Wait 2 hours after eating for physical activity Avoid activities in extreme hot

Wait 2 hours after eating for physical activity avoid

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Wait 2 hours after eating for physical activity Avoid activities in extreme hot, cold, or humid weather Modify activities to conserve energy Positioning; elevation of the HOB to facilitate breathing and rest, support of arms Fluid Volume Excess Assessment for symptoms of fluid overload Daily weight I&O Diuretic therapy- in AM!!!; timing of meds- check Potassium levels especially w/ loop diuretic Fluid intake; fluid restriction Maintenance of sodium restriction Patient Teaching Medications Diet: low-sodium diet and fluid restriction Monitoring for signs of excess fluid, hypotension, and symptoms of disease exacerbation, including daily weight (gain more than 2-3 lbs a day (call physician or take extra Lasix) and more than 5 lbs in a week) Exercise and activity program Stress management Prevention of infection Know how and when to contact health care provider
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Include family in teaching Medications/Role of Nurse Reduce preload and afterload Improve stroke volume Increase cardiac muscle contractility Non-Pharm Treatment Role of the patient Education CPAP AICD (implantable cardiac defibrillator) Biventricular pacing – pacing both ventricles helps to reproduces normal ventricular contraction; helps prevent remodeling Ventricular assist device (VAD)- can’t do ADL’s would be good for them; usually on list for transplant Acute HF or Pulmonary Edema o acute event that results from LV failure o may already be diagnosed w/ chronic may be from MI too o S/S Frothy, blood-tinged sputum pt is literally drowning in their own secretions emergency Wheezes Coughing Crackles and wheezes Increased heart rate Agitation and confusion Pale and possible cyanosis RR > 30; accessory muscle use O2 sat is significantly decreased o Goals Improve LV function by decreasing volume Decrease preload Decrease afterload Improve gas exchange and oxygenation Decrease anxiety o Management First thing you want to do as a nurse if pt is SOB, tachypnic, etc sit them upright w/ legs dangling (fluid traps in legs and doesn’t go back to heart) start O2 Prevent easier to prevent than treat in early stages, it may be alleviated by placing pt upright with feet and legs dependent, eliminating overexertion, and minimizing emotional stress to reduce the LV load Early recognition: monitor lung sounds and for signs of decreased activity tolerance and increased fluid retention Place patient upright and dangle legs Minimize exertion and stress Oxygen face mask used initially may need ventilator monitored via pulse-ox and ABGs Medications
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Morphine – vasodilator, reduces anxiety and helps relax Diuretic: furosemide – causes vasodilation and pooling of blood in peripheral blood vessels, which reduces the amount of blood returned to the heart o Furosemide No more than 10-20mg per minute IV (if given too fast, can cause ototoxicity) Check potassium level Vasodilators Nursing Interventions Administration of loop diuretics (Lasix, Bumex) Foley Catheter to measure UOP IVF’s IV NTG
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  • Fall '16
  • coronary artery, pulmonary artery

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