congestive heart failure cmc Flashcards
A 57 year old female presents with a clinical presentation of JVD, Peripheral edema, Cyanosis, Congestive hepatomegaly, Ascites, and Hepatojugular reflux. What action should the nurse anticipate?
These symptoms are classic for right sided heart failure. The nurse can anticipate
A patient with newly diagnosed hear failure presents with pulmonary crackles, and S3 heart sound adn Aortic regurgitation. Is this left or right heart failure?
Left.
A patient presents with pulmonary crackles and congestion. Echo demonstrates and EF of 55%. BP is 160/90 and a left sided mummer is auscultated. Is it likely that this patient has heart failure? If so, is it left or right, diastolic or systolic?
It is likely that they have left sided diastolic heart failure. Aka: heart failure with preserved EF.
What diagnostic labs should be drawn if a patient is suspected of heart failure?
CBC, BMP, Creatinine, Liver enzymes, TSH, BNP.
What imaging should be performed on a patient suspected of HF?
CXR, 2-D echo, Heart Cath.
What does a BNP 100-300 pg/ml suggest
Possible HF, May be indicative of PE in non-HF patients
What does a BNP > 300 - <600 indicate?
Mild HF
What does a BNP >600- <900 indicate?
Moderate HF
What does a BNP >900 indicate?
Severe HF
What medications should be prescribed to a patient with Sys HF?
Diuretic, Beta blocker, and ACE.
If a Sys HF patient is unable to tolerate an ACE, what is the recommended action?
Use vasodilatory drugs such as Hydralazine or Isordil.
What are the goals for treatment for patients with DHF?
Primary goal is control of HTN. Replace valves if indicated.
