what to report immediately on chf patient

Talk with your provider about symptoms to report Heart failure requires you and your caregivers to pay close attention to any changes in symptoms. If you notice something new, or a sudden worsening of a current symptom, notify your healthcare professional immediately.

Full Answer

What do patients need to know about CHF?

Like any other illness or chronic disease, patients need to have a basic understanding of CHF including the signs and symptoms, the co-morbid diseases, the reasons to manage symptoms, what and when to report to healthcare providers to avoid exacerbation and possible hospitalization and how to improve their outcomes and quality of life.

What should I talk to my doctor about my heart failure symptoms?

Talk with your provider about symptoms to report. Rapid weight gain — Ask your doctor about the amount of weight gain you should report to him or her. It’s so important for people with heart failure to weigh themselves every day – preferably every morning, before breakfast and after urinating.

Is a prompt nursing assessment Key to a quick diagnosis of CHF?

However, "a prompt nursing assessment was a key component to a quick diagnosis of CHF" for this patient, reports Caroline Lynn, BSN, RN, FNE, SANE, shift coordinator for the ED.

What is the nursing care plan for congestive heart failure (CHF)?

Nursing Care Plan for Congestive Heart Failure (CHF) 1 Pathophysiology. The heart fails to pump effectively, causing decreased perfusion forward of the failure and fluid back behind the failure. 2 Etiology. ... 3 Desired Outcome 4 Congestive Heart Failure (CHF) Nursing Care Plan. ... 5 Nursing Interventions and Rationales. ...

What do you report with CHF?

Physical Changes to Report for Heart FailureRapid weight gain — Ask your doctor about the amount of weight gain you should report to him or her. ... Shortness of breath while at rest, not related to exercise or exertion.Increased swelling of the lower limbs (legs or ankles)Swelling of or pain in the abdomen.More items...•

Which of the following heart failure should be reported immediately?

Call 911 if you experience the following symptoms: Chest discomfort or pain that lasts more than 15 minutes (that is not relieved with rest or nitroglycerin) Severe or persistent shortness of breath. Fainting or passing out.

What are priority assessments for CHF?

Assessment of CHF:Vital Signs. Baseline vital signs are important here as well as for our other assessments, including an apical pulse; history is also important.Cardiovascular. Assess heart rhythm, and strength of the heartbeat. ... Respiratory. Assess lung sounds for congestion, rales.General Medical.

What should be monitored in heart failure?

Your doctor can listen to your lungs for signs of fluid buildup (lung congestion) and your heart for whooshing sounds (murmurs) that may suggest heart failure. The doctor may examine the veins in your neck and check for fluid buildup in your abdomen and legs.

How do you monitor CHF?

5 Devices to Monitor CHFPAP. A pulmonary artery (PA) pressure monitoring device is implanted in the pulmonary artery within the heart. ... LAP. A left atrial pressure (LAP) monitoring device are other monitors that can be implanted into the heart. ... Smartwatches. ... Pacemaker. ... Defibrillator.

What should a patient with heart disease be instructed to do?

Rest as needed. Stop activity if you develop symptoms such as chest pain, lightheadedness, or significant shortness of breath. Find activities that you enjoy, such as brisk walking, dancing, swimming, or gardening. These will help you stay active and strengthen your heart.

What are nursing priorities for CHF?

Nursing Priorities Reduce fluid volume overload. Prevent complications. Provide information about disease/prognosis, therapy needs, and prevention of recurrences.

What is the immediate nursing action when a patient with congestive cardiac failure complains of shortness of breath?

Immediate interventions Obtaining a room air pulse oximetry, administering supplemental oxygen as needed, obtaining IV access to offload the fluid overload, obtaining baseline lab work, and administering diuretics. These things should all be done immediately for a CHF patient, says Swailes.

What are nursing interventions for CHF?

Nursing InterventionMaintain strict fluid intake and output measurements.Monitor daily weights.Assess for edema and severe diaphoresis.Monitor electrolyte values and hematocrit level.Maintain strict fluid restrictions as prescribed.

