Congestive Heart Failure

14 terms by MelissaBrokaw 

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CHF

Impaired cardiac pumping
Associated with long-standing HTN and CAD

CHF Risk Factors

CAD
Age
Hypertension
Obesity
Cigarette smoking
Diabetes mellitus
High cholesterol
African American descent

Left sided failure

Most common form
Blood backs up through the left atrium into the pulmonary veins
Pulmonary congestion and edema

Causes of Left Sided Failure

HTN
Cardiomyopathy
Rheumatic heart disease
CAD

Right sided failure

Backward flow to the right atrium and venous circulation
Results from diseased right ventricle
Primary cause is left-sided failure

Clinical Manifestations of RSF

Ascites
Peripheral edema
Hepatomegaly
RUQ pain
Splenomegaly
JVD
Anorexia

Clinical Manifestations of LSF

DOE/PND
SOB
Rales
Cough
Oliguria/nocturia
Confusion/anxiety
Tachycardia
Fatigue
Pale, cool, clammy skin

Complications of CHF

Pleural effusion
Arrhythmias
Left ventricular thrombus
Hepatomegaly

CHF Diagnostics

Chest x-ray
ECG
Hemodynamic assessment
Lytes, BUN, creatinine, UA
BNP
Stress testing

Nursing Diagnoses

Activity intolerance
Excess fluid volume
Disturbed sleep pattern
Impaired gas exchange
Anxiety
Noncompliance

Pharmacologic management

ACEI
ARBs
Combo: hydralazine/isosorbide dinitrate
Beta-blockers
Diuretics
Digoxin
Ca++ channel blockers

Patient teaching

Medication regimen
Dietary restrictions
Daily weights
Physical activity
Smoking cessation
S/S of worsening HF

Pulmonary edema

Abnormal accumulation of fluid in the lungs.
May be in the interstitial space or alveoli
Can occur d/t MI or exacerbation of HF

S/S Pulomonary edema

Agitation, restless, anxious
Pale or cyanotic
Cold, clammy skin
Severe dyspnea/suffocation feeling
Tachypnea
Pink frothy sputum
Pulse weak & rapid
JVD
Incessant coughing

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