Week 6: Heart Failure Assessment/Dx Flashcards
S&S Right-sided HF
-Hypotension (severe disease)
-Fluid overload
-Weight gain
-Anorexia
-Peripheral edema
-Decreased SA02
-Murmers
-Ascites/Anasaracara
-heptomegaly
-Right heaves
-Renal impairment
-Tachypnea
-Tachycardia
S&S Left Sided Failure
-Hypertension
-Hypotension
-Fluid overlaod
-Weight gain
-Crackles
-Decreased SAO2
-Extra heart sound (S3,4)
-Peripheral edema
-Left heaves
-Renal impairment
-Tachypnea
-Tachycardia
-Nocturia
-Dyspnea
-Orthopnea
What is a common sign of severely decompneated HF?
Hypotension, worsening renal function, or altered mentation (mental state)
Dyspnea at ________ is concerning
Rest
Must there be weight gain for us to be concerned about worsening congestion?
NO
List some common comorbid conditions with HF
Pneumonia, pulmonary embolus, diabetic ketoacidosis, acute coronary syndrome, symptoms of transient ischemic attack or stroke
A client presents with an EF of >50%
Grade I (normal)
A client presents with an EF of 41-49%
Grade II, mild
A client presents with an EF of 30-41%
Grade III, moderate
A client presents with an EF of <30%
Grade IV, severe
What lab work is ordered to assess if a patient is undergoing HF?
BNP, CBC, Electrolytes, renal function, Liver function, troponin, CK, glucose, thyroid unction, blood gases
Why an ECG in HF?
Looking for evidence of ischemia, infarction, arrhythmia
Why a chest radiograph in HF?
Assess for signs of pulmonary edema, cardiomegaly, alternative dx
A normal radiograph does NOT rule out heart failure
Why an echo in HF?
Ejection fraction, if cardiac or valvular function unknown, f-u to compare previous
What are a few other imaging tests used in HF?
Exercise testing, stress test, MRI (cardiac), cardiac cath
Which class is the most severe in HF?
Class IV, where you are unable to do any physical activity without discomfort and you have symptoms at rest
What are the goals of therapy in HF?
-Improve LV function
-Decrease intravascular volume
-Decrease preload/afterload
-Improve gas exchange and oxygenation
-Increase CO
-Reduce anxiety
-Patient education and support
-Improve QOL
-Reduce morbidity
What are som non-pharm therapies for HF?
Diet, exercise, activity, O2 therapy (SAO2 more than 90), self-management
What is self management in HF
Diet, med compliance, management of other disease, smoking cessation, restriction or no booze
What comorbidities should be treated with HF
CAD, HTN, cholesterol, diabetes
What vastly improves outcomes with HF?
Medication management
Which devices are commonly used in the management of HF ?
Cardiac resynchronization therapy, implantable cardioverter (defibrillator), mechanical circulatory support
What types of meals are best for patients with HF ?
Pts experiencing HF often have decreased appetite and nausea, so small and frequent meals may be more appropriate than the standard 3 large meals
Sodium restriction in HF
<2-3g/day
1.5g/day if severe
