Rafael Joseph P. Lardizabal Sept.

3, 2020

NCENH06 NDA

HEART
RIDE FAILU
SIDE HEART FAILURE

RISK FACTORS

MODIFIABLE NON-MODIFIABLE

High Blood Pressure. Age

Diabetes Gender
Coronary Artery Disease. Family History
Heart attack Race
Sleep apnea. Viruses.
Life style.
Irregular heartbeats.
Valvular heart disease
congenital heart defects.
Medications
 MEDICAL INTERVENTIONS

MEDICATIONS
ACE Inhibitors A vasodilator that helps lower the blood pressure, improve blood
flow and decrease workload on the heart
Angiotensin II Receptor Are like ACE inhibitors but can be an alternative if patient cannot
Blockers tolerate ACE inhibitors
Beta Blockers This drugs slows heart rate and reduces blood pressure and limits
some damages to your heart
Diuretics This drug will help decrease fluid in your lungs
Aldosterone antagonists These are potassium-sparing diuretics, which also have additional
properties that may help people with severe systolic heart failure
live longer.
Inotropes Are IV medications that are used to people that have severe heart
failure to improve the hurt in pumping blood and in blood
pressure
Digoxin Increases the strength of your heart muscle contractions. It also
tends to slow the heartbeat. This drug reduces heart failure
symptoms in systolic heart failure.

SURGICAL AND MEDICAL

Coronary bypass Surgery
Heart valve repair or replacement
In this procedure, blood vessels from your leg, arm or
chest bypass a blocked artery in your heart to allow
blood to flow through your heart more freely.
Surgeons can also repair the valve by reconnecting
valve leaflets or by removing excess valve tissue so
that the leaflets can close tightly. Sometimes repairing
the valve includes tightening or replacing the ring
around the valve (annuloplasty). Valve replacement is
done when valve repair isn't possible. In valve
replacement surgery, the damaged valve is replaced
by an artificial (prosthetic) valve.

Implantable cardioverter-
defibrillators (ICDs).
Cardiac resynchronization therapy
(CRT), or biventricular pacing
Ventricular assist devices (VADs)
Heart transplant
The ICD monitors the heart rhythm. If the heart starts
beating at a dangerous rhythm, or if your heart stops,
the ICD tries to pace your heart or shock it back into
normal rhythm.
A biventricular pacemaker sends timed electrical
impulses to both of the heart's lower chambers (the
left and right ventricles) so that they pump in a more
efficient, coordinated manner.
Is an implantable mechanical pump that helps pump
blood from the lower chambers of your heart (the
ventricles) to the rest of your body
Heart transplants can improve the survival and quality
of life of some people with severe heart failure
BIOCHEMISTRY

LAB TESTS
Blood tests The doctor may take a blood sample to look for signs of
diseases that can affect the heart
Chest X-ray X-ray images help see the condition of your lungs and heart
and can also be used to diagnose conditions other than heart
failure that may explain your signs and symptoms.
Electrocardiogram (ECG) This test records the electrical ability of your heart through
electrodes attached to your body. This test focuses on the
rhythm of your heart and damage to you heart.
Echocardiogram This test uses sound waves to produce an image of your heart.
This test helps the doctors see the size and shape of your heart
and also its abnormalities. This test measures your ejection
fraction or how your heart pumps that may classify heart
failure.
Stress test Stress tests measure the ability or the health of your heart by
how it responds when doing activities. You may be asked to
walk on a treadmill while attached to an ECG machine, or you
are given an IV drug that will stimulate your heart that is
similar to exercise. Sometimes this test is done while wearing a
mask to see the ability of your heart and lungs to take in
oxygen and breathe out carbon dioxide
Cardiac computerized An X-ray tube inside the machine rotates around your body
tomography (CT) scan and collects images of your heart and chest.
Magnetic resonance Radio waves are broadcast toward these aligned particles,
imaging (MRI) producing signals that create images of your heart.
Coronary angiogram A dye is injected through the catheter and then makes the
arteries supplying your heart visible on an X-ray that’ll help the
doctors see blockage
Myocardial biopsy This test may be performed to diagnose certain types of heart
muscle diseases that cause heart failure
Nursing Diagnoses:
Decreased Cardiac Output
Activity Intolerance
Excess Fluid Volume
Risk for impaired gas exchange
Risk for impaired skin integrity
deficient knowledge
acute pain
ineffective tissue perfusion
hyperthermia
ineffective breathing pattern
ineffective airway clearance
impaired gas exchange
fatigue
risk for decreased cardiac output
fear
anxiety
powerless
Nursing Interventions:
Assess the needs of the patient
Perform thorough physical and mental
examinations
Administer medications as prescribed
Assist in physical mobility
Encourage patient to verbalize problems and
concerns
Encourage to eat healthy foods
Reiterated the importance of exercising to
decrease edema
Reiterated the importance of eating healthy
foods and the importance of sleep and rest
 PATHOPHYSIOLOGY
RIGHT-SIDED HEART FAILURE
INCREASED AFTERLOAD
PLACED ON RIGHT
VENTRICLE
RIGHT-SIDED
VENTRICULAR STRAIN
HEART ATTEMPTS TO MAINTAIN
SYSTOLIC FUNCTION BY INCREASING
PRELOAD IN RIGHT VENTRICLE
THIS COMPENSATION
FAILS IF MYCARDIUM
BECOMES WEAKEND
PRESSURE BUILD UP IN RIGHT
VENTRICLE AND TRAVELS BACK TO
RIGHT ATRIUM
LEADS TO CONGESION OF
SYSTEMIC VASCULATURE
INCREASE JUGULAR
VENOUS DISTENTION
(JVD)
PERIPHERAL EDEMA
DECREASE RIGHT
VENTRICULAR OUTPUT DUE
TO DECOMPENSATION
CAUSES:
-LEFT-SIDED HEART FAILURE
(MOST COMMON)
-RIGHT-SIDED MYOCARDIAL
INFARCTION
-COR PULMONALE
CAN SHIFT INTERVENTRICULAR
SEPTUM TO THE LEFT
DECREASE VENOUS RETURN
TO LEFT SIDE OF HEART
DISTORTS VALVULAR
INCREASE BLOOD VOLUME IN
ARCHITECTURE
RIGHT VENTRICLE CAUSES
HYPERTROPHY
RIGHT VENTRICULAR
HYPERTROPHY DEVELOPS TRICUSPID VALVE INSUFFICIENCY
PULMONARY VALVE INSUFFICIENCY
RIGHT VENTRICULAR DECREASE LEFT-SIDED
HEAVE CARDIAC OUTPUT
HEPATOSPLENOMEGALY
HEPATOJUGULAR REFLEX
PORTAL SYSTEM IS
ASCITES
ESPECIALLY AFFECTED
JAUNDICE
NAUSEA
ANOREXIA CHEST X-RAY ECG:
ELEVATED LIVER FATIGUE
DECREASE RIGHT AXIS DEVIATION
ENZYMES: ANOREXIA
RETROSTERNAL AIRSPACE DEEP S WAVE IN LEAD
AST, ALT, LDH, SHORTNESS OF BREATH
V6
BILIRUBIN LARGE R WAVE IN LEAD
V1
PEAKED P WAVE