Congestive Heart Failure (CHF)

Question 1

risk factors

Answer 1

Presence of Coronary Artery Disease

hypertension

DM

dyslipidemia (elevated low-density lipoprotein (LDL) cholesterol levels, or low levels of high-density lipoprotein (HDL) cholesterol)

sleep-disordered breathing

albuminuria (albumin in urine)

anemia

chronic kidney disease

use of illicit drugs

sedentary lifestyle

psychological stress

THESE ARE COMMON AMONG OLDER ADULTS DUE TO AGE-RELATED CHANGES SUCH AS:
-reduced elasticity & lumen diameter of the vessels

• rises in BP that interferes with the blood supply to the heart
• decreased cardiac reserves or in other words, decreased blood supply to the heart limits the heart’s ability to withstand effects of disease or injury

Question 2

S&S

Answer 2

dyspnea on exertion

confusion

insomnia

wandering during the night

agitation

depression

anorexia

nausea

weakness

SOB

orthopnea (SOB when lying down, but is relieved when sitting up)

wheezing

weight gain

bilateral ankle edema

Question 3

nursing considerations

Answer 3

moist crackles are heard upon auscultation

presence of edema & inadequate tissue perfusion, as well as fragile skin due to age-related factors, increases the risk of skin breakdown

Question 4

Types/classes of CHF

Answer 4

Stage 1: a cardiac disease without physical limitation

Class 2: symptoms experienced with ordinary physical activity; slight physical limitations may be present

Class 3: symptoms are experienced with less than normal activities; physical ability is significantly limited

Class 4: Symptoms are experienced with any kind of activity; bed rest may be required

Question 5

Interventions

Answer 5

adequate bed rest: the duration should not be prolonged to prevent the development of thrombosis & pulmonary congestion

ACE inhibitors

beta-blockers

digitalis (Digoxin)

diuretics

diet (low sodium)