Assessment
Acute heart failure leading S/S
Pink frothy sputum
What lab tests are used to diagnose CHF?
BNP - only goes up with ventricular problems
Name two nursing considerations prior to an echocardiogram
NO IV access needed, PO status not required
What is the best test to diagnose CHF?
Echocardiogram
List two ways the nurse knows the patient is managing their fluid volume
no presence of edema, verbalizes understanding of fluid intake and diuretic use
#1 leading cause of CHF
HTN
Name at least three mixed HF S/S
Audible S3, chest pain (due to decreased oxygen demand), shiny and stretched skin, decreased hair growth, decreased perfusion, cool/dusky extremities, arrhythmias
Expected outcome of 1st body compensation of HF
Activation of SNS
increased HR (1st sign), vasoconstriction, increased preload and afterload
What diet would the nurse recommend for a HF patient?
low sodium/fluid diet
HTN, A-Fib, COPD, CAD, Diabetes, smoking, anxiety, depression, cardiomyopathy, pericarditis, chemotherapy, COVID, cardiac muscle failure, thyroid issues, stenotic valve disease
Name at least 5 left sided HF S/S
dyspnea, SOB, cough (dry or nonproductive), pulmonary edema, pleural effusion, orthopnea (difficulty breathing laying down) , paroxysmal nocturnal dyspnea (pt. awakes in middle of the night and feels as if they are being smothered), cardiac asthma, left ventricular thrombi, pink frothy sputum
Ejection fraction should be what %
50%
Expected outcome of 2nd body compensation of HF
ADH production
- holds onto volume, increases preload
Treatment for first body compensation of HF
Beta Blocker (for increased HR), Ca Channel blocker (to relax arterioles), give nitroglycerin (for vasodilation)
Doing what increases mortality by 70% in HF patients
Smoking
List and describe four stages of HF
1 - Have HF but asymptomatic, no restrictions in place, monitor patient for progression
2 - Some limitations, decrease activity level
3 - NO exercise, walking only, NO stairs, interferes with ADLS and life
4 - Symptoms at rest, just getting out of bed causes increased HR and dyspnea
Systolic HF is defined as
Diastolic HF is defined as
- pump failure
- ventricles can't relax/fill
Expected outcome of 3rd body compensation
RAAS
- increase aldosterone, increased preload and afterload, conversion of angiotensin 1 to 2
Diuretics (to decrease fluid volume)
place cuff over bare arm, ask patient to uncross legs, ensure cuff fits properly, ask patient to keep still and be silent, position patient with arm supported, cuff at heart level, back supported, feet flat on floor, no talking, ensure patient has empty bladder
Name at least 5 right sided HF S/S
edema, fatigue, hepatosplenomegaly, indigestion, no appetite, initial increase in weight due to fluid, then decrease due to no appetite
a stiffening of heart muscle, resulting in inability for heart to relax or fill properly. irreversible damage
The nurse knows that acute HF is caused by either of these three things
MI
arrhythmia
decompensation of chronic HF
Ace inhibitor (lisinopril)
right sided HF is defined as -
left sided HF is defined as -
- fluid backing up into the body
- fluid backing up into the lungs