Presentation on theme: "Congestive heart failure"— Presentation transcript:
1Congestive heart failure Dr. Walaa NasrLecturer of Adult NursingSecond year
2Congestive heart failure outlinesDefinitionCauses and pathophysiologyTypes of heart failureCompensatory mechanism of heart failureClinical manifestationsClassification of heart failureDiagnostic evaluationMedical managementNursing management
3Congestive heart failure Definition Heart failure describes the clinical syndrome that develops when the heart cannot maintain an adequate cardiac output. The heart pumps blood inadequately, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and other changes that may further weaken the heart.
4Causes of congestive heart failure Coronary artery diseaseHeart attackHigh blood pressureHeart valves disordersInflammation of Heart muscle (myocarditis, cardiomyopathy)
8Congestive heart failure Compensatory Mechanisms of heart failure Renin-angiotensin-aldosterone systemSympathetic nervous systemEnlargement of the muscular walls of the ventricles (ventricular hypertrophy).
9Congestive heart failure Clinical manifestations Symptoms (back up of blood and fluid)DyspneaOrthopneaReduced exercise tolerance, lethargy, fatigueNocturnal coughWheezeAnkle swellingAnorexia
10Congestive heart failure Clinical manifestations ( cont…) SignsCachexia and muscle wastingTachycardiaPulsus alternansElevated jugular venous pressureCrepitations or wheezeThird heart soundOedemaHepatomegaly (tender)Ascites
11Congestive heart failure Classification of heart failure New York Heart Association (NYHA) Functional ClassificationSymptoms% of patientsClassNo symptoms or limitations in ordinary physical activity35%IMild symptoms and slight limitation during ordinary activityIIMarked limitation in activity even during minimal activity. Comfortable only at rest25%IIISevere limitation. Experiences symptoms even at rest5%IV
12Congestive heart failure Diagnostic evaluation Patient historyPhysical examinationDiagnostic studiesElectrocardiography (ejection fraction)Radionuclidemagnetic resonancecomputed tomography imagingcardiac catheterization with angiographya biopsy of heart muscle is needed
15Congestive heart failure Treatment (cont…) Potassium-sparing diureticsThiazide and thiazide-like diureticsAnticoagulants (heparine)Opioids (morphine) to relieve anxietyPositive inotropic drugs (drugs that make muscle contract more forcefully) (dopamine)Oxygen for pulmonary edema is required
18Nursing care of patients with congestive heart failure Maintain the patient in high fowler's positionElevate extremities except when the patient is in acute distressFrequently monitor vital signsChange position frequentlyMonitor intake and output and daily weight
19Nursing care of patients with congestive heart failure (cont…) Restrict fluids as orderedTeach the patient and family and provide emotional support (life style change)Explain the side effect of diuretic medications for additional actions ( side effects of diuretics include electrolyte imbalance, symptomatic hypotensionUse aseptic procedures when caring for invasive lines