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58 Cards in this Set
- Front
- Back
What are the three main compensatory mechanisms that are activated in heart failure?
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SNS activation, increased preload and myocardial hypertrophy.
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What is cardiac hypertrophy stimulated by?
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Elevated myocardial wall tension and the growth-promoting actions of neurohormones.
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What is dyspnea and when does it occur in heart failure?
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Breathlessness and it occurs early in the progression of left-sided heart failure and may be considered the main symptom.
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What is cyanosis?
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This is the blue coloration of the skin usually seen around the mouth.
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What is biventricular heart failure?
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This is usually the result of primary left ventricular failure that progressed to right sided heart failure.
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What are some symptoms of insufficient cardiac output?
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Confusion, fatigue, tachycardia, reduced urine output, and poor peripheral circulation.
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What are some signs of left sided heart failure?
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Dyspnea, orthopnea, crackles, cough, pulmonary edema and hypoxemia
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How is heart failure diagnosed?
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Signs and symptoms, x-ray findings, and echocardiographic findings.
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What are the primary reason for treatment of heart failure?
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Improve cardiac output, minimize congestive symptoms and prevent progression.
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What are two things that have been shown to improve mortaility risks in patients with heart failure characterized by low EF?
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ACE inhibitors and B-blocking agents
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What is dysrhythmia?
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An abnormality of the cardiac rhythm of impulse generation or conduction.
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What factors may lead to disturbances of heart beat?
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Hypoxia, electrolyte imbalance, trauma, inflammation, and drugs.
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Why are dysrhythmias significant?
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.1) They indicate an underlying pathopysiologic disorder
2) They can impair normal cardiac output |
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When does a triggered activity occur?
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It occurs when an impulse is generated during or just after repolarization because of a depolarizing oscillation of membrane potential.
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Dysrhythmias are initiated by what three types of depolarizing mechanisms?
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Abnormal automaticity, triggered activity from afterdepolarizations, and reentrant circuits.
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What is sinus tachycardia?
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An abnormally fast heart rate of greater that 100 beats per minute.
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What factors can lead to sinus tachycardia?
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Sympathetic activation, decreased parasympathetic activity, fever, hyperthyroidism, pain, increased metabolism, low blood pressure and hypoxia.
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Can sinus bradycardia be a normal finding in a well conditioned individual?
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Yes it can be a normal finding.
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What is sick sinus syndrome?
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There is alternating periods of sinus bradycardia and tachycardia that occur.
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If you have sick sinus syndrome what may have to be done?
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This may necessitate implantation of a permanent pacemaker.
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What would an ECG show with asystole?
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This is a flat line on an ECG lacking recognizable waveforms.
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Is sinus arrhythmia usually normal and more pronounced in younger or older persons?
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Younger persons
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Where can escape beats originate?
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In the AV nodal region, or in the ventricular Purkinje fibers.
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What is ventricular fibrilation?
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A rapid, uncoordinated cardiac rhythm that results in ventricular quivering and lack of effective contraction.
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What do atrial dysthythmias include?
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Premature atrial complexes, tachycardia, flutter, and fibrillation.
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What is an atrioventricular block?
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This is a disturbance in conduction between the sinus impulse and its associated ventricular response.
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What is an AV block?
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These are disturbances of AV conduction.
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What is heart failure?
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A potential consequence of most cardiac disorders. Occurs when the heart is unable to provide sufficient cardiac output to meet normal metabolic functions of body.
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What is the most common cause of heart failure?
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Myocardial ischemia from coronary artery disease.
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What are other causes of heart failure?
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Hypertension and dilated cardiomyopathy.
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How do you calculate ejection fraction?
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Dividing stroke volume by end-diastolic volume
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A patient with a low ejection fraction, less than 40 percent.
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Systolic failure
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What are the two main causes of diastolic dysfunction?
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Ischemic heart disease and hypertension
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Sympathetic activation of the heart is primarily the result of what?
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Baroreceptor reflex stimulation
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Where are baroreceptors located?
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In the aorta and carotid arteries
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What do baroreceptors do?
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Detect a fall in pressure due to diminished stroke volume and trnasmit this information to the central nervous system.
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What do juxtaglomerular cell do?
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They release renin and initiate the renin-angiotensin-aldosterone cascade.
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What is a first degree block characterized by?
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A prolonged PR interval and usually requires no treatment.
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What are the two types of second degree block?
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Type I (Wenckerbach) is a progressive prolongation of the PR interval until P wave is not conducted.
Type II is a rhythm showing a consistent PR interval with some nonconducted P waves. |
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Which of the second degree blocks is more serious?
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Type II because it can progress into a third degree block.
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What is a third degree block?
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This is a complete heart block.
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What are backwards effects caused by?
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Congestion of blood behind the ineffectively pumping ventricle.
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Where is the congestion located in left-sided heart failure?
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The lungs.
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What are three major types of dysrhythmias?
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1)abnormal rates of sinus rhythm.
2) abnormal sites of impulse initiation. 3)disturbances in conduction pathways. |
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What is preload?
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The volume of blood in the ventricles at the end of diastole.
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What is afterload?
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The peripheral resistance against which the left ventricle must pump.
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What are the three neurohormonal responses?
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1)Heart begins to fail causing decreased CO and decreased BP
2)Perfusion to the kidneys decrease. 3)Ventricular remodeling |
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What is the potential consequence of most cardia disorders?
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Heart failure
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In who is heart failure most likely to develop?
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Elderly, woman, and those without history of MI
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What is heart failure?
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A complex clinical syndrome resulting from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.
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What are the neurohormones that worsen heart failure?
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1)RAAS- renin, angiotensin, aldosterone
2)SNS-epi & norepi 3)ET-endothelin |
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What are the neurohormones that are beneficial in heart failure?
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1)ANP-atrial natriuretic peptide
2)BNP-B-type natriuretic peptide 3)CNP-C-type natriuretic peptide. |
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What is the most common cause of heart failure?
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Systolic heart failure
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What is systolic heart failure?
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Causes ventricle not to empty properly.
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What is Diastolic heart failure?
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Causes ventricle not to fill properly.
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Which ventricle is more common to fail?
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Left ventricular failure.
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What is the most common cause of biventricular heart failure?
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Most often result of primary left sided heart failure progressing to right sided heart failure.
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Why are pacemakers used?
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To help synchronize ventricular contraction.
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