Heart failure is the inability of the heart to maintain adequate cardiac output to meet the metabolic needs of the body because of impaired pumping ability.

1. CONGESTIVE HEART FAILURE
By: Rhoda Layugan

2. CONGESTIVE HEART FAILURE
• Heart failure is the inability of the heart to
maintain adequate cardiac output to meet
the metabolic needs of the body because
of impaired pumping ability.

3. • Diminished cardiac output results in
inadequate peripheral tissue perfusion.
• Congestion of the lungs and periphery
may occur; the client can develop acute
pulmonary edema.

4. RESEARCH

5. CLASSIFICATION
• Acute heart failure occurs suddenly.
• Chronic heart failure develops over time;
however, a client with chronic heart failure
can develop an acute episode.

6. TYPES OF HEART FAILURE
Right ventricular failure, left ventricular failure
• Because the 2 ventricles of the heart represent 2 separate pumping systems, it is
possible for
• 1 to fail alone for a short period.
• Most heart failure begins with left ventricular failure and progresses to failure of
both
• ventricles.
• Acute pulmonary edema, a medical emergency, results from left ventricular
failure.
• If pulmonary edema is not treated, death will occur from suffocation because the
client literally drowns in his or her own fluids.

7. • Forward failure, backward failure
• In forward failure, an inadequate output of
• the affected ventricle causes decreased perfusion to vital organs.
• In backward failure, blood backs up behind the affected ventricle,
causing increased pressure in the atrium behind the affected
ventricle.

8. Low output, high output
•In low-output failure, not enough cardiac output is
available to meet the demands of the body.
•High-output failure occurs when a condition causes the
heart to work harder to meet the demands of the body.

9. Systolic failure, diastolic failure
•Systolic failure leads to problems with con-
•traction and ejection of blood.
•Diastolic failure leads to problems with the
•heart relaxing and filling with blood.

10. COMPENSATORY
MECHANISM
• Compensatory mechanisms act to restore
cardiac output to near-normal levels.
• Initially, these mechanisms increase
cardiac output; however, they eventually
have a damaging effect on pump action.

12. • Compensatory mechanisms contribute to
an increase in myocardial oxygen
consumption; when this occurs,
myocardial reserve is exhausted and
clinical manifestations of heart failure
develop.

13. • Compensatory mechanisms include
increased heart rate, improved stroke
volume, arterial vasoconstriction, sodium
and water retention, and myocardial
hypertrophy.

15. PULMONARY EDEMA

18. INTERVENTIONS
• Assist the client to identify precipitating risk factors of heart failure
and methods of eliminating these risk factors.
• Encourage the client to verbalize feelings about the lifestyle
changes required as a result of the heart failure.
• Instruct the client in the prescribed medication regimen, which may
include digoxin, a diuretic, ACE inhibitors, low-dose beta blockers,
and vasodilators.

19. • Advise the client to notify the HCP if side effects occur from the
medications.
• Advise the client to avoid over-the-counter medications.
• Instruct the client to contact the HCP if he or she is unable to take
medications because of illness.
• Instruct the client to avoid large amounts of caffeine, found in coffee,
tea, cocoa, chocolate, and some carbonated beverages.

20. • Instruct the client about the prescribed low-sodium, low-fat, and low-
cholesterol diet.
• Provide the client with a list of potassium-rich foods because
diuretics can cause hypokalemia (except for potassium-retaining
diuretics).
• Instruct the client regarding fluid restriction, if prescribed, advising
the client to spread the fluid out during the day and to suck on hard
candy to reduce thirst.

21. • Instruct the client to balance periods of activity
• and rest.
• Advise the client to avoid isometric activities,
• which increase pressure in the heart.
• Instruct the client to monitor daily weight.
• Instruct the client to report signs of fluid retention such as edema or
weight gain.

22. THANK YOU!

23. Reference:
• Med-Surg 2017
• NCLEX 2016
• Udan Med-Surg