Heart Failure
What is heart failure?
It is a complex clinical syndrome that develops in response to myocardial insult. It results in the inability of the heart to provide sufficient blood to meet the oxygen (O2) needs of tissues and organs. The decreased cardiac output (CO) leads to decreased tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability. There are multiple types of heart failure, such as left and right, these can also be further put into other categories such as HFrEF or HFpEF.
What is left-sided heart failure?
What is HFrEF?
HFrEF results from an inability of the heart to pump blood effectively (e.g., MI), increased afterload (e.g., HTN), cardiomyopathy, and mechanical problems.
Nursing teaching for HF?
Teach about nutrition= low salt, teach about exercise, teach about medication adherence, etc.
What do we call heart failure with a defect in ventricular systolic function/LV contraction?
Heart failure with reduced ejection fraction or HFrEF.
"Systolic"
What are the manifestations of left sided heart failure?
Shortness of breath, pulmonary edema, pink/frothy sputum, tachypnea, decreased O2 saturation, dyspnea, etc.
What is HFpEF?
HFpEF results from the inability of the ventricles to relax and fill during diastole.
If a patient has weight gain of 3lbs over 2 days, what do you do?
What do we call heart failure with a defect in ventricular diastolic function/filling?
Heart failure with preserved ejection fraction or HFpEF.
"Diastolic"
What is right-sided heart failure?
Right ventricle is not pumping effectively, causes fluid to back up in the venous system, causes fluid to build up into tissues and other organs.
What is acute decompensated HF?
Is an increase (usually sudden) in symptoms of HF with a decrease in functional status, often requiring rapid escalation of therapy and hospital admission
If a patient gains 3-5lbs over the course of a week what do you do?
Call the provider as this is another problem.
Risk factors for heart failure?
Hypertension, diabetes, metabolic syndrome, tobacco use, increased age, and so on.
What are the manifestations of right-sided heart failure?
Edema in other areas of the body, periorbital edema, weight gain, etc.
Manifestations of decompensated HF?
severe tachypnea, shortness of breath, working harder to breath, etc.
Gold Standard for Treatment of Heart Failure?
ACE inhibitors
Manifestations of heart failure?
This really depends upon the side of the heart it is on and what is causing the issues. But some general symptoms are lung congestion, fatigue, edema, weight gain, anorexia, & shortness of breath.
Treatment for Heart Failure?
ACE inhibitors, ARBs, aldosterone antagonist, diuretics, vasodilators, positive inotropes, morphine, chronotropes, RAAS inhibitors, etc.
Other things a nurse can do for HF?
watch potassium levels, put pt on heart monitor, echo, etc.