A nurse caring for clients with heart failure must be aware of ...

[Deast7027]

A nurse caring for clients with heart failure must be aware of the compensatory mechanisms activated in heart failure. Which physiology is not associated with the neuroendocrine compensatory mechanism?
 
  A) Increased cardiac workload causes myocardial muscle to hypertrophy and ventricles to dilate.
  B) Decreased CO stimulates the sympathetic nervous system and catecholamine release.
  C) Decreased CO and decreased renal perfusion stimulate the renin-angiotensin system.
  D) Antidiuretic hormone is released from posterior pituitary.

Question 2

A client diagnosed with systolic heart failure is admitted to the intensive care unit (ICU). When planning care for this client which does the nurse understand about systolic heart failure?
 
  A) Occurs when the ventricle fails to contract adequately to eject a sufficient volume of blood into the arterial system.
  B) Results when the heart cannot completely relax in diastole, disrupting normal filling.
  C) Decreases passive diastolic filling, increasing the importance of atrial contraction to preload.
  D) Results from decreased ventricular compliance caused by hypertrophic and cellular changes and impaired relaxation of the heart muscle.

[missalyssa26]

Answer to Question 1

Answer: A

When the heart begins to fail, mechanisms are activated to compensate for the impaired function and maintain the cardiac output. The primary compensatory mechanisms are as follows:
1. The Frank-Starling mechanism
2. Neuroendocrine responses, including activation of the SNS and the renin-angiotensin system
3. Myocardial hypertrophy
The Frank-Starling mechanism is when increased cardiac workload causes myocardial muscle to hypertrophy and ventricles to dilate. All other choices are characteristics of the neuroendocrine response.

Answer to Question 2

Answer: A

Heart failure is commonly classified as either systolic or diastolic heart failure, based on the underlying pathology. Systolic heart failure occurs when the ventricle fails to contract adequately to eject a sufficient volume of blood into the arterial system. All other choices are true of diastolic heart failure, not systolic.