GOOD

MORNING
HEART FAILURE
PRESENTED BY,
Meena
M.Sc.(N) 1st Year
Heart failure occurs
when the heart is
unable to pump
sufficient blood to
meet the need of the
tissues for oxygen and
nutrients.
Chronic heart failure (CHF)

Congestive heart failure (CHF)

Congestive cardiac failure (CCF)

• Acc. to Joyce M. black,
“Heart failure is a significant cardiac
functional disorder that can result in
reduced oxygen delivery to the body’s
organ and tissue.”
• Acc. to Brunner & Suddarth’s 8th
edition,
“Chronic heart failure is the
inability of the heart to pump sufficient
blood to meet the need of the tissues
for oxygen and nutrients.”
•IN GLOBAL

•IN INDIA
Video ….
VALVES OF THE HEART
BLOOD SUPPLY TO THE HEART
 Stress

Obesity Smoking

Risk
factors

Diabetes
Hyper-
tension

Heart
disease
Others-
 Physical and emotional stress
 Pregnancy
Myocardial infarction
Tachycardia
 Infection
Excessive sodium intake
Pulmonary embolism
Hemorrhage and anemia
Anesthesia and surgery
Transfusion or infusions
PATHOPHYSIOLOGY
Left ventricular failure Right ventricular failure
•Weakness •Weight gain
•Fatigue •Jugular vein distention
•Mental confusion •Increased central venous
•Insomnia pressure
•Anxiety •Abdominal distention
•Diaphoresis •Anorexia, nausea, gastric
•Cough distress
•Pulmonary crackles. •Ascites
•Orthopnea •Hepatomegaly
•Tachycardia •Pitting edema
•Gallop heart sound (s3,s4) •Nocturia
•pulses alternates •Excessive sweating
•congestion in lungs •Weakness
•Hemoptysis •Hypotension, tachycardia
•Tachypnea •Tachypnea
1.History taking
2. Physical examination
3. Echocardiogram
4. Electrocardiography
5. Blood tests
6. B-type Natriuretic Peptide
(BNP) blood test
7. The Ejection Fraction (EF)
8. Exercise Stress Test
9. Chest X-rays
10. Angiography
11. Monitoring

 Fluid balance
Body weight
12. ABG Analysis
13. Liver Enzymes

 Blood urea nitrogen

Creatinine
OBJECTIVES
• To promote rest to reduce the workload
on the heart .
• To increase the force and efficiency of
myocardial contraction through the
action of pharmacologic agents.
• To eliminate the excessive accumulation
of body water by means of diuretics
therapy, diet and rest.
• Monitor daily weight.
• Encourage for exercise.
• Other sign of fluid restriction.
• Improve ventricular pump
performance.
GENERAL MEASURES
DRUGS

1. Vasodilators
2. Angiotensin II receptor
blockers
3. Beta-Adrenergic Blocker
4. Diuretics
5. Positive inotropes
SURGICAL MANAGEMENT-
1. Cardiomyoplasty
Heart valve surgery
Heart transplantation
NUTRITIONAL THERAPY
 NURSING MANAGEMENT -:
The goals of nursing management for
the client with heart failure are to-:

• Monitors for reduced cardiac output.

• Oxygen – administer oxygen in high

concentration by masker cannula to
relieve hypoxia and dyspnea and to
improve oxygen-carbon dioxide
exchange.
• Maintain adequate fluid balance.

• Identifying and evaluating the severity of

dependent edema

• Monitor B.P. & pulse rate as well as

postural hypotension.

• Examine skin turgor and mucus membrane

for sign of dehydration.
• Promoting adequate rest to reduce the
work of the great.

• Reduce myocardial workload.

• Assess response to medical therapies.

• Educate the clients about the self care

following discharge. Weighing the patient
daily at the same time and on the same
scale.
• Increase the patient’s activities
gradually.

• Observe for the complication of bed

rest phlebothrombosis & pulmonary
embolism.

• Provide for psychological rest.

• Maintain a diet plan with low sodium
intake.

• Assess for changes in mental status. It may

indicate decreased cerebral perfusion or
hypoxia.

• Administer prescribed medications

nursing care plan.
COMPLICATIONS
ANY DOUBT