Congestive Heart Failure (CHF)

Condition in which the pumping of the heart becomes impaired and is unable to meet the body's demands.

NEED A LOT OF REST. Pulse O2 is 93-95%

Etiology:
Diabetes

Tx:
Upright (High/Semi Fowler's)
Nitrate
Diuretics (Laxix)
O2

I&O is important! We want to get rid of fluid. Pts. with CHF are almost always on fluid restrictions. (WEIGHT IS MOST ACCURATE MEASUREMENT OF FLUID!!) Na+ restriction.

Left-Sided Failure: Blood backs up the left ventricle and atrium and into the pulmonary veins, increasing the pressure in the veins forcing blood into the lungs.

S/S:
*Dyspnea, orthopnea (Night-proxysmal nocturnal dyspnea)
*Cough
*Fatigue
*restlessness & anxiety

Decreased cardiac output, poor tissue perfusion leads to cardiac hypertrophy (gets larger)


Right Sided Failure:
*Primarily caused by left sided failure

S/S:
*Fluid and pressure in venous system
*Edema (pitting)
*Hepatomegaly
*Anorexia
*Nocturia
*Weakness
*Ascites
*Distended jugular veins

More of a systemic affect.

Diagnostic Studies:
*Echocardiogram
*Angiogram
*MUGA Scan-Evaluates heart size, ventricular wall motion, ejection fraction
*Blood Tests
*Chest X-Ray
*Labs--Electrolyte imbalances from diuretics
Watch for anemia

Assessment:
Changes in LOC, restlessness, confusion
Labored resepiration, adventitous sounds
JVD-distention?
Urinary output
Periph. cap refill, periph pulses





Video found here.




Video found here.