Heart Failure Basics & Types

These flashcards cover the basics of heart failure, its types, pathophysiology, risk factors, signs and symptoms, nursing assessments, labs, drug therapies, treatments, and discharge teaching.

What is left-sided heart failure also called?

Congestive heart failure

What happens in systolic heart failure (HFrEF)?

The heart cannot contract forcefully enough during systole to eject sufficient blood.

What happens to ejection fraction in systolic heart failure?

Drops below 40 percent

What is the normal ejection fraction range?

50 to 70 percent

What happens to preload and afterload in systolic heart failure?

Both increase

Where does blood accumulate in left-sided systolic heart failure?

Pulmonary vessels

What defines diastolic heart failure (HFpEF)?

Normal ejection fraction but impaired ventricular relaxation during diastole

Why does cardiac output decrease in diastolic heart failure?

The left ventricle cannot fill adequately due to stiffness

Who is most commonly affected by diastolic heart failure?

Older adults and women with hypertension or coronary artery disease

What causes right-sided heart failure?

Left ventricular failure, right ventricular MI, or pulmonary hypertension

What is the main pathophysiologic problem in right-sided heart failure?

Right ventricle does not empty completely, causing venous congestion

What is a hallmark sign of right-sided heart failure?

Peripheral edema

What is high-output heart failure?

Cardiac output is normal but metabolic demands are increased

What conditions can cause high-output heart failure?

Septicemia, high fever, anemia, hyperthyroidism

What is NYHA Class I heart failure?

Cardiac disease present with no symptoms

What is NYHA Class II heart failure?

Symptoms with ordinary activity

What is NYHA Class III heart failure?

Symptoms with minimal activity

What is NYHA Class IV heart failure?

Symptoms at rest

Which ventricle usually fails first in heart failure?

Left ventricle

What is the formula for cardiac output?

CO = HR × SV

How does the heart compensate for reduced cardiac output?

Increasing heart rate, stroke volume, or both

What hormones are released during sympathetic nervous system activation?

Epinephrine and norepinephrine

How does SNS affect heart rate and oxygen demand?

Increases both

How does SNS affect preload and afterload?

Increases venous return (preload) and vasoconstriction (afterload)

What activates the renin-angiotensin system in heart failure?

Reduced renal perfusion

What are the effects of angiotensin II?

Vasoconstriction and ventricular remodeling

What are the effects of aldosterone in heart failure?

Sodium and water retention, increased preload and afterload

What triggers BNP release?

Ventricular stretch from fluid overload

What is the effect of ADH in heart failure?

Vasoconstriction and fluid retention

Why is myocardial hypertrophy ineffective long term?

Hypertrophied muscle becomes poorly oxygenated

What are the major cardiovascular risk factors for heart failure?

Hypertension, coronary artery disease, cardiomyopathy

What metabolic and lifestyle factors increase the risk of heart failure?

Diabetes, obesity, smoking, substance abuse

What are other causes of heart failure?

Valvular disease, congenital defects, dysrhythmias, infections, lung disease, sleep apnea, hyperthyroidism

What are key symptoms of left-sided heart failure?

Dyspnea, orthopnea, crackles, cough, frothy pink sputum, fatigue

What causes paroxysmal nocturnal dyspnea?

Pulmonary congestion worsening when lying flat

What lung sounds are associated with left-sided heart failure?

Bilateral basilar crackles, wheezing

What cardiac sounds are associated with heart failure?

S3 or S4 summation gallop

What are signs of poor perfusion in heart failure?

Pallor, weak pulses, cool extremities, dizziness, confusion

What are key symptoms of right-sided heart failure?

Peripheral edema, ascites, hepatomegaly, JVD, weight gain

Why does nocturia occur in heart failure?

Increased renal perfusion when lying flat

What is pulsus alternans?

Alternating strong and weak pulse

What are common dysrhythmias seen in heart failure?

PACs, PVCs, atrial fibrillation

What respiratory assessment finding indicates worsening HF?

Respiratory rate greater than 20 per minute

Where does dependent edema typically appear in bedridden patients?

Sacrum and scrotum

What are the abdominal assessment priorities for right-sided HF?

Measure abdominal girth and assess for hepatomegaly

Why are electrolytes closely monitored in HF?

Diuretics can cause imbalances

What renal lab changes are seen in heart failure?

Increased BUN and creatinine, decreased creatinine clearance

What does BNP indicate?

Ventricular stretch and heart failure severity

What ABG changes are seen in heart failure?

Hypoxemia, respiratory alkalosis or acidosis, metabolic acidosis

What is the best diagnostic test for heart failure?

Echocardiogram

What ejection fraction indicates heart failure?

40 percent or lower

What does a chest X-ray show in left-sided HF?

Cardiac hypertrophy and pleural effusion

What is the primary goal of early heart failure drug therapy?

Reduce preload, afterload, and workload of the heart

What is the primary goal of late heart failure drug therapy?

Improve perfusion and cardiac output

What is the mechanism of action of ACE inhibitors and ARBs?

Reduce afterload and suppress RAAS

What are key side effects of ACE inhibitors?

Hypotension, hyperkalemia, angioedema, dry cough

Which electrolytes do loop diuretics remove?

Sodium, potassium, calcium, magnesium, chloride

What is a major adverse effect of furosemide?

Ototoxicity

What is the purpose of nitrates in heart failure?

Reduce preload via venous vasodilation

What are key nursing considerations for digoxin?

Monitor digoxin, potassium, magnesium; check apical pulse

What is the antidote for digoxin toxicity?

Digoxin immune Fab (DigiFab)

Which beta blockers are approved for heart failure?

Carvedilol and metoprolol

What ARNI medication is used in heart failure?

Entresto

How does CPAP help heart failure patients?

Improves oxygenation and decreases preload and afterload.

What is the purpose of cardiac resynchronization therapy?

Improves coordinated ventricular contractions.

What is pulmonary edema?

Fluid accumulation in pulmonary vessels.

What are immediate nursing interventions for pulmonary edema?

High Fowler’s, oxygen, nitroglycerin, IV furosemide, morphine.

What causes cardiogenic shock?

MI with greater than 40 percent left ventricular damage.

What does MAWDS stand for?

Medication, Activity, Weight, Diet, Symptoms

What are the daily weight reporting guidelines for heart failure?

2 pounds in one day or 3 pounds in one week.

What are the sodium and fluid restrictions in HF?

Sodium 2–3 grams per day, fluids 2 liters per day.

What is the exercise guideline for HF patients?

Able to carry on a conversation while exercising.