CCM for heart failure

Complications History

Vascular compromise A 50 years old male came to

Pathophysiology
ward with concept
Clinical pain in chest radiating
map of CHF
Aortic dissection to left side having difficulty in Heart Failure may present acutely as a
Renal ischemia from breathing with peripheral result of myocardial ischemia
malposition cyanosis. Patient vital sign secondary to a MI. The weakened
cardiac muscle causes the CO to
Shock Weak pulses
decrease. The decreasing cardiac
High blood pressure output then triggers in increased in
systemic vascular resistance and after
load, which only further decreases the
CO. Eventually the heart is unable to
Treatment effectively push against the
increasedafterload and fluid begins to
 The first priority of treatment is airway flow back through the pulmonary veins
management. This is judged by the and fills the lungs. In CHF with acute
severity of the presenting symptoms. pulmonary edema this will be the
Could include supplemental oxygen via terminal event if the systemic vascular
 nasal cannula or mask, noninvasive resistance is not promptly reversed.
ventilation or in this patient’s case
Congestive heart
 Endotracheal intubation. Sign and symptoms
failure
 Urinary catheter should be placed to
closely monitor renal function and allow  Fatigue
patient to rest.  Weakness
 A 12-lead ECG to assess for cardiac  SOB
abnormalities.  Distended neck veins
 IV access to provide prompt medication  Dizziness
administration.  Decreased exercise
 Frequent vital sign assessments to tolerance
monitor for a decline in cardiac function  Anxiety
 Syncope

Intervention
Diagnosis
 Continually assess for signs and symptoms of precipitating
heart failure.  Decreased Cardiac Output
 Monitor for signs of bleeding due to anticoagulation and  Risk for ineffective coping
blood thinning therapies.  PC: Pulmonary Embolism
 Try to find underlying cause and treat the cause.  Risk for infection
 Monitor ST segment continuously to determine changes in  Ineffective tissue
myocardial tissue perfusion. perfusion
 Assess that urine output hourly, alert physician if less than  Acute pain
30 ml/hr.  Impaired gas exchange
 Maintain the patient in the semi-fowlers position to lessen  Impaired verbal
the work of breathing and facilitate venous return. communication
 Continuously monitor O2 and assess vital signs.