TOPIC: HEART FAILURE

Specific Topic: Congestive

Heart Failure
Name: Samantha Daisy Waerasi

ID #: 700018940

Program: Diploma In Nursing

Unit Code: NUR614

Unit Name: Medical Surgical
Nursing 1
 PRESENTATION OUTLINE
 Aims & Objective
 Introduction
 Case Study
 Pathophysiology of Congestive Heart
Failure
 Investigation
 Treatment Management
 Nursing Management Care Plan
 Conclusion
 AIMS & OBJECTIVE

Aims Objective
Improve the quality of life & clinical By the end of the presentation;
outcomes for patients with congestive • Student and patient should be able to
heart failure through comprehensive understand what is congestive heart failure.
management.
• Help in the long-term reduction of CHF-
Reduce hospital readmission for CHF by
related hospital readmissions by 30% within
regular monitoring and managing a year.
symptoms
• Within 3-months ensure that patients
Promote lifestyle changes that supports
demonstrate adequate knowledge and self-
the heart. management skills, as assessed by pre- and
Educate patients to manage their post- education assessments and patient
condition effectively. feedbacks.
Ensure continuous care and support for • Student will by able to know how to prescribe
CHF patients. CHF medications among patients as
measured prescription refill rates and patient
 INTRODUCTION
 Congestive Heart Failure (CHF) is a chronic, progressive condition in which the
heart muscle is unable to pump sufficient blood to meet the body’s need for
blood & oxygen. This insufficiency in the heart’s pumping action leads to a
range of symptoms, including shortness of breath, fatigue and fluid retention,
particularly in the legs, ankles and lungs.
 CHF is a significant public health problem worldwide. It is particularly
prevalent among older adults and is a leading cause of hospitalization and
healthcare cost. In the US, approximately 6.2 million adults have heart failure,
and the incidence is expected to rise with the aging population.
 To compare Solomon Islands in contrast, the exact prevalence of CHF in
Solomon Islands is not well documented due to limited healthcare resources
and data collection capabilities. However, the occurrence of Cardiovascular
diseases including CHF is rising as the population transitions from a
predominantly communicable disease to a non-communicable diseases (NCD).
Factors such as hypertension, diabetes, and rheumatic heart diseases
prevalent in the region contributes significantly to the incidence of CHF.
 CASE STUDY

PATIENT PROFILE PRESENT COMPLAINT

Name: John Doe John presented to NRH with
Age: 65 yrs. increasing shortness of breath,
Gender: Male swelling in his legs and
abdomen and fatigue/tiredness
Residence: White River over the past two months.
Occupation: Farmer
Medical History: Hypertension
type 2, diabetes, rheumatic
heart disease.
Family History: Father had
Coronary Artery disease,
mother had type 2 diabetes.
 CLINICAL EXAMINATION (CASE STUDY
CONTINUATION)

VITALS PHYSICAL EXAMINATION

Blood Pressure – 150/90 Very tired
mmHg Edema in the legs and
Heart Rate – 100 bpm abdomen
Respiratory Rate – 22 Crackles heard in the
breaths/minute lungs on auscultation
Temperature – 37 ̊ C
 CLINICAL EXAMINATION (CASE STUDY
CONTINUATION)
DIAGNOSTIC WORKUP DIAGNOSIS
 Patient have systolic heart  John was diagnosed with
failure through examination, congestive heart failure (CHF)
also during chest x-ray, he has with reduced ejection fraction,
pulmonary congestion and exacerbated by poorly
cardiomegaly and sinus controlled hypertension and
tachycardia with left diabetes.
ventricular hypertrophy. Lastly
his blood test, patient have
mild renal impairment
(elevated creatinine).
 PATHOPHYSIOLOGY OF THE CONDITION

 The pathophysiology of CHF involves a complex interplay of

structural and functional changes within the heart. It often
results from conditions such as coronary artery diseases,
hypertension, myocardial infection and cardiomyopathy. These
conditions lead to a decline in the heart’s pumping ability,
either through systolic dysfunction (inadequate contraction of
the heart muscle) or diastolic dysfunction (inability of the heart
to relax and fill properly). Also congestive heart failure is a
complex syndrome characterized by the inability of the heart
to pump blood effectively leading to inadequate tissue
perfusion.
 PATHOPHYSIOLOGY OF SIGNS & SYMPTOMS

Signs & Symptoms Pathophysiology

 Peripheral Edema Peripheral edema refers
to the accumulation of
fluid in the tissues,
typically in the lower
extremities such as the
legs, ankles and feet. It
results from an imbalance
between the forces that
regulate fluid movement
between the vascular and
 PATHOPHYSIOLOGY OF SIGNS & SYMPTOMS
(CONTINUATION)

