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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?
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List one surgical management option for congestive heart failure.
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What lifestyle change should be recommended to a patient to help manage CHF?
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What are the effects of excessive sodium intake on a patient with CHF?
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Why is it important to monitor for signs of respiratory distress in CHF patients?
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Hypertension is defined as a systolic blood pressure greater than or equal to 150 mm Hg.
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Primary hypertension accounts for 90% to 95% of all hypertension cases.
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Elevated sugar levels can be a complication of persistent high blood pressure.
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Drug therapy is always recommended for individuals diagnosed with prehypertension.
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Hypertensive retinopathy is a complication associated with high blood pressure.
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Secondary hypertension makes up more than 10% of all cases of hypertension in adults.
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The treatment goal for hypertension is to lower BP to less than 140 mm Hg systolic for all patients.
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Hypertensive cardiomyopathy can lead to heart failure.
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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
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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.