What labs are elevated with CHF?

Tests for 2 kinds of natriuretic peptides are currently available for the diagnosis of heart failure: BNP (B-type natriuretic peptide) and pro-BNP (N-terminal pro–B-type natriuretic peptide). Blood levels of both of these substances become elevated in patients with congestive heart failure.

How do you monitor heart problems?

AdvertisementElectrocardiogram (ECG or EKG). An ECG is a quick and painless test that records the electrical signals in your heart. ... Holter monitoring. ... Echocardiogram. ... Stress test. ... Cardiac catheterization. ... Cardiac computerized tomography (CT) scan. ... Cardiac magnetic resonance imaging (MRI).

How does CHF affect vital signs?

This decrease in cardiac output, the amount of blood that the heart pumps, is not adequate to circulate the blood returning to the heart from the body and lungs, causing the fluid (mainly water) to leak from capillary blood vessels. This leads to symptoms that may include shortness of breath, weakness, and swelling.

What is Congestive Heart Failure (CHF)?

Congestive heart failure (also known as CHF) is a chronic progressive condition that affects the pumping power of the heart muscles. In patients with CHF, fluid builds up around the heart, limiting its ability to pump efficiently. Left untreated, CHF can lead to serious health problems, even death.

What causes CHF?

According to the Mayo Clinic, there are 5 main things that can lead to heart failure.

How many people in Europe have heart failure?

FACT: Currently up to 14 million people in Europe ( and nearly 6 million Americans) have heart failure and this number is rising all the time.

How many people are diagnosed with heart disease every year?

Every year, roughly 670,000 Americans are diagnosed with heart disease – that’s more than one a minute. In the time it takes you to read this article, half a dozen individuals will have experienced a major shift in their quality of life. Heart disease is the leading cause of hospitalization in people over 65, and the #1 killer ...

Can heart failure worsen over time?

Well, the first thing to note is that the symptoms of heart failure exist on a spectrum that can run from mild to moderate to severe. Symptoms can come and go and worsen over time , making CHF difficult to diagnose, but here are some of the most common things to look for, according to the American Heart Association.

Is heart failure a normal aging process?

Heart failure is a normal consequence of getting old. MYTH: Although most people with heart failure are elderly, heart failure is not necessarily a part of the aging process. In fact, CHF is a serious cardiovascular condition that can be prevented and greatly helped with available treatments.

Is it important to exercise with heart failure?

However, it is also important to not overdo it. The right amount of exercise can help to improve blood flow and alleviate symptoms .

Causes

Heart failure typically occurs as a result of something else (i.e. another condition/disease or possibly a medication) having already damaged the heart muscle.

Signs and Symptoms

Patients with heart failure can display a variety of symptoms including:

Complications

If heart failure is left untreated it can cause additional complications for the patient including:

Treatment

Since heart failure is a chronic condition it will require lifetime treatment. First form of treatment is aimed at identifying any potential contributing factors and treating those (i.e. repairing a heart valve if possible). Many times, patients require multiple medications to management this condition.

Stages of Heart Failure

There are various stages defined as classes of heart failure dependent on the symptoms the patient is experiencing. These stages along with the associated symptoms are listed below.

Prevention

Prevention is incredibly important and patients should receive proper education on how to prevent heart failure.

The Nursing Process

Nurses play a pivotal role not only in treating patients with heart failure but educating them on lifestyle modifications to prevent disease progression or complications.

What is it called when both sides of the heart fail?

Heart failure can be left-sided, right-sided, or both. When both sides are failing, it is called congestive heart failure (CHF). Heart failure is measured by ejection fraction. Normally functioning hearts have an ejection ...

What diuretic is used for congestive heart failure?

Most commonly used diuretics in congestive heart failure are loop and sometimes thiazides are used with loop diuretics: Furosemide: Loop. Bumetanide: Loop. Hydrochlorothiazide: Thiazide.

