Name : ______________________ Date: ________

Section: _____________________

Activity 3
HEART FAILURE

Matching. Identify the type of ventricular heart failure with its associated pathophysiology. Write only
the letter.

1. Left-sided heart failure

2. Right-sided heart failure

1. ______ Fatigability
2. ______ Dependent edema
3. ______ Pulmonary congestion predominates
4. ______ Distended neck veins’
5. ______ Ascites
6. ______ Dyspnea from fluid in alveoli
7. ______ Orthopnea
8. ______ Hepatomegaly
9. ______ Cough that may be blood-tinged
10. ______ Nocturia

Case Study

 Patient Profile: Mang Tomas is a 63-year-old man who has a history of hypertension, chronic HF,
and sleep apnea. He has been smoking two packs of cigarettes a day for 40 years and has
refused to quit. Three days ago he had an onset of flu with fever, pharyngitis, and malaise. He
has not taken his antihypertensive medications or his medications to control his HF for 4 days.
Today he has been admitted to the hospital intensive care area with Acute Decompensated
Heart Failure (ADHF).

 Subjective Data
 Is very anxious and asks, “Am I going to die?”
 Denies pain but says that he feels like he cannot get enough air
 Says that his heart feels like it is “running away”
 After being weighed, he reports, “That is more than I usually weigh.”
 Reports that he is so exhausted he can’t eat or drink by himself
  Objective Data
 Height: 5 ft, 10 in (175 cm)
 Weight: 210 lb (95.5 kg)
 Vital signs: Temp 99.6°F (37.6°C), HR 118 bpm and irregular, RR 34, BP 90/58
 Cardiovascular: Distant S1 , S2 ; S3 , S4 present; PMI at sixth ICS and faint; bilateral
jugular vein distention; all peripheral pulses are 1+ and there is peripheral edema; initial
cardiac monitoring indicates atrial fibrillation with a ventricular rate of 132 bpm
 Respiratory: Pulmonary crackles, decreased breath sounds right lower lobe, coughing
frothy blood-tinged sputum; SpO2 82% on room air
 Gastrointestinal: Bowel sounds present; hepatomegaly 4 cm below costal margin
 Laboratory work and diagnostic testing are scheduled

Critical Questions:

1. What signs and symptoms of right-sided and left-sided heart failure is Mang Tomas
experiencing?

2. What priority nursing interventions are appropriate for Mang Tomas at the time of his
admission?

3. What diagnostic procedures and findings would help to establish a diagnosis of ADHF with
pulmonary edema?

4. What monitoring will be used to evaluate Mang Tomas condition?

5. The physician mentions the possibility of inserting a pacemaker called cardiac resynchronization
therapy (CRT). Mang Tomas asks the nurse what CRT is. What response would be appropriate
from the nurse?
6. What information should be included in Mang Tomas discharge teaching?

7. Based on the assessment data presented, what are the priority nursing diagnoses for Mang
Tomas? Are there any collaborative problems?