Professional Documents
Culture Documents
GROUP TWO
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DEFINITION
Heart failure is a clinical syndrome not a disease.
Heart failure is a condition in which the heart cant
pump enough blood throughout the body. Heart failure
does not mean that your heart has stopped or is about
to stop working. It means that your heart is not able to
pump blood the way that it should. The heart cant fill
with enough blood or pump with enough force, or both.
SYMPTOMS
ETIOLOGIES
COMPLICATIONS
Pleural effusion
Atrial fibrillation (most common dysrhythmia)
High risk of fatal dysrhythmias (sudden cardiac death,
ventricular tachycardia)
DIAGNOSTIC STUDIES
Primary goal- determine underlying cause
o History and physical examination( dyspnea)
o Chest x-ray
o ECG
o Lab studies (e.g., cardiac enzymes, BNP- (beta
natriuretic peptide- normal value less than 100)
electrolytes
o Echocardiogram-TEE best
2. Nursing diagnosis
Excess fluid volume related to cardiac failure as manifested by edema,
dyspnea on exertion, increased weight gain .
Nursing interventions:
Weigh daily and monitor trends to monitor fluid retention and weight
reduction
Monitor respiratory pattern for symptoms of respiratory difficulty.
Monitor fluid intake and fluid output
Monitor for therapeutic effect of diuretic to assess response to treatment .
Monitor for serum electrolyte levels to assess as a response to treatment
3. Nursing diagnosis
Disturbed sleep pattern related to nocturnal dyspnea, nocturia as manifested by
inability to sleep through the night .
Nursing interventions
Determine patients / activity pattern to establish routine .
Encourage patient to establish a bedtime routine to facilitate transition from
wakefulness to sleep
Adjust environment to promote sleep adjust medication administration schedule to
support patients' sleep cycle
Monitor patients' sleep pattern and number of sleep hours to determine hours of
sleep .
COLLABORATIVE
MANAGEMENT
DRUG THERAPY
Diuretics
Thiazide
Loop
Spironolactone
Vasodilators
ACE inhibitors- pril or ril *first line heart failure
Angiotensin II receptor blockers
Nitrates
-Adrenergic blockers- al or ol
Nesiritide- Natrecor (BNP)
MEDICATIONS
Angiotensin-converting enzyme inhibitors, such as captopril and enalapril, block
conversion of angiotensin I to angiotensin II, a vasoconstrictor that can raise BP. These
drugs alleviate heart failure symptoms by causing vasodilation and decreasing
myocardial workload.
Beta-adrenergic blockers, such as bisoprolol, metoprolol, and carvedilol, reduce
heart rate, peripheral vasoconstriction, and myocardial ischemia.
Diuretics prompt kidneys to excrete sodium, chloride, and water, reducing fluid
volume. Loop diuretics such as furosemide, bumetanide, and torsemide are preferred
first-line diuretics because of efficacy in patients with and without renal impairment.
Low-dose spironolactone may be added to a patient's regimen if he has recent or
recurrent symptoms at rest despite therapy with ACE inhibitors, beta-blockers, digoxin,
and diuretics.
Digoxin increases the heart's ability to contract and improves heart failure symptoms
and exercise tolerance in patients with mild to moderate heart failure
THANKY
OU