Intensifying Our Knowledge In

“INTENSIFYING OUR KNOWLEDGE IN CARDIOVASCULAR DESEASES” March 12, 2008 OLFU

CHRONIC HEART FAILURE (CONGESTIVE HEART FAILURE)

INABILITY OF THE HEART

TO PUMP SUFFICIENT BLOOD TO MEET THE NEEDS OF THE TISSUES FOR O2 AND NUTRIENTS.

CHRONC HEART FAILURE (U.S.)

AT LEAST 5 MILLIONS PEOPLE IN U.S. AND 550,000 CASES ARE DIAGNOSED EACH YEAR (AMERICAN HEART ASSOCIATIONS) AHA 2004. IT CAN AFFECT ALL AGES MOST COMMON REASON FOR HOSPITALIZATIONOF PEOPLE OLDER THAN 65 YRS OF AGE.

TYPES OF CHF

SYSTOLIC HEART FAILURE -WEAKENED HEART MUSCLE -COMMON TYPE IS AN ALTERATION IN VENTICULAR CONTRACTION DIASTOLIC HEART FAILURE -LESS COMMON ALTERATION -CHARACTERIZED BY STIFF AND NONCOMPLAINT HEART MUSCLE

CLINICAL MANIFESTATION : DYSPNEA (difficulty in breathing) PAROXYMAL NOCTURNAL DYSPNEA (dyspnea attack at night) SHORTNESS OF BREATHING ORTHOPNEA (absence of breathing) COUGH OLIGURIA (decreased or absent production of urine )

ASCITES (is an accumulation of fluid in the peritoneal cavity )

EDEMA ANOREXIA

CLASSIFIED ACCORDING IN SYMTOMS:

NEW YORK HEART ASSOCIATION (NYHA) CLASSIFICARION OF CHRONIS HEART FAILURE

CLASSIFICATIO N

SYMPTOMS

PROGNOSIS

-ORDINARY PHYSICAL ACTIVITY DOES NOT CAUSE UNDUE FATIGUE , DYSPNEA , PALPITATION OR CHEST PAIN

I

-PATIENT IS CONSIDERED ASYMPTOMATIC -USUALLY NO LIMITATION OF ACTIVITY OF DAILY LIVING (ADL’s)

GOOD

CLASSIFICATIO N

SYMPTOMS

PROGNOSIS

-SLIGHT

LIMITATION (ADL’s)

-PATIENT REPORTS

II

NO SYMPTOMS AT REST , BUT INCREASE PHYSICAL ACTIVITY WILL CAUSE SYMPTOMS

GOOD

CLASSIFICATIO N

SYMPTOMS

PROGNOSIS

-MARKED

LIMITATION ADL

-PATIENT FEELS

III

COMFORTABLE AT REST BUT LESS THAN ORDINARY ACTIVITY WILL CAUSE SYMPTOMS

FAIR

CLASSIFICATIO N

SYMPTOMS

PROGNOSIS

-SYMPTOMS ARE

CARDIAC INSUFFICIENT AT REST

IV

POOR

DIAGNOSTIC FINDINGS:

ECHOCARDIOGRAM X-RAY BUN (blood urea nitrogen)

MEDICAL MANAGEMENT: -TO REVIVE THE PATIENT SYMPTOMS -TO IMPROVE FUNCTION STATUS AND QUALITY OF LIFE AND EXTEND SURVIVAL -BASED ON SEVERITY OF THE CAUSE

PHARMACOLOGIC MANAGEMENT:

ACE INHIBITORS -BENAPRIL (LOTENSIL) -CATOPRIL (CAPOTEN) BETA BLOCKERS DUIRETICS DIGITALIS

NUTRITIONAL THERAPY:

DECREASE SODIUM 2/3g DAY AVIODANCE OF EXCESSIVE FLUIDS

NURSING MANAGEMENT:

ASSESS FOR SYMPTOM OF FLUID

OVERLOAD ADFMISTERING MEDICATIONS AND ASSESSING THE PX RESPONSE RO PHARMACOLOGIC REGIMEN ASSESS FLUID BALANCE INCLUDING INATAKE AND OUTPUT

WEIGHT PX DAILY AT SAME TIME

SAME SCALE AUSCULTATING LUNG SOUNDS TO DETECT INCREASE AND DECREASE PULMONARY CRACKELS MONITORING PULSE RATE AND BP.CHECK FOR POSTURAL HYPOTENTION DUE TO DEHYDRATION

MONITORING AND MANAGING POTENTIAL COMPLICATION

HYPOTENSION MUSCLE WEAKNES HYPOKALEMIA DIMINISHED TENDON

REFLEXES RISK FOR DYSRYTHMIAS

THANK YOU… MARIEL A. DELACRUZ BSN 3-J OLFU