heart failure Flashcards
when does heart failure occur
Heart failure occurs when the heart muscle is unable to pump effectively
- Myocardial hypertrophy
- Pulmonary/systemic congestion.
Result of an acute or chronic cardiopulmonary problem
Systemic hypertension
Myocardial infarction (MI)
Pulmonary hypertension
Dysrhythmias
Valvular heart disease
Pericarditis
Cardiomyopathy
heart failure class
class 1-4
class 1
Client exhibits no symptoms with activity.
class 2
Client has symptoms with ordinary exertion
class 3
Client displays symptoms with minimal exertion
class 4
Client has symptoms at rest
left sided heart failure
** not connected to lungs but more resp issues, backs into lungs***
- Dyspnea, orthopnea (shortness of breath while lying down), nocturnal dyspnea
- Fatigue
- Displaced apical pulse (hypertrophy)
- S3 heart sound (gallop)
- Pulmonary congestion (dyspnea, cough, bibasilar crackles)
- Frothy sputum (can be blood-tinged), pink tinged
- Altered mental status
- Manifestations of organ failure, such as oliguria (decrease in urine output)
right sided heart failure
*connected to veins
- Jugular vein distention
- Ascending dependent edema (legs, ankles, sacrum) check lbs daily
- Abdominal distention, ascites
- Fatigue, weakness
- Nausea and anorexia
- Polyuria at rest (nocturnal)
- Liver enlargement (hepatomegaly) and tenderness
- Weight gain
cardiomyopathy s/s
- Fatigue, weakness
- Heart failure (left with dilated type, right with restrictive type)
- Dysrhythmias (heart block)
- S3 gallop
- S4 heart sound (extra fluid when ventricles filling)
- Cardiomegaly (enlarged heart), more severe with dilated type
- Angina (hypertrophic type)
diagnostic procedures
- Hemodynamic monitoring
- Ultrasound
- Transesophageal echocardiography (TEE)
Uses a transducer placed in the esophagus behind the heart to obtain a detailed view of cardiac structures. The nurse prepares the client for a TEE in the same manner as for an upper endoscopy - Chest Xray
- ECG, cardiac enzymes, electrolytes, and ABGs
nursing care for heart failure
- Monitor daily weight and I&O.
- Assess for shortness of breath and dyspnea on exertion.
- Administer oxygen as prescribed.
- Monitor vital signs and hemodynamic pressures.
- Position the client to maximize ventilation (high-Fowler’s).
- Check ABGs, electrolytes (especially potassium if on diuretics), SaO2, and chest x-ray findings.
- Assess for signs of medication toxicity (digoxin toxicity).
- Encourage bed rest until the client is stable.
- Encourage energy conservation by assisting with care and ADLs.
- Maintain dietary restrictions as prescribed (restricted fluid intake, restricted sodium intake)
- avoid nsaid: promote bleeding, raise NA in kidney: give tyanol instead
herbals
- Herbal medications can stimulate the cardiovascular system.
- Obtain a list of herbal supplements the client takes, and advise the client of potential contraindications
diuretics used for
used to decrease preload
loop diuretics
Furosemide
Bumetanide
thiazide diruetics
Hydrochlorothiazide
- manage bp
potassium sparing
Spironolactone
- watch K+
diuretics nursing considerations
- Administer furosemide IV no faster than 20 mg/min.
- Loop and thiazide diuretics can cause hypokalemia, and potassium supplementation can be required.
- Teach clients taking loop or thiazide diuretics to ingest foods and drinks that are high in potassium to counter the effects of hypokalemia.
procedures
Ventricular assist device (VAD)
Heart transplantation
complications from procedures
Cardiogenic Shock
Cardiac Tamponade
Acute Pulmonary Edema
