Congestive Heart Failure (CHF), previously known as left-sided heart failure, involves fluid accumulation which inhibits the heart from pumping effectively (Ignatavicius, Workman, & Mishler, 2018). CHF can be systolic heart failure or diastolic heart failure and can be categorized as acute or chronic and range from mild to severe depending on the patient. The systolic type is when the heart does not contract forcefully enough during systole to eject the adequate amount of blood to be sent into circulation. The diastolic type occurs when the left ventricle does not relax as completely as it should during diastole. Because it is not relaxing as it should, it does not fill with as much blood which results in less blood getting pumped out into circulation. In most cases, this type of heart failure is caused by systemic hypertension. In some cases, the patient may have a myocardial infarction or structural heart changes (that lead to pressure or volume overload) which can lead to heart failure.
Common diagnostics for CHF include obtaining BNP, a chest x-ray, and a radionuclide study. Additionally, an echocardiogram is a common diagnostic used to diagnose heart failure as it can determine ejection fraction, cardiac valvular changes, pericardial effusion, chamber enlargement, and ventricular hypertrophy. A patient may also have ABG values obtained to determine if they have hypoxemia. A typical patient may receive beta blockers, ACE inhibitors, angiotensin receptor blockers, digoxin, or aldosterone to assist in lowering blood pressure and reducing the workload of the heart. Non Pharmacological treatment may include limiting salt and fluid in the diet and depending on severity, the patient may need a pacemaker to be implanted.
Clinical manifestations of CHF include shortness of air, dizziness, oliguria, tachycardia, fatigue, acute confusion and pulmonary congestion. Overall, the signs and manifestations depend on the the ventricle involved and the underlying cause. CHF typically manifests with impaired tissue perfusion and pulmonary congestion. As far as treatment, a patient is not able to be cured, but lifestyle modifications and drug therapy may help to manage symptoms. Usual nursing care involves administering medications as prescribed, assessing mental status, assessing respiration with their rhythm, rate, and character, oxygen saturation, auscultating at the apical pulse particularly for any S3 gallops, and auscultating for crackles and wheezes in the lungs (Ignatavicius, Workman, & Mishler, 2018).
To read more about Congestive Hearth Failure. Consider checking out Ignatavicius, D., Workman, M., & Mishler, M. (2018). MedicalSurgical Nursing: Concepts for
Interprofessional Collaborative Care (9th Ed.). St. Louis: Elsevier Saunders.