Nursing > Study Guide > EXAM 2 MEDICAL SURGICAL STUDY GUIDE
HEART FAILURE Assessment of left and right CAD: lab test Hct and LDL Left Sided Heart Failure (think about s/s of Pulmonary disorders) Most common Prevents normal forward flowing blood Blood backs up into the left atrium, and then to the pulmonary vein o Pressure increases, fluid ... leaks from the pulmonary capillary bed into the interstitium and then the alveoli o Results in pulmonary congestion and edema Signs o LV heaves o Pleural effusion o Alternating pulses (strong, weak): o Changes in mental status, o Increased HR restlessness, confusion o Decreased PaO2, slight increase o Orthopnea, shallow respirations, dry PaCO2 (result poor oxygen hacking cough exchange) o Nocturia o Crackles (pulmonary edema) o **Frothy, pink-tinged sputum o S3/S4 sounds (advanced pulmonary edema) Right Sided Heart Failure RV fails to contract effectively Backup of blood into the right atrium, and then venous circulation Venous congestion in systemic circulation results in o JVD o Hepatomegaly o Splenomegaly o Vascular congestion of GI tract o Peripheral edema: blood returning is blocked/backed up Can result from acute conditions such as RIGHT VENTRICULAR INFARCTION or P.E. CorPulmonale: right ventricular dilation and hypertrophy caused by pulmonary disease Primary cause: Left-sided HF o Left side HF results in pulmonary congestion, increased pressure in the blood vessels of lungs (pulmonary HTN) o Chronic pulmonary HTN puts increased right ventricular afterload and results in right-sided hypertrophy and HF Signs/Symptoms oooooRV heaves, murmurs JVD: 30-45 degree angle to be able to see Edema (pedal, scrotum, sacrum) Weight gain Increased HR ooooAscites: abdomen Anasarca (massive generalized body edema): 2+ everywhere Hepatomegaly (liver enlargement): RUQ pain, anorexia, GI bloating 1 [Show More]
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Category:
Study Guide
Course:
Nursing
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