NCLEX Review & Nursing School

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.