C A R E O F PAT I E N T S WI T H C A R D I A C D I S O R D E R S Chapter 19
Learning Objectives Theory 1. Compare left-sided and right-sided heart failure. 2. Discuss treatment of systolic and diastolic heart failure. 3. Describe the nursing assessment specific to the patient who is admitted with congestive heart failure. 4. Identify life-threatening heart rhythms from a selection of cardiac rhythm strips. 5. Describe usual treatment for atrial fibrillation, third-degree heart block, and ventricular tachycardia. 6. State the nursing responsibilities in the administration of cardiac drugs. 7. Describe under what circumstances cardiac surgery is appropriate treatment. 8. Discuss the nurse’s role in caring for patients with heart disorders in the long- term care facility or the home. 9. Develop a teaching plan with dietary recommendations for heart disease. Clinical Practice 10. Develop a plan of care for a patient who has heart failure. 11. Perform a basic physical assessment on a patient who has a mitral valve stenosis and dysrhythmia. 12. Use the nursing process to care for assigned patients who have cardiovascular disorders. 13. Safely administer medications for patients with cardiac disorders. 14. Provide support to patients undergoing diagnostic testing and treatment for cardiac disorders. 15. Develop a teaching plan for patients with newly implanted pacemaker or implantable cardiac defibrillator.
Why is heart failure a problem? Heart failure is a complication of other cardiovascular conditions, rather than a disease itselfAffects 5 million Americans670,000 diagnosed each yearHalf of pts diagnosed with HF die within 5 years
Etiology of Heart Failure Coronary artery disease and uncontrolled HTN! Infection of the muscle Anemia Dilation from blood backup behind stenosed valves Damaged myocardial tissue Usually a result of a MI (myocardial infarction) Toxins Cocaine, excessive alcohol, NSAIDs
Pathophysiology of Heart Failure Key words – Congestion and increased pressure Develops b/c heart unable to move blood as quickly as it should D/t heart muscle weakness or atherso/arterio-sclerosis Vessels cannot handle normal supply of blood, heart becomes exhausted d/t increased pressure (pumping resistance) Valve problems may cause dilation of chambers Right-sided heart failure or left-sided heart failure (Know Table 19-2 pg 426)
Left vs. Right and I don’t mean politics Can be classified as either right sided or left sided HF Left sided typically occurs first Left ventricle unable to pump effectively blood backup in the Left atrium lungs This eventually can lead to blood back in right side How?
Left vs. Right cont.If right ventricle becomes weakened, it will not empty properly (same as left sided)Caused by chronic pulmonary diseaseSlows blood flowBacks up into the vena cava and the peripheral circulation Leads to increased pressure in the ventriclesThen fluid from intravascular compartment leaks into interstitial spaceProduces retention of fluid and edemaWhen the right side fails, first evident in lower extremities causing pitting edema
Left vs. Right cont.
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- Fall '19
- right ventricle, Heart block, Heart failure