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15 Cards in this Set
- Front
- Back
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acute decompensated HF |
previously called congestive HF the body's compensatory mechanisms fail cardiac cells remodeled congestion in lungs pulmonary edema |
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clinical manifestations of pulmonary edema |
anxiety skin: pale, cyanotic, clammy, cold dyspnesa orthopenea resp rate >30 use of accessory muscles frothy blood tinged sputum crackles and wheezes rapid HR |
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left sided HF |
pulmonary congestion and edema crackles and wheezing SOB |
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right sided HF |
more systemic effects JVD enlarged liver enlarged spleen peripheral edema
right sided is usually caused by left sided |
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biventricular HF |
usually seen in Chronic HF SOB persistent dry cough extra heart sounds swelling in legs and ankles JVD ascites enlarged liver crackles in lungs |
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other signs and symptoms of HF |
Nocturia (6-7times)
changes in skin: cool, shiny, no hair, brown pigment
hypoxia effects: irritable, confused, memory changes
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diagnostics |
chest xray CBC check for cardiac enzymes ECG 12 lead 2 dimensional echochardiagram cardiac cath stress test daily weights VAD |
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Chronic HF nursing managment |
O2 therapy (canula) rest / activity periods telehealth monitoring drug therapy pace maker/ defibrillators VAD for left side transplant palliative
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Acute decomp. HF nursing management |
high fowlers O2 mask or canula biPAP intraaortic ballon pump mechanical intubation/ endotracheal VS UOP at least every hr intra arterial bp ultrafiltration (removes salt and water)
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digoxin |
increases contractility improves activity tolerance 0.8-2 therapeutic anything over 2 toxic -N/V, visual disturbances used in chronic not ADHF take apical pulse full minute notify if <60
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vasodilators |
used to decrease preload and afterload if pt cant tolerate ACE or ARB
IV= monitor BP q5-10 min s/e = n/v h/a dizziness blurred vision
patches = hair free spot take off for night
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nutrition |
DASH diet daily weights
report : 2lbs in 24hrs-48hrs 3-5lbs in a week
in renal probs : limit fluid 2L day |
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teaching |
take meds eat low sodium weigh daily report gains avoid alcohol, caffeine, dietpills, otc, balance rest and activity
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s/s or worsening HF |
fatigue activity limitation congestion edema SOB |
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joint commission measures |
pt with know systolic must be on ACE or ARB
smokers must get cessation education |
