block_3.1_review

block_3.1_review - Congestive Heart Failure o Reduced...

Info iconThis preview shows pages 1–4. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: Congestive Heart Failure o Reduced stroke volume causes an overload of fluid in the bodys tissues Presents as edema Pulmonary, peripheral, sacral or peritoneal edema o Acute CHF Pulmonary edem Pulmonary hypertension Myocardial infarction Cardiomegaly (enlargement of the heart) Left and right ventricular failure o Signs and Symptoms Will cough up clear or pink-tinged sputum Labored breathing Especially upon exertion Changes in skin color in arms, face, chest, and back Mottling OPQRST Progressive or acute SOB Paroxysmal nocturnal dyspnea Progressive accumulation of edema or weight gain over a short time Mild chest pain and generalized weakness o Usually due to underlying cardiac problem o May be due to weakened myocardial muscle mass, myocardial ischemia, or current MI Medications Loop diuretic o Lasix or Bumex o Hypertension meds Digoxin (Lanoxin) o Increases hearts contractile force Oxygen dependent o Home O2 Medication compliance o Also report herbal meds and meds borrowed from someone else Altered level of consciousness (or unconsciousness) Indicates pending respiratory failure Breathing Labored, dyspnea, and productive cough Tripod position PND = pillow orthopnea o Ask, Do you use pillows at night o More pillows = worse problem o Skin Pallor, diaphoresis, mottling, or signs of cyanosis Peripheral pulses o Quality and rhythm Check for edema o Lower extremities o Can obliterate distal pulses o Check for pitting o Sacral edema = bed-bound pts. o Ascites = abdominal cavity edema Difficult to assess w/o x-ray or ultrasound Blood pressure o May be elevated Attempt to compensate for low cardiac output o Decompensating Can have normal BP that drops suddenly Pulmonary edema o Most serious complication o Can quickly lead to respiratory failure o Serum fluid in the alveoli inhibits oxygen exchange in the lungs Hypoxia ensues o Tachypnea o Adventitious lung sounds o Crackles (rales) at bases of the lungs o Rhonci fluid in the larger airways of the lungs Sign of severe pulmonary edema o Wheezes sign of lungs protective mechansisms Bronchioles contrict attempting to keep additional fluid from entering the lungs Called cardiac asthma Consider wheezes in geriatric pts. to be CHF until proven otherwise Pulsus paradoxus o Systolic BP drops more that 10 mmHg with inspiration o Due to compression of the great vessels or the ventricles Pulsus alternans o Pulse alternates between weak and strong o JVD Apical pulse o May be abnormal or difficult to auscultate because of abnormalities such as bulges in the heart, displaced apex or severe pulmonary edema Late stages o Frothy sputum with coughing o Cyanosis o Treatment High flow oxygen Positive pressure ventilation Demand valve or BVM in unresponsive Fluids IV TKO Minidrip to avoid accidental infusion of excessive fluids...
View Full Document

Page1 / 27

block_3.1_review - Congestive Heart Failure o Reduced...

This preview shows document pages 1 - 4. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online