Understanding Heart Failure: Causes, Symptoms, and Nursing Care, Study notes of Global studies

Download Understanding Heart Failure: Causes, Symptoms, and Nursing Care and more Study notes Global studies in PDF only on Docsity! What is Heart Failure? Heart failure (HF) or Congestive Heart Failure (CHF) is a physiologic state in which the heart cannot pump enough blood to meet the body s metabolic needs � following any structural or functional impairment of ventricular filling or ejection of blood. Heart failure results from changes in the systolic or diastolic function of the left ventricle. The heart fails when, because of intrinsic disease or structural, it cannot handle a normal blood volume or, in the absence of disease, cannot tolerate a sudden expansion in blood volume. Heart failure is a progressive and chronic condition managed by significant lifestyle changes and adjunct medical therapy to improve quality of life. Heart failure is caused by various cardiovascular conditions such as chronic hypertension, coronary artery disease, and valvular disease. Heart failure is not a disease itself. Instead, the term refers to a clinical syndrome characterized by manifestations of volume overload, inadequate tissue perfusion, and poor exercise tolerance. Whatever the cause, pump failure results in hypoperfusion of tissues, followed by pulmonary and systemic venous congestion. Clinical Manifestations Heart failure can affect the heart s left side, right side, or both sides. Though, � it usually affects the left side first. The signs and symptoms of heart failure are defined based on which ventricle is affected left-sided heart failure causes a � different set of manifestations than right-sided heart failure. Left-Sided Heart Failure Dyspnea on exertion Pulmonary congestion, pulmonary crackles Cough that is initially dry and nonproductive Frothy sputum that is sometimes blood-tinged Inadequate tissue perfusion Weak, thready pulse Tachycardia Oliguria, nocturia Fatigue Right-Sided Heart Failure Congestion of the viscera and peripheral tissues Edema of the lower extremities Enlargement of the liver (hepatomegaly) Ascites Anorexia, nausea Weakness Weight gain (fluid retention) Because heart failure causes vascular congestion, it is often called congestive heart failure, although most cardiac specialists no longer use it. Other terms used to denote heart failure include chronic heart failure, cardiac decompensation, cardiac insufficiency, and ventricular failure. Nursing Care Plans & Management Nurses greatly influence the outcomes of patients with heart failure through education and monitoring despite high morbidity and mortality rates. Education empowers patients, improving adherence and preventing complications. Vigilant monitoring enables early intervention, reducing risks. Nurses play a crucial role in reducing HF morbidity and mortality. Nursing Problem Priorities The following are the nursing priorities for patients with congestive heart failure: Improve myocardial contractility and perfusion. Enhance heart s pumping � function to ensure adequate blood flow to organs through medications, monitoring vital signs, and optimizing fluid balance. Manage fluid volume. Monitor fluid balance, assess for signs of retention, administer diuretics, monitor weight, and promote adherence to a low-sodium diet. Prevent complications. Monitor for and manage complications such as pulmonary edema, arrhythmias, and thromboembolism through close monitoring, medication administration, and patient education. Promote activity tolerance. Encourage 30 minutes of daily physical activity (as tolerated), collaborate on a schedule, and prioritize activities. Reduce anxiety. Provide comfort, psychological support, and teach anxiety management techniques. Minimize powerlessness. Encourage patient expression of concerns and involve them in decision-making. Provide disease information and prevention education. Educate patients about heart failure, its impact, prognosis, lifestyle modifications, medication adherence, and seeking timely care to prevent worsening of symptoms. Nursing Assessment Nursing assessment for patients with heart failure emphasizes evaluating the efficacy of treatment and the patient s adherence to self-management strategies. � Monitoring and reporting worsening signs and symptoms of heart failure are essential for adjusting therapy. Additionally, the nurse addresses the patient s � emotional well-being, as heart failure is a chronic condition linked to depression and psychosocial concerns Health History Assess the signs and symptoms such as dyspnea, shortness of breath, fatigue, and edema. Assess for sleep disturbances, especially sleep suddenly interrupted by shortness of breath. Explore the patient s understanding of HF, self management strategies, and the � ability and willingness to adhere to those strategies. Physical Examination Auscultate the lungs for presence of crackles and wheezes. Auscultate the heart for the presence of an S3 heart sound. Assess JVD for presence of distention. Evaluate the sensorium and level of consciousness. Assess the dependent parts of the patient s body for perfusion and edema.� Assess the liver for hepatojugular reflux. Measure the urinary output carefully to establish a baseline against which to assess the effectiveness of diuretic therapy. Weigh the patient daily in the hospital or at home. Assess for the following subjective and objective data: Increased heart rate (tachycardia) ECG changes