Management/Treatments Flashcards
How can CHF be managed?
With drugs and lifestyle changes such as a DASH diet
What medications should be given to decrease preload, improve contractility, and decrease after load?
Preload – diuretics (furosemide, bumetanide, spironolactione), ACE inhibitors (captopril, enalapril), ARB’s (losartan, valsartan), ARNI’s (sacubitril/valsartan)
Contractility – Inotropes (dobutamine), cardiac glycosides (digoxin)
Afterload – Beta Blockers (metoprolol, carvedilol), vasodilators (hydralazine, nitrates)
What is the expected outcome of administration of Furosemide? Digoxin?
Furosemide – should see increase in urine output and decrease in respiratory symptoms – may also see a decrease in any peripheral edema
Digoxin – decrease heart rate and increase the force of contraction – should see evidence of improved peripheral perfusion.
What are the necessary education information to inform patients with CHF?
- medications
- disease process of HF
- symptoms to monitor for
- importance of daily weight monitoring
- monitor BP and HR
- importance of adhering to a diet and exercise regime
- smoking cessation
What are the nursing interventions for CHF?
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).
● Monitor diagnostic results to track progress.
● Assess for manifestations 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).
● Provide emotional support to the client and family.
What are the signs of digoxin toxicity that you should look for?
- anorexia
- nausea and vomiting
- blurred or yellow vision
- cardiac dysrhythmias
- hyperkalemia????
