreased oxygen supply to the heart. Angina is chest pain caused by decreased oxygen supply without tissue death.

Stenosis

Narrowing of a blood vessel, often caused by atherosclerosis in the context of coronary artery disease.

Vasospasm

Sudden constriction of blood vessels, contributing to angina in coronary artery disease.

PTCA

Percutaneous transluminal coronary angioplasty, a procedure to treat coronary artery disease by widening narrowed or blocked arteries.

Stents

Devices placed in narrowed or blocked arteries during PTCA to keep them open and improve blood flow.

Atherectomy

Procedure to remove plaque from arteries, often used to treat coronary artery disease.

Nitroglycerin

Potent vasodilator commonly used to treat angina. It can be given as an IV drip or sublingually. Side effects may include severe headache and drop in blood pressure. It should not be given to patients taking phosphodiesterase inhibitors (Levitra or Viagra) for erectile dysfunction due to the risk of life-threatening hypotension.

Ranolazine

Medication that lowers oxygen demand, commonly used to treat chronic angina.

Statins

Medications given to people who have had a myocardial infarction (heart attack) to lower the risk of reinfarction.