Chapter 17-Table 17-1 Part 2 Flashcards
What position does a patient with congestive heart failure find easier to breathe?
Sitting up
When lying down, more blood returns to the right ventricle and lungs, causing pulmonary congestion.
What emotional state might a patient with congestive heart failure exhibit?
Agitated
What symptom may or may not be present in a patient with congestive heart failure?
Chest pain
What physical sign is often observed in patients with congestive heart failure?
Distended neck veins that do not collapse even when sitting
What can cause swollen ankles in a patient with congestive heart failure?
Dependent edema (backup of fluid)
What vital signs are generally present in a patient with congestive heart failure?
High blood pressure, rapid heart rate, rapid respirations
What additional muscles do patients with congestive heart failure often use to breathe?
Accessory breathing muscles of the neck and ribs
What is the typical skin appearance of a patient with congestive heart failure?
Pale or cyanotic and sweaty
What lung sounds may be produced due to fluid surrounding small airways in CHF?
Crackles (formerly known as rales)
Where are crackles best heard in a patient with congestive heart failure?
Either side of the chest, about midway down the back
In severe CHF, where can soft lung sounds be heard?
Even at the top of the lung
Can congestive heart failure be cured?
No, it can be treated but not cured
What may alleviate symptoms in patients with congestive heart failure?
Regular use of medications
What is the prognosis for patients with congestive heart failure within 5 years of symptom onset?
Approximately one-half will die
What is the first step in treating a patient with CHF and pulmonary edema?
Take the vital signs and give oxygen by continuous positive airway pressure (PAP)
PAP helps move some fluid out of the lungs and improve oxygenation.
What position should a patient with CHF be allowed to remain in?
Sitting in an upright position with the legs down
Why is it important to reassure patients with CHF?
Many patients feel anxious because they feel as if they cannot breathe
What should be done with medications for patients who have had previous CHF problems?
Gather these medications and take them along to the hospital
Under what condition may nitroglycerin be administered to reduce pulmonary edema?
If the patient’s systolic blood pressure is more than 100 mm Hg
What route should nitroglycerin be administered if advised?
Sublingually
What is essential after treating a patient with CHF?
Prompt transport to the ED
Fill in the blank: If CPAP is not available or not tolerated by the patient, you may give oxygen by _______ or _______ to maintain the oxygen saturation between 95% and 99%.
mask, cannula
What is the goal of using continuous positive airway pressure (PAP) in CHF treatment?
To move some of the fluid out of the lungs and improve oxygenation
