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NURS2019 Week 2 Exam Study Set
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NURS2019 Week 2 Exam Study Set ...
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NURS2019 Week 2 Exam Study SetCONGESTIVE CARDIAC FAILURE - Answer - Impaired pumping ability of heart due to
damage
- Starts on left side & moves to right
- Decreased CO but increased workload from HTN, malfunctioning heart valves or
genetic predisposition
- Heart has to work harder = myocardium grows = heart failure = cardiac hypertrophy
- Cardiac Hypertrophy = myocytes enlarge/stretch = contractile dysfunction =
decreased contractility/SV/CO = activation of RAAS
ADAPTIVE MECHANISMS OF THE HEART - Answer - When heart damaged, body's
natural systems kick in to improve cardiac function in short term
- Long term = increased workload, hypertrophy, damage
- When CO decreases, RAAS kicks in = increased fluid retention & peripheral resistance
= hypertrophy & damage
CARDIOMYOPATHY - Answer - Heart disease that results in myocardial dysfunction
(decreased pumping ability)
- Dilated = too much blood pools in heart with nowhere to go -> heart walls stretch/dilate
to accommodate it -> heart walls weaken -> decreased pumping ability
- Hypertrophic = increase BP -> heart must work harder to pump all blood ->
myocardium enlarges -> decreased space in heart to hold blood -> less blood being
pumped around body
OBSTRUCTIVE SHOCK - Answer - Mechanical obstruction of blood flow away from heart
through cardiac chambers
- Causes = heart obstruction (clot or embolus), extrinsic compression (cardiac
tamponade or pneumothorax)
- Treatment = removing obstruction, resolving compression, supportive care
CARDIOGENIC SHOCK - Answer - Failure of heart to pump effectively
- Causes = large myocardial infarction, myocarditis, mitral regurgitation
- Treatment = treat cause (PCI, ABs, mitral valve surgery), support heart, administer O2
DISTRIBUTIVE SHOCK - NEUROGENIC - Answer - Interruption of nerve supply from CNS
= SCI above T6 or TBI
, - Symptoms = systemic vasodilation, hypoperfusion, decreased CO/HR/BP
- Nursing Care = administer O2 & noradrenaline, replace lost fluids
DISTRIBUTIVE SHOCK - SEPTIC - Answer - Life-threatening organ dysfunction caused
by infection
- Infection causes capillaries to become leaky = fluid escapes into intravascular space &
surrounding tissues = sets off systemic inflammatory response
- Treatment = Abs, fluids, inotropes
DISTRIBUTIVE SHOCK - ANAPHYLACTIC - Answer - Overwhelming response to antigen
which sets off increased histamine-mediated inflammatory response
- Symptoms = wheezing, shortness breath, increased RR, hypoxia, tachycardia
- Nursing Care = O2, fluids, adrenaline
LEFT-SIDED HEART FAILURE PATHOPHYSIOLOGY - Answer - Back-flow of blood from
left atria pulmonary vein lungs
- HTN = arteries narrowed but same amount of blood needs to leave heart = heart work
harder = myocardium grow bigger = increased O2 demands & decreased room in
ventricles = not as much blood can leave heart
- AMI = scar tissue forms & reduces contractility ventricular remodelling ventricle walls
weaker & thinner can't contribute to ejection of blood
- Aortic Valve Malfunctioning = exit from L ventricle narrowed not as much blood can
leave heart blood pools in heart
LEFT-SIDED HEART FAILURE SYMPTOMS - Answer - Pulmonary congestion/oedema
- Fine lung crackles heard on auscultation
- Shortness of breath/cough
- Cyanosis
- Tachypnoea/tachycardia
LEFT-SIDED HEART FAILURE INVESTIGATIONS - Answer - Chest X-ray
LEFT-SIDED HEART FAILURE TREATMENT - Answer - Symptom management
- Reduce oedema
- Diuretics
- Beta Blockers
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