Congestive Heart Failure (CHF) is a result of RIGHT / LEFT -sided heart failure
Cor Pulmonale is a result of RIGHT / LEFT -sided heart failure.
Name five precipitating factors for CHF:
- patient induced factors
- excessive fluid administration
- pulmonary embolism
- myocardial infarction, resp failure, renal failure
- high cardiac output - fever - anemia
- hyper or hypothermia
What is a normal pulmonary artery (PA) pressure?
Where is the pulmonary artery (PA) pressure measured?
Which side of the heart is the PA pressure measured?
How is PA measured?
balloon tip catheter
The greater the stretch of myocardial fibers by increased ventricular volume, the greater the force of contraction describes which compensatory mechanism?
Increase in the size of the ventricle to accommodate increased ventricular volume describes which compensatory mechanism?
The release of norepinephrine by the sympathetic nervous system causes increases in:
- heart rate
- force of contraction
- improved cardiac output
Right-sided heart failure often results in ____________________________ edema because of ____________________________________ & _______________________________________
because of increased capillary blood pressure & increased systemic venous blood pressure
Left-sided heart failure often results in ____________________________ edema because of
because of increased pulmonary blood pressure. fluid accumulates around alveoli, small airways and pleural space (fluid goes back to lungs)
Describe what a chest x-ray for a patient in CHF might look like:
peripheral portion of the lung often remains clear producing a "butterfly" or "batwing" distribution
enlarged pulmonary vessels, dense, fluffy opacities
What types of respiratory therapy may be used for the treatment of CHF/Pulmonary edema?
- intubation and controlled mechanical ventilation w/ PEEP
List the 4 vasodilators to treat CHF
- adrenergic blockers
- angiotensin II blockers
- calcium channel blockers
vasodilator that is a peripheral vasodilator and reduces anxiety
vasodilator that decreases the vasoconstrictive effects of norepinephrine
vasodilator that reduces blood pressure, causes vasodilation
angiotensin II blockers / angiotensin converting enzyme ACE inhibitor
vasodilator that inhibit the action of vasoconstriction machinisms. helps control tachyarrhymias (irregular heart beat combines w/ an elevated rate
calcium channel blockers (diltiazem, cardizem)
The first pressure to typically be elevated in left-sided heart failure is
PCWP- pulmonary capillary wedge pressure
The first pressure to typically be elevated in right-sided heart failure is
PAP- pulmonary artery pressure
resistance to blood flow out of the ventricle during ventricular contraction
volume of blood filling the ventricle just before ventricular contraction
form of shock where the heart is unable to supply enough blood to the body because of blood loss or inadequate blood volume
serious, abnormal condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. vital organs such as the brain, heart, kidneys, and liver may not function properly or may fail
dilation of peripheral vasculature from an allergic response that results in circulatory failure
caused by a toxin made by staphylococcus aureus, characterized by shock and multiple organ dysfunction
What is the purpose of analyzing a patient’s anion gap?
indicates lactic acidosis, meaning that the shock is severe enough to cause lactic acidosis. (accumulation of lactic acid in the blood. is produced at a faster rate than normal when there is inadequate oxygenation of skeletal muscle and other tissues
How is the anion gap calculated?
Na - (Cl + HCO3)
normal 8-16 mEq/Liter