- General term used to describe several types of cardiac dysfunction that result in inadequate perfusion of tissues with vital

blood-borne nutrients.

1. SYSTOLIC DYSFUNCTION

2. DIASTOLIC DYSFUNCTION

Also known as Pulomnary Congestion Heart is unable to pump the total volume of blood it receives from the right side of the heart.

Also known as Venous Congestion

Impairs the ability to move deoxygenated blood from the systemic circulation into the pulmonary circulation

R enal disease
A nemia
P ulmonary embolism I nfection (myocarditis, pericarditis) D elivery after pregnancy

F orget to take the meds

A rrythmias I schemia/infarction L ipid aggregation U ncontrolled hypertension R HD E ndocarditits

GENERAL: 2%- 40 to 59 years old 5%- 60 to 69 years old 25% greater among black than white population. PHILIPPINES: 1,521,912 filipinos have CHF 6th leading cause of death affects male more than male

A. LEFT SIDED HEART FAILURE Drinking too much alcohol Heart attack Heart muscle infections High blood pressure Hypothyroidism

Leaking or narrow heart valves

Any other disease that damages the heart muscle Poor left-side heart function due to prior heart attacks

B. RIGHT SIDED HEART FAILURE Persistent left sided heart failure Stenosis/Regurgitation of tricuspid or pulmonic valves Right ventricular infarction

Acute/chronic pulmonary disease: COPD, severe pneumonia, pulmonary embolus

Pulmonary hypertension (Cor Pulmonale)

Left: Dyspnea in the early stages Decreases O2 saturation Increase RR Easy fatigability, weakness and dizziness Orthopnea
Auscultation reveals S3 gallop Pulsusalternans Paroxysmal Nocturnal Dyspnea Cardiac asthma Acute pulmonary edema= lifethreatening since it may progress to shock & death

RIGHT:

 Chest x-ray Echocardiography

Elevated SGPT
Decrease CVP

 ACE inhibitors
Diuretics Digitalis glycosides Angiotensin Receptor Blockers Oxygen Therapy

LEFT VENTRICULAR ASSIST DEVICE

HEART TRANSPLANTATION

CORONARY ARTERY BYPASS GRAFT

CORONARY ANGIOPLASTY

CARDIAC RESYNCHRONIZATION THERAPY

 Ineffective tissue perfusion

Excess fluid volume

Activity intolerance

a. O2 saturation at 99%;

b. capillary refill time of 2 seconds from 4; and

c. absence of cyanosis.

1. Administer oxygen therapy per nasal cannula at 2-6 LPM as ordered. 2. Semi-Fowlers or High-Fowlers position 3. Evaluate ABG analysis results

Oxygen corrects hypoxemia and alleviates clients need for air. To promote greater lung expansion. Any alteration in the ABG components may inidicate sogns of respiratory failure. Respiratory distress and presence of adventitious breath sounds are indicative of pulmonary congestion. It could be indicative of falling arterial pH.

4. Auscultate lung fields at least every 4 hours for crackles and wheezes in dependent lung fields 5. Observe for increased rate of respirations.

a. balance intake and output;

b. stable weight;
c. free from signs of edema; and d. demonstration of behaviors to monitor fluid status.

1.

Administer diuretics as ordered.

Helps rid body fluids and sodium.

2. Set an appropriate rate of fluid intake/ infusion throughout 24 hour period. 3. Weigh daily or on a regular schedule, as indicated. 4. Record intake and output accurately.

To prevent peaks/ valleys in fluid level and thirst.

Provides a comparative baseline and evaluates the effectiveness of diuretic therapy when used.

To determine fluid balance.

5. Place in semi- Fowlers position, as appropriate.

To facilitate movement of diaphragm, thus improving respiratory effort.

a. verbalize relief from fatigue;

b. vital signs within normal range; and

c. able to turn to sides without experiencing dyspnea

1. Assist client with self-care activities as needed

To conserve energy and protect the client from injury

2. Keep supplies and personal articles within easy reach

3. Provide a quiet environment and uninterrupted rest periods 4. Encourage range of motion exercise such as Moving clients arms and legs as far as they can comfortably go in any direction 5. Gradually increase clients level of activity if tolerated well 6. Give client information that provides daily/weekly progress

Articles within reach minimizes clients effort

Restores energy needed for activity and cellular regeneration

A simple exercise can enhance circulation thus improving clients wellness to promote tolerance to certain activities To sustain motivation