Can heart failure be caused by a virus?

contribute to heart failure occurring. If the CHF is acute, it may have been caused by a virus, infection , or blood clot.

Can atria quiver cause heart failure?

Patients may also have Atrial Fibrillation – a condition in which the atria quiver instead of contracting – this can lead to the development of heart failure.

Can fluid cause shortness of breath?

Fluid can back up into the lungs and cause shortness of breath, especially upon exertion. Be careful about laying these patients flat as you can put them in respiratory distress. Place the patient on O2 as needed to help them keep their O2 levels adequate – usually above 92% or as ordered by the provider.

What causes CHF?

Contributing factors include chronic lung disease, coronary artery disease, genetic or inherited diseases such muscular dystrophy, HTN, regurgitant valvular decease, cardiac rate or rhythm disease such as bradycardia, alcohol abuse, myocardial damage due to toxins or drug abuse, and viral infections. Other conditions such as obesity, anemia, renal disease, COPD and diabetes especially with co-morbid cardiac disease that are not well-managed can contribute to cardiac disorders and lead to CHF .

What is CHF in medical terms?

Acute versus chronic CHF are the most widely used and understood terms. CHF is a progressive disease characterized by declining cardiac function. This decline adversely affects quality of life. Most people don’t know they have CHF initially.

What are the symptoms of sudden increase in weight?

Remind patients to comply. The sudden increase in any symptoms such as weight gain, shortness of breath, fatigue, chest pain, heart rate, etc. should be reported to the healthcare provider for instructions in modification of medications or other regimens to prevent an exacerbation requiring hospitalization.

Why is patient education important in nursing?

When nursing care pathways were first being developed, CHF was one of the very first to be enacted. Patient education is key to preventing and managing CHF. Nurses need to keep up to date with best practices and treatments and can do so through continuing education courses for nurses. This helps ensure nurses have the knowledge and information to make a difference for patients.

What is the optimal blood pressure for CHF?

Managing HTN is of prime importance in preventing as well as managing CHF. Guidelines suggest an optimal blood pressure less than 130/80.

How to reduce edema in legs?

Elevating lower extremities while sitting also helps to decrease the edema. The patient needs to understand why this is necessary and how it helps. The legs need to be elevated higher than the heart level. A reclining chair will help but lying on the bed for 20-30 minutes might work better. They need to try each and perhaps alternate them.

What does it mean when you gain 2 pounds in a day?

A weight gain of 2 or more pounds in one day can mean an exacerbation. Patients need to understand the parameters to report to their physician and the importance of getting a response. Ask when they might expect to hear back. Patients need medication information and education.

Why is it important to monitor patients admitted with congestive heart failure closely?

In particular, detailed and accurate intake and output records should be kept to show the progress and success of treatments being administered .

What is congestive heart failure?

Heart failure is a chronic, progressive condition. It occurs when the heart is unable to pump effectively and produce enough cardiac output to successfully perfuse the rest of the body’s tissues and organs. An individual can have right-sided or left-sided heart failure as well as systolic or diastolic heart failure.

What is the goal of a tachycardic patient?

This demonstrates to the nurse that the patient is not hemodynamically stable and the main goal is stabilizing the patient’s respiratory status.

Why is it important for nurses to assess the individual's airway and breathing status immediately?

It is important for nurses to understand the various symptoms a patient may present with when experiencing an acute exacerbation. It is also imperative that the nurse assesses the individual’s airway and breathing status immediately and prioritizes this above any other nursing intervention.

What is the next task for a patient who is breathing?

Once the patient’s breathing status is stabilized the next likely task will be to diuresis the patient . In doing this, it will help to remove additional fluid thereby improving his oxygen and breathing capability further.

What happens if you remove excess fluid from a patient?

Excess fluid will be removed and the patient’s weight will return to baseline.

Is congestive heart failure a chronic condition?

