Heart Failure Nursing Cheat Sheet PDF

Heart Failure Patho Nursing Care HF–HEART FAILURE (failure to PUMP forward) DR. BEDS HF–HEAVY FLUID (lungs & body) D–Diet: Low SCC (Sodium, Calories, Ch...

Heart Failure Patho Nursing Care HF–HEART FAILURE (failure to PUMP forward) DR. BEDS HF–HEAVY FLUID (lungs & body) D–Diet: Low SCC (Sodium, Calories, Cholesterol) Low Sodium & Fluid (2L + 2g or LESS/day) Memory Trick: NO OTC meds (Cough or Flu, Antacids or NSAIDS NCLEX TIP S–Sodium Swells NO Canned or packaged foods (chips, sauces, meats, cheeses, W–Weight Gain = Water Gain Crisis! wine) R–Risk for Falls! (Change positions slowly!) B–Blood Pressure & BNP (shoud NOT be increasing) Signs & Symptoms E–Elevate HOB & Legs (with pillows) high fowlers R–RIGHT sided HF L–LEFT sided HF D–Daily Weights and Is and Os (0ver 3 lbs/day or R–ROCKS the BODY with fluid L–LUNG fluid 5 lbs in 7 days) = Worsening! NCLEX TIP Peripheral Edema “Pulmonary Edema” S–Stairs (No sex until able to climb 2 flights of stairs Weight Gain = Water Gain Crackles “rales” that don't clear without dyspnea) Edema (pitting) with cough (NOT rhonchii or wheeze) S–Stocking (TED hose) (decreases blood pooling, remove daily) JVD (big neck veins) Frothy Pink “blood tinged” sputum Abdominal Growth orthopnea–dyspnea while lying flat NEVER massage calves (CHF patients) NCLEX TIP Ascites Hepatomegaly (big liver) Pharmacology Splenomegaly (big spleen) A–ACTS on BP only (not HR) Causes A–ACE (-pril) Lisinopril “chill pril” 1st choice R–RIGHT sided HF L–LEFT sided HF A–ARBS (-sartan) Losartan “relax man” 2nd choice Left sided HF can cause Right HF (weak heart = weak pump) A–Avoid Pregnancy MI (heart attack) A–Angioedema (Airway Risk) *only Ace Pulmonary HTN Ischemic Heart Disease C–Cough *only Ace Fibrotic Lungs “stiff lungs” E–Elevated K+ (normal 3.5-5.0) (CAD, ACS) B–BETA BLOCKERS (-lol) AtenoLOL “LOL = LOW” Treatment Priority Blocks both BP & HR (AVOID Low HR & BP) Caution: HOLD IF: B–Bradycardia (LESS than 60) & BP low (90/60) KEY WORDS: new, sudden, worsening, rapid = only hold if the patient is in an acute exacerbation of CHF Pulmonary Edema CRISIS (Lung Fluid!) B–Breathing problems “wheezing” (Asthma, COPD) B–Bad for Heart Failure patients #1 Furosemide “Body Dried” (drain fluid) B–Blood sugar masking “hides S/S” (Diabetics) H–HOB 45 degrees + (semi fowlers, high fowlers, orthopneic C–CALCIUM CHANNEL BLOCKERS position) Calms BP & HR (AVOID Low HR & BP) O–Oxygen (Nifedipine) P–Push Furosemide + Morphine, Positive inotropes -dipine “declined BP & HR E–End sodium & fluids (Sodium Swells) -amilipine “chill heart” NO drinking fluids + STOP IV fluids D–DIURETICS Drain Fluid D–Drains Fluid “Diurese” “Dried” Diagnostic tests K+ Wasting–Furosemide & Hydrochlorothiazide (caution: Low K+, Eat melons, banana & green leafy) Labs: BNP–”Broken Venticles” K+ Sparing–Spironolactone “Spares potassium” (AVOID Salt Substitues, melons & green leafy) 300+ Mild 600+ Moderate 900+ SEVERE HF D–DILATORS (Vasodilators) Echo Nitroglycerin, Isosorbide Ejection Fraction 40% or LESS is HF! (normal-55-70%) Nitroglycerin “Nitro = Pillow for heart” LVH–Left Ventricular Hypertrophy Caution: NO Viagra “-afil” Slidenafil = DEATH! Nitro drip: STOP = Systolic BP below 90 or 30 mmHg Drop Hemodynamic Monitor “Swan Ganz" (Pulmonary artery catheter) Adverse effect: CVP (norm: 2-8) Over 8 = NOT GREAT HA= side effect Low BP= adverse effect (SLOW position changes) Risk Factors D–DIGOXIN (Inotropic) Digs for a DEEP contraction #1 risk factor is HTN Increased contractility ECG Dysrhythmias (Atrial Fibrillation) Apical Pulse x 1 minute Valvular Malfunction (mitral valve regurgitation) Toxicity (over 2.0) Vision changes, N/V TEST TIP Cardiomyopathy Potassium 3.5 or less (higher r/f toxicity) Notes