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CHF (Patho (Primary causes (CAD, Cardiomyopathy, HTN, Congenital heart…
CHF
Patho
Precipitating causes
Dysrhythmias: decrease CO and increase workload and O2
Hypervolemia: increase preload causing volume overload on RV
Anemia: decrease O2 carrying capacity
Left sided
Fluid backs up into the pulmonary system
The left ventricle cannot empty properly during systole, or fill adequately during diastole
Primary causes
CAD
Cardiomyopathy
HTN
Congenital heart defects
Systole failure
Inability of the heart ti pump efficiently
Decreased ejection fraction
Right sided
Fluid backs up into venous system
RV fails, can't pump efficiently
Diastolic failure
Inability of ventricles to relax and fill during diastole
Nursing diagnosis
Risk for impaired gas exchange
Activity intolerance
Excess fluid volume
Risk for impaired skin integrity
Decreased cardiac output
Deficient knowledge
Risk factors
CAD
Diabetes
HTN
Advanced age
Tobacco use
Vascular disease
Management
PT/OT
Dietitian consult
Drug therapy
LVAD
O2 therapy
Patient Teaching
Diet/Exercise
Low sodium/Fluid restrictions
Rest
Health promotion
Drug therapy
Ongoing monitoring
Meds
Diuretics
Decrease fluid volume, preload, venous return
ACE inhibitors
Dilate venules and arterioles, improve renal blood flow
Beta blockers
Decrease afterload, promote reverse remodeling
Labs/Diagnostics
EF: 55%-60% norm, patients with CHF: <45%
BNP
Source:
Lewis, S. M., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical-surgical nursing: Assessment and management of clinicalproblems (10th ed.). St. Louis, MO: Elsevier.