Congestive Heart Failure Slide

1. Congestive Heart Failure

2. Definition
What Is Heart Failure?
• Heart failure does not mean the heart has stopped working. Rather, it
means that the heart's pumping power is weaker than normal. With
heart failure, blood moves through the heart and body at a slower
rate, and pressure in the heart increases. As a result, the heart cannot
pump enough oxygen and nutrients to meet the body's needs. The
chambers of the heart may respond by stretching to hold
more blood to pump through the body or by becoming stiff and
thickened. This helps to keep the blood moving, but the heart muscle
walls may eventually weaken and become unable to pump as
efficiently. As a result, the kidneys may respond by causing the body
to retain fluid (water) and salt. If fluid builds up in the arms,
legs, ankles, feet, lungs, or other organs, the body becomes
congested, and congestive heart failure is the term used to describe
the condition.

3. Cause
• What Causes Heart Failure?
• Heart failure is caused by many conditions that damage the heart muscle,
including:
• Coronary artery disease. Coronary artery disease (CAD), a disease of
the arteries that supply blood and oxygen to the heart, causes decreased blood
flow to the heart muscle. If the arteries become blocked or severely narrowed, the
heart becomes starved for oxygen and nutrients.
• Heart attack. A heart attack occurs when a coronary artery becomes suddenly
blocked, stopping the flow of blood to the heart muscle. A heart attack damages
the heart muscle, resulting in a scarred area that does not function properly.
• Cardiomyopathy. Damage to the heart muscle from causes other than artery or
blood flow problems, such as from infections or alcohol or drug abuse.
• Conditions that overwork the heart. Conditions including high blood
pressure, valve disease, thyroid disease, kidney disease,diabetes, or heart defects
present at birth can all cause heart failure. In addition, heart failure can occur
when several diseases or conditions are present at once.

4. Risk Factors
Non-Modifiable
• Age
• Family History
• Heart Valve Disease
Modifiable
• Diet
• Poorly Controlled High
Blood Pressure
• High Cholesterol
• Diabetes
• Smoking
• Alcohol and Drug abuse
• Weight
• Sleep Apnea

5. Symptoms
Sign or Symptom People with Heart Failure May Experience... Why It Happens
Shortness of breath (also
called dyspnea)
...breathlessness during activity (most commonly),
at rest, or while sleeping, which may come on
suddenly and wake you up. You often have
difficulty breathing while lying flat and may need
to prop up the upper body and head on two pillows.
You often complain of waking up tired or feeling
anxious and restless.
Blood "backs up" in the pulmonary veins (the
vessels that return blood from the lungs to the
heart) because the heart can't keep up with the
supply. This causes fluid to leak into the lungs.
Persistent coughing or
wheezing
...coughing that produces white or pink blood-
tinged mucus.
Fluid builds up in the lungs (see above).
Buildup of excess fluid
in body tissues (edema)
...swelling in the feet, ankles, legs or abdomen or
weight gain. You may find that your shoes feel
tight.
As blood flow out of the heart slows, blood
returning to the heart through the veins backs up,
causing fluid to build up in the tissues. The kidneys
are less able to dispose of sodium and water, also
causing fluid retention in the tissues.
Tiredness, fatigue ...a tired feeling all the time and difficulty with
everyday activities, such as shopping, climbing
stairs, carrying groceries or walking.
The heart can't pump enough blood to meet the
needs of body tissues. The body diverts blood away
from less vital organs, particularly muscles in the
limbs, and sends it to the heart and brain.
Lack of appetite, nausea ...a feeling of being full or sick to your stomach. The digestive system receives less blood, causing
problems with digestion.
Confusion, impaired
thinking
...memory loss and feelings of disorientation. A
caregiver or relative may notice this first.
Changing levels of certain substances in the blood,
such as sodium, can cause confusion.
Increased heart rate ...heart palpitations, which feel like your heart is
racing or throbbing.
To "make up for" the loss in pumping capacity, the
heart beats faster.

6. Prevention & Treatement
Lifestyle Changes
• Quitting Smoking
• Losing or maintaining your weight
• Tracking Daily Fluid intake
• Avoiding Alcohol
• Avoiding or limiting Caffeine intake
• Eating a Heart-Healthy Diet
• Being physically active
• Managing stress
• Keeping Track of your symptoms
• Monitoring BP
• Getting adequate rest
• Developing Support
• Avoiding Flu and Pneumonia w/
Vaccination
• Following heart patient guidelines for
sexual activity
• Selecting appropriate clothing
Treatment
Meds:
• Anticoagulants (Warfarin)
• AntiPlatelets (Aspirin)
• Ace Inhibitors (Captopril)
• Angiotensin II Receptor blockers
(Losartan, Micardis)
• Beta Blockers (Atenolol)
• Combined Alpha & Beta Blockers
(Carvedilol)
• Calcium Channel Block
(Amlodipine)
• Digitalis (Lanoxin/Digoxin)
• Diuretics (Furosemide)
• Vasodilators (Isordil)
Surgery:
• Percutaneous Coronary Intervention
(PCI)
• Coronary Artery Bypass
• Heart Transplant

7. Continuation
Implanted Medical Devices
For Heart Failure
• Valve Replacement
• Defibrillator Implantation
• Left Ventricular Assist
Device (LVAD)
• Cardiac Resynchronization
Therapy (CRT)
Physical Changes to Report
• Rapid weight gain
• Shortness of breath
• Increase swelling of lower limbs
• Swelling of or pain in the abdomen
• Trouble Sleeping
• Frequent dry, hacking cough
• Loss of appetite
• Increase fatigue or feeling tired all
the time
Psychological Changes:
• Feelings of Sadness or Depression

8. Heart Failure Stages &
Functional Classifications

10. Nursing Care Plans
1. Decreased Cardiac Output
2. Excessive Fluid Volume
3. Acute Pain
4. Ineffective Tissue Perfusion
5. Hyperthermia
6. Ineffective Breathing Pattern
7. Activity Intolerance
8. Ineffective Airway Clearance
9. Impaired Gas Exchange
10. Fatigue

11. End …