Congestive Heart Failure (CHF) : Causes Diagnosis
Congestive Heart Failure (CHF) : Causes Diagnosis
Congestive Heart Failure (CHF) : Causes Diagnosis
Tags RLE
Causes Diagnosis
: May result from a primary abnormality of the heart muscle - such as EKG
an infarction -inadequate myocardial perfusion due to coronary disease
Reflects heart strain or enlargement, or ischemia.
or cardiomyopathy. Other causes include:
May also reveal arterial enlargement, tachycardia, and
Mechanical disturbances in ventricular filling during diastole there
extrasystoles suggesting CHF.
is too little blood for the ventricles to pump.
Chest X-ray
Systolic hemodynamic disturbances, such as excessive cardiac
workload due to volume overloading or pressure overload, that Shows increased pulmonary vascular markings, interstitial
limit the heart's pumping ability. edema, or pleural effusion and cardiomegaly.
: An increase in end-diastolic ventricular : An increased in muscle mass or diameter : A response to decreased cardiac output and
volume (preload) causes increased stroke work of the left ventricle allows the heart to pump blood pressure by enhancing peripheral
and stroke volume during contraction, against increased resistance (impedence) to vascular resistance, contractility, heart rate, and
stretching cardiac muscle fibers beyond the outflow of blood. venous return.
optimum limits and producing pulmonary : An increased in ventricular diastolic : Signs of increased sympathetic activity,
complications and pulmonary hypertension → pressure necessary to fill the enlarged
Cool extremities and clamminess
right ventricular failure. ventricle may compromise diastolic
coronary blood flow → limiting oxygen May indicate impending heart
supply to the ventricle → ischemia and failure.
impaired muscle contractility. Reduced Glomerular Filtration Rate
(GFR) and increasing tubular
reabsorption of salt and water
📢 The mechanisms improve cardiac output at the expense of increased ventricular work
CHF 1
Diastolic gallop Tachycardia - arrhythmias Assist with intubation and mechanical
ventilation, and resuscitate if necessary.
Nursing Responsibilities Hypotension
Auscultate chest for rales and S3. Insert I.V. if not already done.
Monitor apical and radial pulse. Give digitalis, morphine, and potent
diuretic (e.g. furosemide), as ordered.
Assist patients with all needs, to conserve
strength. Insert foley catheter.
Provide emotional support (through all Calculate intake and output accurately.
stages) for patient and family.
Draw blood to measure arterial blood
gases.
Affects the feet and ankles Dyspnea on exertion (DOE) and/or othropnea
: May result from the venous engorgement and venous stasis within SNS stimulation
the abdominal organs. Vasoconstriction
Generalized weakness Pale or ashen skin; cool and clammy skin
CHF 2
Tachycardia
Altered digestion
Diziness
Lightheadedness
Confusion
Restlessness
Anxiety
Fatigue
Expended in breathing
Insomia
Coughing
Nocturia
No fried food Monitor vital signs (for increased respiratory rate, heart rate,
No canned foods and narrowed pulse pressure) and mental status.
Auscultate the heart for abnormal sounds (S3 gallop) and the
No OTC
lungs for rales and rhonchi.
C - Cold & flu meds
Report changes immediately.
A - Acetaminophen
Frequently monitor BUN, creatinine, and serum potassium,
A - Antacids chloride, and magnesium levels.
N - NSAIDs Assist with range of motion exercises to prevent deep-vein
R - Risk for falls thrombosis due to vascular congestion.
Change position slowly Enforce bed rest and apply antiembolism stockings.
Notify the HCP immediately Advise/educate the patient to avoid foods high in sodium, such
as canned or commercially prepared foods and dairy products to
E - Elevate legs
curb fluid overload.
With pillows and high fowlers
Tell the patient that potassium loss through diuretics must be
D - Daily weights replaced by taking a prescribed potassium supplement and eating
high-potassium rich foods such as bananas, apricots, and
S - Sex
orange juice.
Only after 2 flights of stairs with NO SOB
Stress the need for regular check-up
S - Stockings
Emphasize the importance of taking digitalis exactly as prescribed
TED hose
CHF 3
Remove daily Instruct the patient to watch for signs of toxicity (anorexia,
nausea and vomiting, yellow vision, cardiac arrhythmias).
Do not massage the calves
Tell the patient to notify the doctor if pulse is unsually irregular or
Pharmacological Treatment
less than 60 beats per minute; or if the patient experiences
A - ACEs and ARBs ( Lowers BP ) dizziness, a persistent dry cough, palpitations, increased fatigue,
ACE Inhibitors paroxysmal nocturnal dyspnea, swollen ankles, or decreased
urinary output; or if the patient gains 5 Ibs ( 2.25 kg ) in a week
-pril ending drugs ( Lisinopril, enalapril, captopril )
OR 2 to 3 Ibs ( 1 to 2.25 kg ) in a day.
1st choice of drug
Precautions
A - Avoid pregnancy
A - Angioedema
E - Elevated potassium
Avocados
Orange juice
Melon
Liver
Salt substitutes
Muscle spasms
Precautions
Bradycardia
Breathing problems
vamil )
Nursing Considerations
C - Count HR & BP
CHF 4
D - Digoxin ( Lowers HR )
Deep contractions
Very toxic
Precautions
T - Toxicity
Notify HCP
D - Dilators ( Vasodilator )
Precautions
Confusion
Irritability
Sweating
Pallor
Headache
Hypotension
D - Diuretics ( Lowers BP )
than 3.5 )
[HCTZ] )
Furosemide
No licorice
Nursing considerations
Check BP
CHF 5
Administer in the morning
Daily weights
CHF 6