Congestive heart failure Dr Walaa Nasr Lecturer of
- Slides: 20
Congestive heart failure Dr. Walaa Nasr Lecturer of Adult Nursing Second year
Congestive heart failure outlines Definition n Causes and pathophysiology n Types of heart failure n Compensatory mechanism of failure n Clinical manifestations n Classification of heart failure n Diagnostic evaluation n Medical management n Nursing management n heart
Congestive heart failure Definition Heart failure describes the clinical syndrome that develops when the heart cannot maintain an adequate cardiac output. The heart pumps blood inadequately, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and other changes that may further weaken the heart.
Causes of congestive heart failure n. Coronary artery disease n. Heart attack n. High blood pressure n. Heart valves disorders n. Inflammation of Heart muscle (myocarditis, cardiomyopathy)
Causes of congestive heart failure (cont…) n Severe lung disease ( pulmonary hypertension) n Severe anemia n Overactive thyroid gland (hyperthyroidism) n Underactive thyroid gland (hypothyroidism) n Abnormal heart rhythms ( atrial fibrillation) n Kidney failure
Congestive heart failure Types n Left-sided n There heart failure are two types of leftsided heart failure n Systolic dysfunction n Diastolic dysfunction n Right-sided heart failure
Congestive heart failure Compensatory Mechanisms of heart failure n n n Renin-angiotensin-aldosterone system Sympathetic nervous system Enlargement of the muscular walls of the ventricles (ventricular hypertrophy).
Congestive heart failure Clinical manifestations n Symptoms (back up of blood and fluid) n Dyspnea n Orthopnea n Reduced exercise lethargy, fatigue n Nocturnal cough n Wheeze n Ankle swelling n Anorexia tolerance,
Congestive heart failure Clinical manifestations ( cont…) n Signs Cachexia and muscle wasting n Tachycardia n Pulsus alternans n Elevated jugular venous pressure n Crepitations or wheeze n Third heart sound n Oedema n Hepatomegaly (tender) n Ascites n
Congestive heart failure Classification of heart failure New York Heart Association (NYHA) Functional Classification Class % of patients Symptoms I 35% No symptoms or limitations in ordinary physical activity II 35% Mild symptoms and slight limitation during ordinary activity III 25% Marked limitation in activity even during minimal activity. Comfortable only at rest IV 5% Severe limitation. Experiences symptoms even at rest
Congestive heart failure Diagnostic evaluation n Patient history Physical examination Diagnostic studies 1. Electrocardiography (ejection fraction) 2. Radionuclide 3. magnetic resonance 4. computed tomography imaging 5. cardiac catheterization with angiography
Congestive heart failure Treatment n lifestyle change 1. 2. 3. 4. 5. Salt restriction Exercises Smoking and alcoholism Body weight (daily weight) Supportive stockings
Congestive heart failure Treatment (cont…) n n n n Drug management Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers Beta-blockers Other vasodilators ( nitroglycerin) Cardiac glycosides (digoxin) Aldosterone receptor blockers (spironolactone) Loop diuretics
Congestive heart failure Treatment (cont…) Potassium-sparing diuretics n Thiazide and thiazide-like diuretics n Anticoagulants (heparine) n Opioids (morphine) to relieve anxiety n Positive inotropic drugs (drugs that make muscle contract more forcefully) (dopamine) n n Oxygen for pulmonary edema is required
Congestive heart failure Treatment (cont…) n Non pharmacological management of heart failure (surgical intervention) n Coronary artery bypass grafting ( n Percutaneous coronary intervention revascularization) (Angioplasty) Valve replacement n Biventricular pacemaker n n n Heart transplantation Left ventricular assist device (LVAD)
Nursing care of patients with congestive heart failure Maintain the patient in high fowler's position n Elevate extremities except when the patient is in acute distress n Frequently monitor vital signs n Change position frequently n Monitor intake and output and daily weight n
Nursing care of patients with congestive heart failure (cont…) n Restrict fluids as ordered n Teach the patient and family and provide emotional support (life style change) n n Explain the side effect of diuretic medications for additional actions ( side effects of diuretics include electrolyte imbalance, symptomatic hypotension Use aseptic procedures when caring for invasive lines
- Cor pulmonale
- Nursing assessment for congestive heart failure
- Pathophysiology of valvular heart disease
- Congestive heart failure zones for management
- Lecturer's name or lecturer name
- Cup and cone fracture ductile or brittle
- Capture beat
- Failure to pace vs failure to capture
- Teacher
- Lecturer asad ali
- Guest lecturer in geography
- Designation of lecturer
- Lector vs lecturer
- Photography lecturer
- Lecturer name
- Physician associate lecturer
- Lecturer in charge
- Lecturer in charge
- Pearson lecturer resources
- Spe distinguished lecturer
- Cfa lecturer handbook