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Congestive Heart Failure

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by

Jennifer Acker

on 21 February 2014

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Transcript of Congestive Heart Failure

The systolic point of view in chf
Left-Sided heart failure
RIGHT-Sided heart failure
The different sides to
Congestive Heart Failure

CHF
Failure of the heart to pump sufficient blood to meet the needs of the body
cardiac output
blood pressure
leads to
Renin and ADH release
Sympathetic response
Vasoconstriction
Fluid retention
Catecholamines
workload of the heart
HR and SV
blood volume
and preload
afterload
Autoregulatory
Mechanisms
THE
CIOU
CYCLE
S
I
V
The diastolic point of view in chf
Heart muscle is unable to contract properly due to myocardial muscle injury
Then the cycle begins
Ventricle hypertrophies and becomes stiff
due to increased afterload

Promotes poor ventricular filling
Then the cycle begins
Blood backs up in the lungs
Pulmonary congestion
Primary cause of Right-sided failure
fatigue
dyspnea
tachycardia
low urine output
S-3 heart sound
Echocardiogram to estimate ejection fraction
do not have to be NPO
no consent required
measures heart, chamber size and valve movements
ANP and BNP levels
presence of S-3
DIAGNOSIS
Blood backs up in the body
fatigue
edema
hepatomegaly
ascites
S-3 heart sound
JVD
low preload to the left side
decreased blood oxygenation
diagnosis
echocardiogram
estimate EF
ANP and BNP levels
presence of S-3
Treatments
health promotion
best practice guidelines by AHA
decrease preload and afterload
oxygen therapy
improve contractility
prevent sudden death
end of life care
digoxin
limit alcohol
quit smoking
regular exercise
sodium restriction
medication compliance
core measure
beta blockers
ACE inhibitors
implantable
cardioverter
defibrillator
diuretics
ACE inhibitors
beta blockers
vasodilators (nitrates)
reduces demand on the heart
thorough cardiovascular assessment
Nursing interventions
promoting activity tolerance
managing fluid volume
controlling anxiety
patient teaching
assess for complications
lung sounds
heart sounds
JVD
CRT
LOC
edema
urinary output
strict I & O's
daily weights
sodium intake
IVF infusions
monitor potassium
sedatives in moderation
relaxation exercises
monitor oxygen
thrombosis
arrhythmias
hypotension
potassium abnormalities
dehydration
renal damage
importance of lifestyle changes
reporting symptoms early
lifelong disease
diet changes
smoking cessation
regular exercise
sodium intake
avoiding prolonged rest
collaborate with PT
plan activities around patient
cardiac rehab consult
rest when fatigued
digoxin not used as much
Class I - no limitation on ADL's
no pulmonary edema
Class II - slight limitation on ADL's
basilar crackles with S3
Class III - marked limitation on ADL's
Class IV - symptoms at rest
poor prognosis
Full transcript