CHF

Question 1

Can a heart attack cause heart failure?

Answer 1

Yes

Question 2

What is heart failure?

Answer 2

When the heart pumps blood inadequately, leading to reduced blood flow to tissue, backing up blood in veins and lungs, making the heart even more weak.

Question 3

Where does left heart failure go?

Answer 3

Lungs

Question 4

Where does right heart failure go?

Answer 4

edema in body

Question 5

S/S Left sided heart failure

Answer 5

Paroxysmal nocturnal dyspnea (SOB and coughing at night)

Pulmonary congestion

• cough
• crackles
• wheezes
• blood-tinged sputum
• tachypnea

Restlessness

Confusion

Tachycardia

Exertional dyspnea

Fatigue

Cyanosis

Question 6

S/S of right sided heart failure (Cor Pulmonale)

Answer 6

Fatigue

Increased peripherla venous pressure

Ascites

Enlarged liver and spleen

Distended jugular veins

Anorexia

GI distress

Weight gain

Edema

Question 7

First signs of Dig toxicity

Answer 7

Abdominal pain

Anorexia

N/V

Visual disturbances-yellow aura

Bradycardia/arrhythmias

Question 8

Medications for CHF

Answer 8

• Vasodilators
• Diuretics
• Morphine
• Angiotensin-converting enzyme inhibitors
• Angiotensin II receptor blockers
• Beta-Blockers
• Digitalis
• Anticoags
• Other dysrhthmics

Question 9

Assessment for CHF

Answer 9

Health history

Sleep & activity

Diet

Knowledge and coping

Physical exam

• mental status
• lung sound: crackles & wheezes
• Heart sounds: s3, s4
• Fluid status/signs of fluid overload (daily weight, I&O)

-Assess responses to medications

Question 10

PCs of CHF

Answer 10

• Pleural effusion
• Dysrhythmias
• Thromboembolism
• Pericardial effusion and cardiac tamponade
• Enlarged liver
• Renal liver
• Cardiogenic shock

Question 11

What is pulmonary edema?

Answer 11

Acute event-lung volume can’t handle an overload of blood volume.

Pressure increases in pulmonary vasculature, causing fluid to move out of the capillaries and into interstitial space of the lungs and alveoli=hypoxia.

Question 12

S/S of pulmonary edema

Answer 12

Restlessness
Anxiety
Dyspnea
Cool/clammy skin
Cyanosis
Weak and rapid pulse
Cough
Lung congestion (moist, noisy respirations)
Increased sputum production (frothy and blood-tinged)
Decreased LOC

Question 13

Management of CHF

Answer 13

Prevention
Early Recognition
-monitor lung sounds and signs of decreased activity tolerance and increased fluid retention

Patient in upright position and dangle legs
Minimize exertion and stress
Oxygen
Meds
-mophine
-diuretics (furosemide)

Question 14

Treating CHF

Answer 14

Upright Position
Nitrates
Lasix
Oxygen
Ace inhibitors
Digoxin

Fluids (decrease)
Afterload (decrease)
Sodium restriction
Test (Dig level, ABGs, K level)

Question 15

Cardiac classifications (NY Heart Association)

Answer 15

Class I-no s/s
Class II-ADLs ok, gets winded with exertion
Class III-Trouble completing ADLs
Class IV-SOB even at rest

Question 16

Cardiac classifications (American College of Cardiology & AHA)

Answer 16

Class A-several risk factors, no s/s
Class B-has heart disease but no s/s
Class C-has heart disease, has s/s
Class D-Advanced heart disease requiring special treatment