AHN 447 Exam 3 2025(Questions and answers) LATEST UPDATE
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Course
AHN 447
Institution
AHN 447
What are the clinical manifestations of left-sisded HF? - ️️Manifestations of
pulmonary congestions:
- cough, worse at night (ask how many pillows they sleep with)
- dyspnea
- crackles and wheezing
- frothy, pink sputum (pulmonary edema)
- tachypnea
What is the difference between S1 and ...
AHN 447 Exam 3
What are the clinical manifestations of left-sisded HF? - ✔️✔️Manifestations of
pulmonary congestions:
- cough, worse at night (ask how many pillows they sleep with)
- dyspnea
- crackles and wheezing
- frothy, pink sputum (pulmonary edema)
- tachypnea
What is the difference between S1 and S2? - ✔️✔️S1
- closure of AV valves
- best heard at the apex
- ventricular systole
S2
- closure of PV/AV
- best heard at the base
- diastole
What do baroreceptors do? - ✔️✔️they're stimulated with elevated BP; drop BP
What do chemoreceptors do? - ✔️✔️sensitive to hypoxia; increases vasoconstriction to
increase perfusion
What happens to the heart as one ages? - ✔️✔️- valves thicken adn stiffen
- coronary arteries become harder and thicker
What happens to the blood vessels as one ages? - ✔️✔️- thicken/stiffen
- slow exchange of nutrients from blood and tissues
What happens to the blood as one ages? - ✔️✔️- blood volume increases
- decrease in bone marrow production of RBC (decrease in H&H)
What is considered orthostatic hypotension? - ✔️✔️systolic drop of 20 mmHg or
diastolic drom of 10 mmHg with 10-20% increase in HR
What is the difference between S3 and S4? - ✔️✔️S3
- faily normal under 35
- ventricular gallop
- early sign on HF
S4
- atrial gallop
- HTN, MI, Aortic or pulmonic stenosis
,turbulent blood flow across the valves - ✔️✔️
What is the "gold standard" fro diagnostics of cardiac damage and why? -
✔️✔️Troponin 1; released with any myocardial damage; any troponin is abnormal and
should be treated as a cardiac event
Why is CK-mb not reliable for diagnosing cardiac issues? - ✔️✔️can give a false
positive because it can be found in multiple places
What MAP is required for adequate flow? - ✔️✔️at least 60 mmHg
What are normal total cholesterol levels? - ✔️✔️less than 200
What are normal HDL levels? - ✔️✔️greater than 45 in men and greater than 55 in
women
What are normal LDL levels? - ✔️✔️less than 130
What are normal Triglyceride levels? - ✔️✔️less than 160 in men and less than 135 in
women
What should you inform your pt about before a heart cath? - ✔️✔️may have
palpitations; may feel hot
What are the two types of left-sided heart failure? - ✔️✔️systolic HF and diastolic HF
loss of ability to contract forcefully - ✔️✔️systolic heart failure
loss of ventricular wall compliance; cant' adequately fill - ✔️✔️diastolic heart failure
RV doesn't empty completely and "backs up" into venous system causing peripheral
edema - ✔️✔️right-sided heart failure
What are the clinical manifestations of right-sisded HF? - ✔️✔️Manifestations of
systemic congestions:
- JVD
- enlarged liver/spleen
- depended edema
- weight gain (need to do daily weights)
- distended abdomen
- swollen hands/fingers
- polyuria
, What does it mean when BNP is elevated? When is it released? - ✔️✔️elevated BNP
is indicative of HF and can mean fluid overload; BNP is released when the cardiac
muscle stretches
What are some interventions that can be done to treat dyspnea? - ✔️✔️- high fowlers
to get pressure off of the heart
- pillows under arms to get edema back to the heart
- reposition every 2 hours
- coughing/deep breathing exercises
IS to avoid atelectasis
What pharmacological interventions can be used to increase perfusion in HF and how?
- ✔️✔️ACEI's and ARB's reduce afterload by suppression of the renin-angiotensin
system
What do you monitor/teach pts about regarding side effects of ACEI? - ✔️✔️- nagging
cough
- hyperkalemia
- angiedema
What nutritional and pharmacological interventions are used to reduce preload in HF? -
✔️✔️- sodium/fluid restriction
- daily weights
- diuretics (loop and thiazide)
- morphine sulfate
- venous vasodilators (nitrates)
What pharmacological interventions can be used to enhance contractility? - ✔️✔️-
Digoxin
- Dobutamine
- Milrinone
- Spironolactone
- Ivabradine
What should you monitor for when administering Digoxin? - ✔️✔️- bradycardia (do not
administer if apical rate is below 60)
- drug toxicity (0.8-2.0 is therapeutic range)
What are some non-surgical options for treatment of HF? - ✔️✔️- CPAP
- CRT (permanent pacemaker)
- cardioMEMS
- Gene therapy
What are some surgical options fro treatment of HF? - ✔️✔️- heart transplantation
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