CONGESTIVE HEART

FAILURE
GROUP MEMBERS

 NAJEELA AMRUDDIN
 ANUM NOORUDDIN
 FAIZAN RAFIQUE
 FAIZ ALI
 SAINILA
 SHAHZEB
 IMTIAZ
 OSAMA YOUSUFZAI
 GUL SABAH
OBJECTIVES

 By the end of this presentation students will be able to understand

about conjestive heart failure.
 Causitive factors, pathophysiology, manifestation.
 Health assessment related to heart failure.
 Nursing diagnoses and nursing interventions
 Pharmacological and non pharmacological treatments
 Diagnostic tests
 CASE PRESENTATION

A 53-year-old man who had sustained previous inferior and

anterior myocardial infarctions presented with gradually
increasing fatigue and edema despite increasing diuretic
therapy. On examination he had dependent edema to the
mid-thigh and basal fine crepitation. He had a resting
tachycardia of 105 beats min−1 in sinus rhythm. Mitral and
tricuspid regurgitation were evident and the supine blood
pressure was low at 95/48 mmHg. Laboratory investigation
revealed reduced serum sodium (125 mmol l−1) with
impaired renal function (urea 12.8 mmoll−1; creatinine 189
μmol l−1). The chest radiograph showed minimal interstitial
edema, a right sided pleural effusion and marked
cardiomegaly
 CONJESTIVE HEART FAILURE

DEFINITION:

CHF can be defined as a

physiologic state in which the
heart in unable to pump enough
blood to meet the metabloic
needs of the body .
HEALTH ASSESMENT

INSPECTION:
1. Position the patient supine with the head of the bed slightly elevated.
2. 2. General appearance: The healthcare provider will observe the
patient's overall appearance, including their level of consciousness, skin
color, and breathing rate.
3. 3.Inspection of the chest: asses chest rise and fall, assess if any
deformities present.
4. 4. Assess for peripheral edema.
PALPATION:
1. The healthcare provider may also use their hands to palpate the patient’s chest and legs to
check for any tenderness, swelling, or abnormal masses..
2. Palpate capillary refill time (capillary fill time (CFT) - should be <3 seconds.

AUSCULTATION:
Auscultation: The healthcare provider will listen to the patient’s heart and lungs using a
stethoscope to check for any abnormal sounds, such as a heart murmur or crackling
sounds in the lung.
DIAGNOSTIC TEST

 Echocardiography
 Electrocardiogram
ECG
 Blood test
(electrolyte level)
 Chest X ray
NURSING DIAGNOSE

 Impaired gas exchange related to pulmonary edema, as

evidenced by the abnormal breath sound (crackle).
 Activity Intolerance related to an imbalance myocardial oxygen
supply and demand as evidence by alteration in heart rate and
BP.
 Excess fluid volume related to impaired cardiac function, as
evidenced by dependent edema.
 CAUSES OF CHF

• Coronary artery disease

• Myocardial infarction
• Mitral and tricuspid regurgitation
• Cardiomegaly
• Kidney complication
. Over weight, smoke, alcohol
Sign and symptoms

❖ Pulmonary edema
❖ Fatigue
❖ Basal fine crepitation
❖ Hypotension
❖ Tachycardia
PATHOPHYSIOLOGY
 PHARMACOLOGICAL TREATMENT

DRUGS DOSAGE Mode of Action indications Side effect/ Adverse

Ionotropic Indicated in hyperkalemia
drugs
125 to Increased the strength condition like thrombocytopenia
DIGOXIN 250 ug of heart contraction. acute left nausea dizziness
abocain 24 hourly ventricular
abbutol failure,fibrillation,
heart failure.
Ototoxicity,
Diuretics hypokalemia,
20mg to It increase the urination Oligurea,Oedema deafnes, drowsiness
Furosemi 80 mg and decrease the hypertension, thirst, rashes
de 24 hourly amount of water renal failure
retained in body. pulmonary
edema. Hypotension cough
ACE dizziness and
inhibitors 2.5mg to Stop the conversion of Used for headache
5mg OD angiotensin ! To symptomatic
Vasotec Depend angiotensin 2 which heart failure
on cause vasoconstriction usually with
patient and raised blood diauretics.
condition preassure
NON PHARMACOLOGICAL TREATMENT

 Lifestyle modifications: The patient may be advised to make changes in their

lifestyle to improve their heart function. limiting alcohol consumption, smoking and
increasing physical activity…
 Weight management: Maintaining a healthy weight is important in reduce heart
failure. The patient may be advised to weigh themselves regularly and report any
significant weight gain or loss to their healthcare provider.
 Regular exercise: Exercise can help to improve heart function and reduce
symptoms of heart failure. The patient may be advised to start with low-intensity
exercise and gradually increase the duration and intensity of their workouts. A
cardiac rehabilitation program may be recommended to help the patient safely
increase their activity level.
 Stress reduction: Stress can contribute to heart failure symptoms. The patient may
be advised to practice stress-reduction techniques such as deep breathing,
meditation, or yoga
 Monitoring: Regular monitoring of symptoms, blood pressure, weight, and fluid
intake is important in managing heart failure. The patient may be advised to
keep a record of their symptoms and report any changes to their healthcare
provider. The patient may also be advised to monitor their blood pressure at
home and report any significant changes.
 Sleep apnea treatment: Sleep apnea is a common condition in patients with
heart failure and can worsen symptoms. The patient may be advised to
undergo a sleep study and use a continuous positive airway pressure (CPAP)
machine if necessary.
 Smoking cessation: Smoking can worsen heart failure symptoms and increase
the risk of further cardiac events. The patient may be advised to quit smoking
and may be offered smoking cessation resources and support
 NURSING INTERVENTIONS

 Monitor BP, Temperature.

 Administer prescribed medications.
 Monitor fluid intake and output
 Monitor oxygen saturation.
 Motivate the patient.
 Encourage to change life style
 Restrict fluids
 Monitor ECG and xray changes
 Monitor weight