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HEART FAILURE

– 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

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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