Heart Failure: Clinical Manifestations., Exams of Nursing

Download Heart Failure: Clinical Manifestations. and more Exams Nursing in PDF only on Docsity! Heart Failure: Clinical Manifestations HF due to LV dysfunction is categorized according to LV ejection fraction. - What EF is associated with HFrEF? - What EF is associated with HFpEF? - What EF is associated with HFmrEF? - HFrEF: 40% or less HFpEF: 50% or more HFmrEF: 41-49% Another term for HFrEF is: - Systolic HF Another term for HFpEF is: - Diastolic HF What is considered the "gold standard" for a clinical diagnosis of HF? - Identification of an elevated pulmonary capillary wedge pressure at rest or exercise on an invasive hemodynamic exercise test in a patient with symptoms of HF What is pulmonary capillary wedge pressure? - It is a measurement of the pressure of the left atrium which is obtained by inserting a balloon- tipped, multi-lumen catheter into a central vein and advancing the catheter into a branch of the pulmonary artery. The balloon is then inflated, which occludes the branch of the pulmonary artery and then provides a pressure reading that is equivalent to the pressure of the left atrium. ACC/AHA Stage A - At high risk for HF but without structural heart disease or symptoms of HF ACC/AHA Stage B NYHA functional class I - B: Structural heart disease present but without signs or symptoms of HF I: No limitation of physical activity. Ordinary physical activity does not cause symptoms of HF. ACC/AHA Stage C NYHA functional classes II and III - Structural heart disease with prior or current symptoms of HF II: Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF. III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes symptoms of HF. ACC/AHA Stage D NYHA functional class IV - D: Refractory HF requiring specialized interventions IV: Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest. What is meant by "left-sided heart failure?" - HF that is caused by left-sided pathologies (dysfunction of LV, aortic valve, or mitral valve) What is meant by "right-sided heart failure?" - HF that is caused by right-sided pathologies (dysfunction of RV, pulmonic valve, tricuspid valve; pulmonary HTN) True or false: a person can have left-sided and right-sided HF concurrently. - True True or false: lef-sided HF is a common cause of right-sided HF. - True Can someone in NYHA class I have a diagnosis of HF? - Yes, if they were previously symptomatic Symptoms of HF are related to: 1) 2) - 1) Excess fluid accumulation 2) A reduction in cardiac output What HF symptoms are related to excess fluid accumulation? - Dyspnea, orthopnea, edema, pain from hepatic congestion, abdominal discomfort from ascites Some symptoms (eg dyspnea) worse with exertion What HF symptoms are related to a reduction in CO? - Fatigue and weakness that are most pronounced with exertion What causes fluid accumulation in HF? - Reduced CO, which in turn causes changes in renal function (such as sodium retention through RAAS activation) Acute and subacute presentations of HF are characterized by what presenting symptom? What other symptoms are common in acute presentations of HF? - Shortness of breath (both with exertion and at rest)