Heart Failure

Question 1

What is heart failure?

Answer 1

inability of heart to pump enough blood to meet tissue nees

Question 2

What are risk factors for heart failure?

Answer 2

• ischemic heart disease (atherosclerosis, MI)
• hypertension (increases workload of heart)
• diabetes
• metabolic syndrome
• smoking
• valvular disease
• cardiomyopathy
• arrhythmias

Question 3

What are signs and symptoms of left-sided heart failure?

Answer 3

• fatigue
• extra heart sound
• dyspnea
• cough
• crackles on auscultation of lungs
• low SpO2
• oliguria
• decreased cardiac output
• increased heart rate
• arrhythmia
• palpitations
• weak, thready pulses

Question 4

What are signs and symptoms of right-sided heart failure?

Answer 4

• fatigue
• extra heart sound
• JVD
• peripheral edema
• enlargement of liver
• ascites
• anorexia, nausea

Question 5

What tests would help confirm a diagnosis of CHF?

Answer 5

• an echocardiogram to determine the ejection fraction
• a chest x-ray (visualize pulmonary edema) or enlarged heart
• ECG
• stress test
• angiogram
• BNP
• BUN, creatine and GFR may be affected by decreased cardiac output and abdominal organ distension

Question 6

How is CHF managed?

Answer 6

lifestyle modifications:

• decrease sodium
• decrease excessive fluid intake
• quit smoking or alcohol
• oxygen
• angioplasty, bypass or transplant?

drugs:

• ACEI and ARB
• beta blockers
• diuretics
• vasodilators
• positive inotropes (increase contractility and decrease heart rate)
• calcium channel blockers

Question 7

What are some nursing interventions for CHF?

Answer 7

• sit up (decreases venous return to the heart)
• decrease anxiety to decrease sympathetic stimulation of the heart
• edema increases risk for skin breakdown