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a state of circulatory congestion produced by myocardial dysfunction the inability of the heart to pump blood towards the systemic circulation.
Is
Types:
Left
Right
Types:
Right
Left
Types:
Right
Left
Types:
Right
Left
Types:
Right
Left
Types:
Right
Left
Types:
Right
Left
Types:
Right
Left
Pulmonary edema / congestion Dyspnea Paroxysmal nocturnal dyspnea Orthopnea Blood tinged frothy sputum Rales / crackles Bronchial wheezing Cyanosis Anorexia and body malaise
Venous congestion Neck / jugular vein distention Pitting edema Ascites Weight gain Hepatosplenomegaly Jaundice Pruritus / urticaria Esophageal varices Anorexia and body malaise
DIAGNOSIS
Collaborative Management:
Digitalis
therapy -
myocardial contractility = CO (N = 3-6 L/m) 3assess heart rate before administration monitor serum potassium digitalis toxicity:
Nausea Anorexia Vomiting Diarrhea Xanthopsia
Diuretic
therapy
to decrease cardiac workload assess signs of HYPOkalemia give potassium supplements / potassium rich foods diuretics used in treatment of CHF
Thiazides
Chlorothiazide (Diuril) Diuril)
Loop diuretics
Furosemide (Lasix) Lasix)
Potassium
sparing
Vasodilators
to decrease afterload by decreasing resistance to ventricular emptying most commonly used drugs:
Hydralazine (Apresoline) Apresoline) Nifedepine (Ca channel blocker w/ vasodilator effect) Captopril (vasodilator effect)
Diet
Sodium restricted
Oxygen
therapy
Nursing Management
Provide
oxygenation Semi-Fowler s or High-Fowler s position SemiHigh Provide meticulous skin care Weigh patient daily, assess pitting edema, measure abdominal girth daily & notify AP Monitor V/S, I & O, Breath sounds Institute BLOODLESS PHLEBOTOMY Health teaching
BLOODLESS PHLEBOTOMY
Rotating
tourniquet / BP cuff Three extremeties are occluded Rotate clockwise every 15 mins Perform neurovascular check distal to the tournequet application:
Skin color, temperature, pulse, presence of numbness/tingling
To