Congestive heart failure is a chronic condition that can progress over time. Acute exacerbations of this chronic condition can also be very common especially if an individual is not following or is unaware of the appropriate guidelines and recommendations.

What does it mean when you wake up feeling short of breath?

Shortness of breath (difficulty breathing) that is new, has become worse, or occurs more often, especially if it occurs when you are at rest or when you wake from sleep feeling short of breath. Extreme tiredness or decreased ability to complete daily activities.

What is Cleveland Clinic?

Changes in sleep patterns, including difficulty sleeping or needing to sleep a lot more than usual. Cleveland Clinic is a non-profit academic medical center.

What happens if you lose more than 4 pounds?

Unexplained change in weight — if you gain or lose more than or equal to 4 pounds from your dry weight (After hospital discharge, your dry weight is 1 pound less than your weight on your first day home.) Increased swelling in your ankles, feet, legs, or abdomen.

How to manage heart failure?

The keys to managing heart failure are to take your medications, make diet changes, exercise regularly and be active, live a healthy lifestyle, monitor your health for new or worsening heart failure signs or symptoms, and keep your medical appointments . Your doctor or nurse will tell you how often to visit. If you are having any of the symptoms ...

What are the symptoms of a fast heart rate?

Constant dizziness or lightheadedness. Nausea or poor appetite. Vomiting. Chest pain or discomfort during activity that is relieved with rest. Changes in sleep patterns, including difficulty sleeping or needing to sleep a lot more than usual. Fast heart rate - at or over 120 beats per minute while at rest.

Can you change your medication without talking to your doctor?

If you are having any of the symptoms described in this handout, DO NOT wait for your next appointment to tell your doctor or nurse. If your symptoms are discovered early, your doctor or nurse may change your medications to relieve your symptoms. (Do not change or stop taking your medications without first talking to your doctor or nurse.)

Is Cleveland Clinic a non profit?

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cle veland Clinic products or services. Policy

What to do for CHF patient?

Obtaining a room air pulse oximetry, administering supplemental oxygen as needed, obtaining IV access to offload the fluid overload, obtaining baseline lab work, and administering diuretics. These things should all be done immediately for a CHF patient, says Swailes.

How to know if interventions are working for the patient's symptom control?

If the problem is chronic, she says to "get a feeling of where the patient is vs . their baseline. Have the patient rate their shortness of breath or dyspnea to gauge where they are, based on their personal best. This also helps to know if interventions are working for the patient's symptom control." (See related stories on immediate interventions for CHF, subtle signs of CHF, and use of nitroglycerine, below.)

What X-ray showed bilateral infiltrates?

A EKG and stat portable chest X-ray were done, which showed bilateral infiltrates.

How long does it take for a triage nurse to give an EKG?

The triage nurse gives the patient an EKG within 10 minutes, followed by a chest X-ray. "Then, they grab the attention of the ED physician or a nurse practitioner, to get the proper medications started quickly," says Bruner. "The quicker you begin treatment, the sooner the load on the heart is reduced.".

Where is the ED overflow unit for CHF?

Congestive heart failure (CHF) patients often wait too long to seek medical treatment and arrive in the ED in an acutely exacerbated state, says Eileen Swailes, RN, nurse manager of the ED overflow unit at Good Samaritan Hospital Medical Center in West Islip, NY.

Is CHF a symptom of heart disease?

While your patient's CHF might be chronic and a symptom of underlying heart damage, it also might be a result of problems from a valve, acute coronary syndromes, hypertension, fever, acute respiratory distress syndrome, or certain medications, says Zanotti.

Can you titrate nitroglycerine in congestive heart failure?

Nitroglycerine should be titrated aggressively in your congestive heart failure patient, says Madonna Scatena, RN, MSN, advanced practice nurse for the ED at Advocate Christ Medical Center in Oak Lawn, IL.

Quiz

Congestive heart failure (CHF) is indicative of which of the following:

Discussion

Use the comment system below to explain how you would handle this scenario.