When planning care for a patient with heart failure, which concept should the nurse keep in mind?
A) The sympathetic nervous system is activated when cardiac output drops.
B) The renin-angiotensin-aldosterone system is inhibited when cardiac output drops.
C) Heart muscle demonstrates excessive contractility.
D) Inflammatory mediators inhibit heart muscle repair and remodeling.
A) The sympathetic nervous system is activated when cardiac output drops.
Explanation: A) Heart failure manifests itself in volume overload and fatigue, which occur in response to a cascade of compensatory mechanisms set into motion by decreased cardiac output. In response to decreased CO, the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) are activated. Ideally, these compensatory mechanisms will maintain adequate CO.
B) Heart failure manifests itself in volume overload and fatigue, which occur in response to a cascade of compensatory mechanisms set into motion by decreased cardiac output. In response to decreased CO, the RAAS and the SNS are activated. Ideally, these compensatory mechanisms will maintain adequate CO.
C) Heart failure is a condition caused by an inability of the heart to pump an adequate amount of blood to meet the body's metabolic needs. This can be caused either by a problem with muscular contraction, causing decreased ejection of the blood out of the heart; by a problem with muscular relaxation, thereby not allowing the heart to fill adequately with blood prior to contraction; or a combination of both.
D) In heart failure, the heart cannot contract normally, and its pumping capacity is reduced. Compensatory mechanisms are activated to maintain left ventricular function within a range that preserves or slightly reduces the functional capacity of the patient. This includes activation of the SNS, the RAAS, and inflammatory mediators. The inflammatory mediators are responsible for cardiac repair and remodeling.
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