Congestive Heart Failure

Congestive Heart Failure

1. DIAGNOSTICS (Gopal & Karnath, 2010)

   • CT Scan
   • ECG
   • Electrolytes
   • BNP

2. NURSING INTERVENTIONS

   • Elevate Head of Bed 30-45 degrees
     • Promote effective breathing
   • Patient Education
     • Symptom management
     • Disease process
   • Daily weights
     • Assess for fluid retention
   • Vital Signs q4-6h
   • Administer Oxygen
   • Monitor Electrolytes
     • Potassium 3.5-5.0 mmol/L
   • Interdisciplinary Team
     • Telemetry Nurse
     • Recreational Therapist
     • Cardiologist
     • Family Physician
     • Physical Therapist

3. MANAGEMENT (Alagiakrishnan et al., 2013)

   • Nutritional
     • (Lichtenstein et al., 2006, p 83)
       • Fruits and Vegetables
         • 4 -7 servings a day (Heart and Stroke Foundation, 2018)
           • Peas
           • Bananas
           • Apples
           • Lettuce
           • Broccoli
       • Whole grain foods
         • Fibre
           • 21-38 grams daily
             • Brown rice
             • Oatmeal
     • Fluid Restrictions (Philipson et al., 2014, p 1305)
       • 1500 mL daily
         • Further prevent fluid overload
   • Medications
     • Diuretics
       • Furosemide (Casu & Marella, 2015, table 1)
         • Decrease Edema
     • ACE-Inhibitors
       • Decrease BP
       • Catopril
       • Ramipril
     • Calcium Channel Blockers
     • Antiplatelets
       • Clopidogrel
     • Anticoagulants
       • Heparin
         • Prophylaxis for cloft formation
     • Digoxin
       • Decrease heart workload
       • Increase Cardiac Output

4. CHARACTERISTICS

   • Manifestations (Arroll, Doughty & Anderson, 2010), (American Heart Association, 2018)
     • American Heart Association (2018). Types of Heart Failure.
     • Right-Sided
       • Edema
         • Weight Gain
       • Jugular Vein Distention
     • Left-Sided
       • Pulmonary Edema
         • Shortness of Breath
         • Pink-tinged sputum
       • Decreased Cardiac Output
         • Activity Intolerance
           • Fatigue
         • Cyanosis
   • Complications
     • Pleural Effusion
     • Dysrhythmia
     • Left Ventricular Thrombus
     • Hepatomegaly
     • Renal Failure
   • Risk Factors (Lewis et al., 2014)
     • Medical (Bui, Horwich & Fonarow, 2010, p 31
       • Hypertension
       • Diabetes
       • Ischemic heart disease
       • Renal Failure
       • Obesity
     • Familial
       • Coronary Artery Disease
       • Sudden Cardiac Death
       • Dilated Cardiomyopathy
     • Social
       • Excessive Alcohol Use
       • Smoking
       • Illicit Drug Use

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