HEART FAILURE AND NURSING MANAGEMENT

The heart pumps out blood that supplies the body with oxygen and nutrients. Heart failure is a condition where the heart cannot pump enough blood to the rest of the body. This results in a reduction in blood supply to the different organs in the body. It can be caused by factors such as

• rheumatic fever
• bacterial endocarditis
• anemia
• and valvular defects to name a few

Some symptoms of heart failure are: shortness of breath on exertion or with activity, cough, swelling of the feet, stomach area and ankles, tiredness, loss of appetite and frequently urinating at night.

Nursing Diagnoses for Heart Failure

After assessing a patient with heart failure, the nurse may come across one or more symptoms of this disorder such as shortness of breath. The nurse formulates nursing diagnoses based on the symptoms the patient displays. Some nursing diagnoses for heart failure are:

• decreased cardiac output related to decreased myocardial contractility
• fatigue due to poor oxygenation
• altered tissue perfusion related to insufficient blood flow
• impaired gas exchange related to lung congestion
• and fluid volume excess related to compensatory mechanisms of heart failure

Nursing Interventions for Decreased Cardiac Output

Decreased cardiac output refers to low blood supply in the body because the heart is not contracting efficiently enough to push blood to the rest of the body. The nurse nurse administers medication that increase the contractility of the heart as ordered by a physician. Some of these medications are digoxin, inotropic agents like dobutamine and dopamine and diuretics. Other nursing interventions for heart failure include administering diuretics and weighing the patient.

Nursing Interventions for Fatigue due to Heart Failure

fatigue occurs when the cells in the body are inadequately oxygenated. This occurs when blood supply through the body is reduced. Nursing interventions for fatigue are:

• placing items often used by the patient close by so that they dont have to exert themselves to reach such items.
• using slow progression during the patients daily activity to avoid sudden exertion.
• teach the patient how to use environmental aids such as hand rails, chairs in the bathroom or bedside commode to avoid getting tired.
• teach the patient energy conserving practices like sitting down to perform tasks and pushing instead of pulling.

Nursing Interventions for Altered Tissue perfusion and Impaired Gas Exchange

Altered tissue perfusion describes a situation where the cells do not receive enough oxygen therefore the tissues where they are located are oxygen deprived and at risk for injury. Gas exchange occurs in the lungs and in heart failure, the lungs may become congested with blood and this reduces it's ability to absorb oxygen. The nurse can do a few things to address these problems like:

• administering oxygen as ordered to increase tissue oxygenation
• elevating the head of the patients bed to alleviate lung congestion
• inspecting the patients skin for wounds and instituting pressure ulcer precautions
• raising the side rails of the bed to prevent falls incase the patient gets confused due to hypoxia-- reduced oxygen in the brain.

Nusing interventions for the other nursing diagnoses related to heart failure include restricting fluids as ordered by a physician, to prevent or address excess fluid volume in the patient's body. The patient should also be taught to avoid high sodium intake by not eating processed and cooked foods with a lot of salt in them. The expected outcome of the nursing interventions for this condition is that the patient's level of fatigue is reduced therefore, the patient can perform activities of daily living and other lifestyle activities the patient engages in.

References:

Read more at Suite101: Heart Failure and Nursing Management: Nursing Management Of A Congestive Heart Failure Patient http://heart-disease-treatment.suite101.com/article.cfm/heart-failure-and-nursing-management#ixzz0mBQaZKYn