Congestive Heart Failure (CHF) Overview

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Questions and Answers

Name two diagnostic tests used to evaluate congestive heart failure.

Chest radiography and ECG

What is the primary cause of congestive heart failure (CHF) in the first three years of life?

Congenital Heart Disease (CHD)

What is a primary nursing diagnosis for a patient with CHF?

Decreased cardiac output

How does the use of diuretics benefit a patient with CHF?

Diuretics reduce venous and systemic congestion. Signup and view all the answers

List one surgical management option for congestive heart failure.

Coronary bypass surgery Signup and view all the answers

What lifestyle change should be recommended to a patient to help manage CHF?

Low-sodium diet Signup and view all the answers

What are the effects of excessive sodium intake on a patient with CHF?

It can exacerbate fluid retention and worsen heart failure symptoms. Signup and view all the answers

Why is it important to monitor for signs of respiratory distress in CHF patients?

Respiratory distress can indicate worsening heart failure and pulmonary congestion. Signup and view all the answers

Hypertension is defined as a systolic blood pressure greater than or equal to 150 mm Hg.

False Signup and view all the answers

Primary hypertension accounts for 90% to 95% of all hypertension cases.

True Signup and view all the answers

Elevated sugar levels can be a complication of persistent high blood pressure.

True Signup and view all the answers

Drug therapy is always recommended for individuals diagnosed with prehypertension.

False Signup and view all the answers

Hypertensive retinopathy is a complication associated with high blood pressure.

True Signup and view all the answers

Secondary hypertension makes up more than 10% of all cases of hypertension in adults.

False Signup and view all the answers

The treatment goal for hypertension is to lower BP to less than 140 mm Hg systolic for all patients.

False Signup and view all the answers

Hypertensive cardiomyopathy can lead to heart failure.

True Signup and view all the answers

Study Notes

Congestive Heart Failure (CHF)

Congenital Heart Disease (CHD) is the primary cause of CHF in children under 3 years of age.
Other common causes of CHF include cardiomyopathies, arrhythmias, hypertension, pulmonary embolism, chronic lung disease, severe hemorrhage, anemia, adverse effects of anesthesia or surgery, adverse effects of transfusions or infusions, increased body demands due to fever or infection, adverse effects of drugs like doxorubicin, severe physical or emotional stress, and excessive sodium intake.

Diagnostic Evaluation

Chest radiography reveals cardiomegaly and pulmonary congestion.
Complete blood count (CBC) indicates dilution hyponatremia, hypochloremia, and hyperkalemia.
Electrocardiogram (ECG) shows ventricular hypertrophy.

Medical Management

Treat the underlying cause of CHF.
Control fluid and sodium retention to reduce preload.
Increase myocardial contractility.
Decrease cardiac workload.
Reduce pulmonary and systemic venous congestion.

Surgical Management

Coronary bypass surgery is a surgical option for treating CHF.
Percutaneous transluminal coronary angioplasty (PTCA) uses a balloon-tipped catheter to enlarge narrowed coronary arteries.
Other innovative therapies like mechanical assist devices and transplantation are used as needed.

Pharmacologic Intervention

Antiarrhythmias enhance cardiac performance.
Diuretics alleviate venous and systemic congestion.
Iron and folic acid supplements support nutritional status.

Nursing Interventions

Monitor for signs of respiratory distress and altered cardiac output.
Evaluate fluid status.
Administer medications according to prescription.
Prevent infection.
Reduce cardiac demands.
Promote a low-sodium diet and adequate nutrition.

Hypertension

Definition: Persistent high blood pressure (BP), defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg, or current use of antihypertensive medication.
Relationship with cardiovascular disease (CVD): Direct relationship between hypertension and CVD.
Contributing factors: Cardiovascular risk factors, socioeconomic conditions, and ethnic differences.
Symptom: Often asymptomatic
Most important modifiable risk factor: Stroke

Complications

Brain:
- Cerebrovascular accident (strokes)
- Hypertensive encephalopathy: confusion, headache, convulsion
Blood:
- Elevated sugar levels
Retina of eye:
- Hypertensive retinopathy
Heart:
- Myocardial infarction (heart attack)
- Hypertensive cardiomyopathy: heart failure
Kidneys:
- Hypertensive nephropathy: chronic renal failure

Etiology

Primary hypertension: Elevated BP without an identified cause, accounts for 90-95% of cases.
Secondary hypertension: Elevated BP with a specific cause, accounts for 5-10% of cases.

Classification of Blood Pressure

Optimal: SBP < 120 mm Hg, DBP < 80 mm Hg
Pre-hypertensive: SBP 120-139 mm Hg, DBP 80-89 mm Hg.
Hypertensive: SBP ≥ 140 mm Hg, DBP ≥ 90 mm Hg
- Stage 1: SBP 140-159 mm Hg, DBP 90-99 mm Hg
- Stage 2: SBP ≥ 160 mm Hg, DBP ≥ 100 mm Hg

Drug Therapy

Prehypertension: Drug therapy not typically recommended unless another condition exists, such as diabetes mellitus or chronic kidney disease.
Mechanism of action:
- Decreasing blood volume
- Reducing systemic vascular resistance (SVR).

Nursing and Collaborative Management

Treatment goals: Lower BP to < 140 mm Hg systolic and < 90 mm Hg diastolic for most people with hypertension.
Treatment goals for people with diabetes mellitus and chronic kidney disease: Lower BP to < 130 mm Hg systolic and < 80 mm Hg diastolic.

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Description

This quiz covers essential aspects of Congestive Heart Failure (CHF), including its causes, diagnostic evaluation methods, and medical management strategies. Learn about the significant factors contributing to CHF and how to identify and treat this condition effectively.