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Friday, April 17, 2009

Nursing Care Plans for Congestive Heart Failure CHF

Nursing Care Plans for Congestive Heart Failure CHF, Congestive Heart Failure CHF is the inability of the heart to pump blood in sufficient amount to meet the needs of the network nutrient and oxygen. The fundamental mechanism of heart failure including the nature of the damage contractile from the heart, leading to less pump sufficient blood from the normal heart. General conditions that underlie including atherosclerosis, atrial hypertension, and infections diseases or degenerative heart muscle. A number of systemic factors and can support the development of the illness of heart failure. Increased metabolic rate (for example: fever, coma, tiroktoksikosis), and anemia hypoxia need an increase in sufficient blood pump to meet the needs of the heart of oxygen
For many patients, the symptoms of heart failure restrict the ability to perform activities of daily living, severely affecting quality of life. Advances in diagnostic and therapeutic techniques have greatly improved the outlook for these patients, but the prognosis still depends on the underlying cause and its response to treatment.

Causes Congestive Heart Failure CHF
Heart failure frequently results from a primary abnormality of the heart muscle that impairs ventricular function to the point that the heart can no longer pump sufficient blood
In addition, certain conditions can predispose the patient to heart failure, particularly if he has an underlying heart disease. These include:

  • Arrhythmias such as tachyarrhythmia, which can reduce ventricular filling time; bradycardia, which can reduce cardiac output; and arrhythmias that disrupt the normal atrial and ventricular filling synchrony
  • pregnancy and thyrotoxicosis, because of the increased demand for cardiac output
  • pulmonary embolism, because it elevates pulmonary arterial pressures that can cause right-sided heart failure
  • infections, because increased metabolic demands further burden the heart
  • anemia, because to meet the oxygen needs of the tissues, cardiac output must increase
  • increased physical activity, emotional stress, increased salt or water intake, or failure to comply with the prescribed treatment regimen for the underlying heart disease .


Complications
Pulmonary congestion can lead to pulmonary edema
Myocardial infarction

Assessment Nursing Care Plans for Congestive Heart Failure CHF

  1. shortness of breath, which in early stages occurs during activity and in late stages also occurs at rest
  2. dyspnea worsens at night
  3. peripheral edema
  4. increasing fatigue, weakness, insomnia, anorexia, nausea, and a sense of abdominal fullness (particularly if he has right-sided heart failure).
  5. pulse rate is rapid, and an alternating pulse may be present
  6. Hepatomegaly and, possibly, splenomegaly also may be present
  7. Percussion reveals dullness over lung
  8. Heart auscultation may disclose an S3 and S4
  9. Lung auscultation reveals moist, bibasilar crackles

Diagnostic Care Plans for Congestive Heart Failure CHF

  • Electrocardiography
  • Chest X-rays
  • Echocardiography
  • Cardiopulmonary exercise testing determines oxygen consumption and severity of heart failure

Diagnosis Nursing Care Plans for Congestive Heart Failure CHF

  • Activity intolerance
  • Decreased cardiac output
  • Excess fluid volume
  • Fatigue
  • Imbalanced nutrition: Less than body requirements
  • Impaired gas exchange
  • Ineffective airway clearance
  • Ineffective breathing pattern
  • Ineffective tissue perfusion: Cardiopulmonary

Outcomes Nursing Care Plans for Congestive Heart Failure CHF
Patient will:

  1. carry out activities of daily living without excess fatigue or decreased energy
  2. Develop no complications of fluid volume excess
  3. verbalize the importance of balancing activities with adequate rest periods
  4. identify foods high in potassium.
  5. maintain adequate ventilation and oxygenation
  6. maintain patent airway.
  7. respiratory rate within five breaths of baseline.
  8. maintain hemodynamic stability
  9. maintain adequate cardiac output.

Nursing interventions Nursing Care Plans for Congestive Heart Failure CHF

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