CONGESTIVE HEART FAILURE
DEFINITION:-
Heart failure is a condition in which the heart's function as Pump is indicated
inadequate to deliever oxygehal blood to the body .
Causes and Risk factors : =
-obesity
-Coronary artery
-Hypertension
-Myocardial Infection ( MI)
-Coronary Artery disease ( CAD)
-kidney failure
.
-Smokeing
Classifications:-
-Left Sided Heart failure
-Right Sided Heart failure .
-Acute and corchronic
-High out Put and Low out Put
Right sided heart failure :-
-Liver and spleen enlargement
-Right upper quadrant abnormal Pain.
-Nausea , vomiting
-slow weight gain
-Irregular heart rhythm .
Left Side heart failure : =
-fatigue and shortness of breath .
-Paroxysmal neetural dyspnea .
-orthothea
.
-Pulmonary edema
-Astma- like wheezing or dry hacking cough .
-wheezing -Pale cor bluish skin .
-Palpitations, irregular heart rhythm
-weakness , Insumia and Restlessness
Clinical Manifestations =
-orthaPena
-Hacking cough
-Nectural dyspnea
Diagnostic Evaluation : .
-Physical examination and History collection
-chest x - xey
-MRI -Blood test Electro Physiology study
-ECG
Medical Management =
-Assessment of the client and History of collection of the client . A number of
medications are prescribed for heart failure and most client will take more than
one drug .
-Medications may Be Prescribed to dilate blood vessels , strengthen
the heart's pumping reduce water and sodium in the body to lessen the heart's
work load .
(1 ) Diuretics : Bumetanide ( Bumex and furosemide ( Lasix ) . )
(2)Angiotensin- converting enzyme ( ACE ) inhibitors : = Ace inhibitors
(enalaPril , lisinopril.captopril) inhibit the adverse effects of angiotensian
2nd (Potent vasoconstriction / sodium retention ).
(3) Angiotensin II receptor blocking (ARBs):-Angiotensin II - receptor
blockers ( Losartan , and valsartan ) similar to Ace inhibitors Used in client
who can not tolerate Ace inhibitors due to cough or angioedema .
(4) Digitalis :-• Positive inotropic agents Digoxin ( Lanoxin ) ]
increase the heart's ability to Pump more effectively by improving the
contractile force of the muscle .
(5) Bita Blockers:- Beta - adrenergic
blockers [ cravedilo ! ( Coreg ) , metoProlol ( Low Pressor ) and bisoprolol
zebeta ) ] decrease myocardial workload and Protect against fatal dysxhythmias
by blocking morett .. nepfixine effects rayocardial workload of the syrthithetic
nervous system .
(6) Aldosterone antagonists : Aldosterone antagonists (
spironolacto e and eplerenone ) decrease sodium setention , sympathetic nervous
system activation and Cardiac remodeling .
(7 ) vasodilator Thearly : =
vasodilator " theary decrease the workload of the heart by dilating . Peripheral
vessels . Nitroglycerin , bydralazin = isosorbide , dinitrate and morphine
sulphate.
Surgical Management:-
.
-coronary angioPlasty -coronary artery by Pass
surgery .
-Implantable cardiac defibrillator ( ICD )
.
-Intra aortic balloonepump (IABP).
-Left ventrialar assist device (LVAD ).
-valve repair or value replacement surgery
- Heart transPlantation
.
-Pace maker insertion .
.
-Cardiac resynchronization thearly (CRT ) or
biventricular Pacing.
Nursing Management:-
-The nurse explain sleep disturbances Perticulary sleep suddently interpted by
Shortness of breath .
-The nurse also asks about the number of Pillows needed
for sleep activitie of daily living and the activity that causes shortness of
breath .
-Assess Peripheral arterial Pullies heart rhythum rate and B.P. -Assess
Patient for Presence of peripheral edema .
-Assess externities for colour andtemperature .
→ Note result of serum electialytes level and other laboratory test
.
-Assess abdomen for hepatomegally and ascites.
NOTE :- TREATMENT ADVISED IN MY BLOG ARE ONLY FOR REFFERENCE FOR STUDY PURPOSE WHICH ARE BASED ON VARIOUS BOOKS .TREATMENT FOR ANY DISEASES
TO BE TAKEN ONLY AFTER CONSULTATION WITH CONSERNED DOCTER .
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