CHF Teaching
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Part II Diseases Cardiovascular Diseases Client Teaching Guides for Home Health Care, 2nd ed. © 2008 Jones and Bartlett Publishers, Inc. www.jbpub.com Congestive Heart Failure 4 I. The client/caregiver can define congestive heart failure. A. The heart is unable to pump sufficient blood to meet the body’s metabolic needs. B. Heart failure describes the accumulation of blood and fluids in organs and tissues as a result impaired heart function. C. Heart failure is classified as acute or chronic and right sided or left sided. II. The client/caregiver can briefly describe the anatomy and physiology of the heart. A. The heart consists of four chambers: the right and left ventricles and the right and left atria. B. The upper chambers, the atria, receive the blood from various parts of the body and pump it into the ventricles. C. The right ventricle pumps blood into the lungs, and the left ventricle pumps blood into all parts of the body. D. The primary reason for heart failure or decreased cardiac output is damage to muscular wall of the heart. III. The client/caregiver can list factors that may increase risk. A. Myocardial infarction B. Coronary artery disease C. Hypertension D. Congenital heart defects E. Obesity F. Aging G. Diabetes mellitus IV. The client/caregiver can recognize the signs and symptoms. A. Left-sided failure produces hypoxemia and respiratory symptoms 1. Fatigue with activity 2. Effort at breathing when active (exertional dyspnea) 3. Inability to breathe unless sitting upright (orthopnea) 4. Awakening at night by breathlessness (paroxysmal nocturnal dyspnea) 5. Elevated blood pressure 6. Productive cough with pink, frothy sputum 7. Decreased urine output 8. In acute situation, pulmonary edema develops demonstrated by sudden hypoxic, restlessness, and confusion 9. Elevated blood pressure B. Right-sided failure 1. Gradual unexplained weight gain from fluid retention 2. Dependent pitting edema in feet and ankles 3. Fluids retention in sacral area or abdomen (ascites) 4. Loss of appetite and/or nausea 5. Dyspnea as a result of enlarged abdomen V. The client/caregiver can report measures to prevent congestive heart failure. A. Lifestyle changes include stress reduction and energy conservation. B. Schedule rest periods to reduce fatigue and dyspnea. C. Follow the diet or any fluid restrictions prescribed by physician. D. Take medication exactly as prescribed. E. Avoid tobacco and alcohol. F. Weigh daily at the same time of day using the same scale. Notify physician if a more than 2-pound gain in 24 hours is identified. G. Measure pulse rate and blood pressure daily. Report a heart rate that is less than 60 beats per minute or more than 120 beats per minute. H. Elevate legs while sitting. I. Avoid extreme heat, cold, or humidity. J. Keep follow-up appointments with physician and have laboratory work obtained as ordered. Patient name: ____________________________________________ Admission: ________________________ NRS DATE INITIAL NRS DATE INITIAL (Continued)
Transcript of CHF Teaching
Part II Diseases Cardiovascular Diseases
Client Teaching Guides for Home Health Care, 2nd ed. © 2008 Jones and Bartlett Publishers, Inc. www.jbpub.com
Congestive Heart Failure4
I. The client/caregiver can define congestiveheart failure.
A. The heart is unable to pump sufficientblood to meet the body’s metabolicneeds.
B. Heart failure describes the accumulation ofblood and fluids in organs and tissues as aresult impaired heart function.
C. Heart failure is classified as acute orchronic and right sided or left sided.
II. The client/caregiver can briefly describe theanatomy and physiology of the heart.
A. The heart consists of four chambers: theright and left ventricles and the right andleft atria.
B. The upper chambers, the atria, receive theblood from various parts of the body andpump it into the ventricles.
C. The right ventricle pumps blood into thelungs, and the left ventricle pumps bloodinto all parts of the body.
D. The primary reason for heart failure ordecreased cardiac output is damage tomuscular wall of the heart.
III. The client/caregiver can list factors thatmay increase risk.
A. Myocardial infarctionB. Coronary artery diseaseC. HypertensionD. Congenital heart defectsE. ObesityF. AgingG. Diabetes mellitus
IV. The client/caregiver can recognize the signsand symptoms.
A. Left-sided failure produces hypoxemia andrespiratory symptoms1. Fatigue with activity2. Effort at breathing when active
(exertional dyspnea)
3. Inability to breathe unless sittingupright (orthopnea)
4. Awakening at night by breathlessness(paroxysmal nocturnal dyspnea)
5. Elevated blood pressure6. Productive cough with pink, frothy
sputum7. Decreased urine output8. In acute situation, pulmonary edema
develops demonstrated by suddenhypoxic, restlessness, and confusion
9. Elevated blood pressureB. Right-sided failure
1. Gradual unexplained weight gain fromfluid retention
2. Dependent pitting edema in feet andankles
3. Fluids retention in sacral area orabdomen (ascites)
4. Loss of appetite and/or nausea5. Dyspnea as a result of enlarged
abdomen
V. The client/caregiver can report measures toprevent congestive heart failure.
A. Lifestyle changes include stress reductionand energy conservation.
B. Schedule rest periods to reduce fatigue anddyspnea.
C. Follow the diet or any fluid restrictionsprescribed by physician.
D. Take medication exactly as prescribed.E. Avoid tobacco and alcohol.F. Weigh daily at the same time of day using
the same scale. Notify physician if a morethan 2-pound gain in 24 hours is identified.
G. Measure pulse rate and blood pressuredaily. Report a heart rate that is less than60 beats per minute or more than 120beats per minute.
H. Elevate legs while sitting.I. Avoid extreme heat, cold, or humidity.J. Keep follow-up appointments with
physician and have laboratory workobtained as ordered.
Patient name: ____________________________________________ Admission: ________________________NRS
DATE INITIALNRS
DATE INITIAL
(Continued)
VI. The client/caregiver can demonstrateunderstanding of nutritional issues relatedto congestive heart disease (refer toNutrition and Cardiovascular Disease).
VII. The client/caregiver can list possiblecomplications of congestive heart disease.
A. Acute pulmonary edemaB. Damage to organs such as liver, kidney, or
brainC. PneumoniaD. Electrolyte imbalance related to diuretic
therapyE. Need for oxygen therapy
RESOURCESAmerican Heart Associationwww.americanheart.org
National Heart, Lung, and Blood Institute (NHLBI)www.nhlbi.nih.gov
REFERENCESAckley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis
handbook: A guide to planning care. Philadelphia: Mosby Inc.Cohen, B. J., & Wood, D. L. (2000). Memmler’s the human body
in health and disease (9th ed.). Philadelphia: LippincottWilliams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott,Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002).Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals ofnursing. Philadelphia: Lippincott Williams & Wilkins
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. LippincottWilliams & Wilkins.
Part II Diseases Cardiovascular Diseases
Client Teaching Guides for Home Health Care, 2nd ed. © 2008 Jones and Bartlett Publishers, Inc. www.jbpub.com
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