Heart Failure

Heart Failure

1. Describe the pathophysiology which occurs in heart failure (CHF)

CHF may be caused by any interference with the normal mech regulating cardiac output. CO depends on preload, afterload, myocardial contractibility, HR, and metabolic state of the individual.   Any alteration in these factors can lead to decreased ventricular function and the resultant manifestations of CHF.   The major causes of CHF may be divided into two groups 1. Underlying diseases and 2. precipating causes.   Precipitating causes often increase the workload of the ventricles, causing a decompensated condition that leads to decreased myocardial function  

2. Explain the effects of heart failure on the clients ability to meet basis needs

*Fatigue
*Dyspnea
*Tachycardia
*Edema
*Nocturia*Skin Changes (Dusky, cool to touch, swollen)
*Behavioral Changes (restlessness, confusion)
*Chest pain*Weight Changes (At first Wt gain than Wt loss)

3. Identify data to be collected when assessing clients with heart failure  

· History
· ECG
· VS
· Medications
· Head to Toe assessment
· Blood work (labs) SMA7, BMP, CBC with diff, CXR, Cardiac Troponin I, CK-MB,CK

4. Identify possible nursing Dx, outcomes and therapeutic nursing interventions for a client with heart failure that may guide clinical decision making

Dx: Decreased Cardiac output r/t impaired cardiac function
Outcomes:
1. Demonstrates adequate cardiac output as evidenced by BP and pulse rate and rhythm within normal parameters for client, strong peripheral pulses; and an ability to tolerate activity without symptoms of dyspnea, syncope, or chest pain.
2. Remains free of side effects from the medications used to achieve adequate cardiac output.
3. Explains actions and precautions to take for cardiac disease.
NI:
1. Monitor for signs and symptoms of heart failure and decreased cardiac output, including diminished quality of peripheral pulses, cool skin and extremities, increased RR, presence of... [continues]

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