Chronic Heart Failure Exacerbation
1. List the risk factors for chronic left-sided heart failure related to coronary artery disease. Coronary Artery disease, Hypertension, Substance abuse, Dysrhythmias, Diabetes mellitus, Smoking/tobacco use, Obesity 2. Explain the cause of the compensations for chronic heart failure. Insufficient cardiac output causes compensatory mechanisms work to improve cardiac output. They include, sympathetic nervous system stimulation, Renin=angiotensin system activation, other chemical responses, and myocardial hypertrophy. 3. Describe the manifestations and effects of right-sided and left-sided heart failure. Left Side: Decreased cardiac output-Fatigue, weakness, Oliguria during the day and nocturia at night, angina, confusion, restlessness, dizziness, tachycardia, palpitations, pallor weak peripheral pulses, cool extremities. Pulmonary congestion-Hacking cough, dyspnea/breathlessness, crackles or wheezes in lungs, frothy, pink tinged sputum, tachypnea, s3/s4 summation gallop. Right Side: Systemic Congestion- Jugular distention, enlarged liver and spleen, anorexia and nausea, dependent edema, distended abdomen, swollen hands and fingers, polyuria at night, weight gain, increased blood pressure or decreased blood pressure. 4. List the goals in the interdisciplinary care of a patient with chronic heart failure. Relieve symptoms and improve quality of life, Slow disease progression, Reduce the need for emergency room visits and hospitalization, help people live longer 5. List the two hormones released by the heart muscle in response to changes in blood volume. A-type Natriuretic Peptide ( ANP) This hormone of 28 amino acids is released from stretched Atria (hence the "A").
B-type Natriuretic Peptide (BNP). This hormone (29 amino acids) is released from the Ventricles. . (It was first discovered in brain tissue; hence the "B".) Both hormones lower blood pressure by relaxing arterioles, inhibiting the...
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