Congestive Heart Failure
I make breathing hard when you lie flat, but sitting up gives relief. Who am I?
What is Orthopnea?
Rationale: The sensation of shortness of breath (dyspnea) that occurs when lying flat, often forcing individuals to sleep propped up on pillows or sit up to breathe comfortably.
This drug class reduces preload and fluid overload in heart failure.
What are Diuretics?
Rationale: Diuretics remove excess fluid, decreasing cardiac workload
This medication is given first-line for symptomatic bradycardia.
What is Atropine?
Rationale: Atropine is the first-line medication used to treat symptomatic bradycardia. It acts as a vagolytic agent, increasing the heart rate by blocking the effects of the vagus nerve on the heart's SA and AV nodes. The recommended initial dosage is a 0.5 mg IV push, which can be repeated every 3-5 minutes, up to a maximum of 3 mg.
This position best improves oxygenation in a dyspneic patient.
What is High Fowler's Position?
Shortness of breath, crackles, orthopnea.
What is pulmonary edema?
I cause crackles when air meets fluid below,
Listen to lungs—I’ll let you know.
What complication am I?
What is pulmonary edema?
Rationale: Left-sided heart failure (specifically left ventricular failure) is the primary cause of cardiogenic pulmonary edema. When the left side cannot efficiently pump oxygenated blood out to the body, blood backs up into the pulmonary veins and capillaries, causing fluid to seep into the lungs.
This medication class decreases heart rate and myocardial oxygen demand.
Beta-blockers (beta-adrenergic antagonists) are the primary medication class that decreases heart rate, contractility, and myocardial oxygen demand by blocking adrenaline and noradrenaline on beta 1 adrenergic receptors.
This drug is used during cardiac arrest to improve coronary and cerebral perfusion.
What is Epinephrine?
Rationale:
This nursing measure is the most sensitive indicator of fluid balance.
What is daily weights?
Sudden onset dyspnea, pleuritic chest pain, and tachycardia.
What is pulmonary embolism?
I bulge in the neck when pressure is high,
Seen best when the patient reclines.
What sign am I?
What is jugular vein distension?
Rationale: Jugular vein distension (JVD) is caused by increased pressure in the superior vena cava, forcing blood to back up into the neck veins, signaling poor blood flow to the heart. The primary cause is right-sided heart failure.
This drug improves contractility but must be used cautiously due to toxicity.
What is Digoxin?
Rationale: Digoxin is a cardiac glycoside used to improve myocardial contractility (positive inotropy) in heart failure and to control the ventricular rate in patients with atrial fibrillation.
This medication treats ventricular tachycardia and ventricular fibrillation.
What is Amiodarone?
Rationale: Amiodarone is a primary anti-arrhythmic medication used to treat and prevent both ventricular tachycardia (VT) and ventricular fibrillation (VF). Often considered the drug of choice for hemodynamically unstable VT, it is effective in reversing arrhythmias and is used in both in-hospital and out-of-hospital cardiac arrest scenarios. Loading dose is 150 mg over 10 mins
This is done before giving a patient any new IM/IV medications
What is a test dose?
Chest pain radiating to the left arm with diaphoresis.
What is a myocardial infarction?
I’m reduced when the heart can’t eject well,
A key echo number nurses should tell.
What measurement am I?
What is ejection fraction?
Rationale: percentage measurement of how much blood the left ventricle pumps out with each heartbeat. It assesses the heart's pumping efficiency, with a normal, healthy heart typically ejecting 55% to 70% of the blood filled in the chamber.
This medication class reduces afterload and prevents cardiac remodeling.
What are ACE Inhibitors?
Rationale: By inhibiting the ACE enzyme, they reduce the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, leading to systemic vasodilation and decreased vascular resistance.
This medication reverses opioid-induced respiratory depression.
What is Naloxone?
Rationale: Naloxone is the primary, first-line, fast-acting medication used to reverse opioid-induced respiratory depression and opioid overdoses by antagonizing opioid receptors. Delivered intranasally, intravenously, or intramuscularly, it acts rapidly to restore breathing.
What is the sequence for abdominal assessment?
What is inspection, auscultation, percussion, and palpation?
Unresponsive patient, weak or no pulse, no breathing.
What is cardiac arrest?
I’m checked every morning, same time, same scale,
A sudden increase means something’s not well.
What am I?
What is daily weight?
Rationale: Daily weight is the most sensitive indicator of fluid retention in CHF.
This medication is used to relieve chest pain by dilating coronary arteries.
What is GTN?
Rationale: Nitroglycerin reduces preload and improves myocardial oxygen supply.
This drug may be given for torsades de pointes.
What is Magnesium Sulphate?
Rationale: Intravenous magnesium sulfate is considered the first-line, drug-of-choice for the treatment of torsades de pointes (TdP). It works by suppressing early afterdepolarizations that trigger the arrhythmia.
This nursing action prevents aspiration during oral intake.
What is elevating the head of the bed?
Peripheral edema, JVD, and hepatomegaly (enlarged liver).
What is Right-sided heart failure?