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NCLEX Review Notes:

NCLEX Review on Cardiac Diseases: Heart Failure

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- It is an insufficiency and the inability of the pumping ability of the heart.

LEFT SIDED HEART

- Failure of the left side of the heart to pump enough blood to meet the metabolic demands of the body.

  • THERE IS AN IMPAIRED OXYGENATION AND A DECREASE IN MYOCARDIAL WORKLOAD IN THE HEART.

ASSESSMENT FINDINGS in patients with Left Sided heart failure.

  • CRACKLES
  • DYSPNEA
  • GALLOP RHYTHM: S3, S4

NCLEX Review on Heart Failure Cont.

What we would usually find in patient with left sided heart failure  is that there is an INCREASE IN PULMONARY CONGESTION and there would be a left ventricular hypertrophy.
MANAGEMENT

  • LOW SODIUM DIET
  • SEMI FOWLERS POSITION ON PT.
  • WEIGHT PATIENT DAILY
  • ADMINISTER IV, OXYGEN AND MEDS AS ORDERED.
  • MONITOR VITALS, I/O

RIGHT SIDED FAILURE

- Failure of the right side of the heart to pump enough blood to meet the metabolic demands of the body.
Causes:

  • LEFT SIDED HEART FAILURE
  • COPD
  • ATHEROSCLEROSIS
  • PULMONARY HYPERTENSION

Assessment:

  • JUGULAR VEIN DISTENTION
  • DEPENDENT EDEMA
  • WEIGHT EDEMA

Diagnostic Procedures:

  • B- Type Natriuretic Peptide (BNP)  Levels= Elevated
  • ABG’s indicates hyposemia and hypercapnia.
  • Hemodynamic Monitor= Increase CVP

TREATMENT:

  • Oxygen Therapy
  • Paracentesis
  • Thoracentesis

Drug Therapy:

  • Cardiac Glycoside (Digoxin) Lanoxin
  • Inotropic Agents (Dopamine, Dobutamine)
  • Diuretics: Furosemide (Lasix)
  • Human BNP: (Nesiritide (Natrecor)

Interventions:

  • Keep Ct. in semi- fowlers position to increase chest expansion
  • Assess cardiovascular status and vital signs
  • Weigh the client daily: A weight gain of 1 to 2 lbs. indicates fluid gain.
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