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16 Cards in this Set

  • Front
  • Back
Congestive Heart Failure
Main cause is Cardiovascular Disease
Not pumping enough blood to meet the body's needs, may be due to either the increased cellular demands or, more commonly, to impaired pumping of the heart.
Compensatory mechanisms to improve CO
Increased HR, Improved Stroke volume, Arterial vasoconsriction, Sodium and water retention, Myocardial hypertrophy
Systolic vs Diastolic dysfunction
Systolic dysfunction results when the ventricle is unable to contract forcefully enough during systole to eject adequate amounts of blood into circulation
Diastolic- when L ventricle is unable to relax adequately during diastole.
Contributing factors to heart failure
*Cardiovascular Disease*
Hypoxia, Anemia, Elecrolyte abnormalitites
Left Ventricle Failure
Left ventricle becomes stiff and resistant to filling.
Uncontrolled left-sided heart failure and lead to right-sided heart failure.
Signs and Symptoms of Left Ventricular Failure
SOB, Edema (in extremeties, then lungs), fatigue, weakness.
Orthopnea (SOB-when laying flat) paroxysmal nocturnal dyspnea, cough, restlessness, confused, weight gain (fluid)
Right-sided Heart Failure
Edema (sacral area, abdominal area, and jugular distention), weight gain, liver enlargement, ascites, anorexia & nausea, nocturia, weakness
Differences in s/s
L-SOB,orthopnea, cough, restlessness, confused.

R-liver enlargement, ascites, anorexia & nausea (b/c of pressure from fluid),nocturia.
Shared s/s in L and R heart failure
Edema, weakness, weight gain.
In R side failure there is systemic congestion (jugular, legs and sacrum, distended abd, swollen hands and fingers)
In L side failure edema starts in extremities and moves to lungs.
Left ventricular failure info
Decreased Stroke volume, increase of blood in L ventricle and atrium
RESPIRATORY-dyspnea, cough
Right ventricular failure info
Venous congestion, periphral edema, shows both L & R failure symptoms, decreased urinary output
Medical Treatment Goals
Reduce cardiac workload, stregthen myocardial contractility (w/ meds; digoxin), eliminate excess fluid (Diuretics & low sodium diet)
Cardiac Glycosides
Digitalis: increases HR & force of contractions which increases CO which increases circulation and tissue perfusion. Also increases renal blood folw and decreases edema
Cardiac glycosides
Digoxin(lanoxin): .25mg Q day or .125mg Q day
Digitoxin(Crystodigin): 0.05mg-0.3mg -longer half life (increases toxicity) ANTIDOTE- Digoxin immune AFB (Ovine)
Digoxin Side effects & Toxicity
Typical side effects: decreased appetite, slight nausea, altered taste. -All GI symptoms.
Toxicity- Nausea & vomiting, visual disturbances, arrythmias, confusion.
Therapeutic levels: 0.9-2.0
Interactions/Precautions: Diuretics (decreases K+ level, which ^ effects of dig.), Steroids (promote Na retention), Antacids (interfere w/ absorption of meds.)
CHF Nursing Assessment
Medical Hx, s/s, current medical dx and tx, VS, heart sounds (Q4hrs), tissue perfusion, edema/weight (2 or more lbs-call Dr.), urinary output (25-30cc/hr), change positions freq.