Signs & Symptoms Pathophysiology

Dyspnea (Shortness of breath)  It is often described as an
uncomfortable awareness of
breathing or difficulty
breathing. It can result from a
variety of cardiovascular
respiratory and other
systematic conditions. The
underlying mechanism can be
broadly categorized into
increased respiratory drive,
increased work of breathing
 INVESTIGATION
CATEGORY TEST PROCEDURE PURPOSE

Clinical Assessment Assessment Symptoms Identify Symptoms of

History Past Medical History Dyspnea, fatigue, edema
and risk factors

Physical Examination Inspection Auscultation Detect Signs of Heart

and Palpation Failure. Identify edema
and crackles in lungs

Electrolytes Sodium, Potassium, Renal Assess kidney function

function tests and electrolyte balance.

Chest x-ray, Chest Imaging of the heart and Assess for cardiomegaly,
Radiograph lungs pulmonary congestion,
pleural effusion
 MANAGEMENT OF TREATMENT
CATEGORY INTERVENTION PURPOSE / BENEFIT
 LIFESTYLE MODIFICATION Sodium & Fluid restriction, Reduce fluid retention.
 DIETARY CHANGES healthy diet. Improve overall
cardiovascular health.
Exercise Regular physical activity and Improve cardiovascular
cardiac rehab fitness reduce symptoms,
increase exercise tolerance
Weight Management Daily weight monitoring, Detect fluid retention early,
achieve healthy weight reduce strain on heart
Smoking cessation Quit smoking Improve cardiovascular
health, reduce risk factors
Alcohol Limitation Limit or eliminate alcohol Reduce risk factors prevent
worsening of heart failure
 Medication Furosemide Reduce fluid overload, relieve
 Diuretics hydrochlorothiazide symptoms
spironolactone
Ace Inhibitors Enalapril Lisinopril Reduce mortality, improve
symptoms, prevent disease
progression
 MANAGEMENT OF NURSING CARE PLANS

Nursing Care Plan For Congestive Heart Failure

NURSING DIAGNOSIS
Ineffective Cardiac Tissue perfusion related to decreased cardiac output and impaired
myocardial function.
GOALS EVALUATION
 Improve Cardiac Tissue Perfusion & reduce symptoms of  Improved cardiac tissue
Heart Failure perfusion as evidenced by
stable vital signs and reduced
 Promote Patient understanding and adherence to
symptoms of heart failure.
treatment plan.
 Monitor fluid intake and output as well as daily weight  Patient demonstrates
to assess for fluid retention. understanding of treatment
plan and compliance with
 Educate the patient & family about dietary restrictions
prescribed regimen.
like sodium and fluid intakes.
 Encourage adherence to prescribed exercise regimen,  Patient reports improved
with appropriate modification as needed. quality of life and ability to
 Provide emotional support & counselling to the patient perform activities of daily
& family, addressing fears and concerns about the living.
 SIDE EFFECTS OF DRUGS

Diuretics Ace Inhibitors

Can cause dry cough
Cause the loss of electrolytes
Dizziness
such as potassium, sodium
and magnesium, leading to It can cause difficulty
Hyposalemia (Low Potassium). breathing
Muscle weakness
Cramps Beta – Blockers
Hyponatremia (Low Sodium) Numbness
Cause confusion Pain when walking
Hypomagnesemia (Low Can cause decrease in blood
Magnesium) pressure
 CONCLUSION

In conclusion, Congestive Heart Failure (CHF), is a complex

and challenging condition characterized by the heart’s
inability to pump blood effectively, leading to symptoms
such as fatigue, shortness of breath and fluid retention.
While CHF poses a significant risk and can significantly
impact a patient’s quality of life, advancements in medical
management including medications, life style modification
and device therapies, have improved outcomes and
provided hope for patients living with this condition.
 REFERENCES
 American Heart Association (2022). Types of Heart Failure.
 Benjamin EJ, Muntner P, Alonso A, et al. Heart Disease and Stroke
Statistics 2019 update: A Report from the American Heart Association.
Circulation 2019; 139: e526 – e528.
 Solomon Islands Ministry of Health and Medical Services, (2020). National
Health Strategic Plan 2021-2030.
 Word Health Organization, (2018). Non-Communicable Disease Country
Profiles 2018.
 Karnani, N. Reisfield G.M. & Wilson, G.R. (2005). Evaluation of Dyspnea in
the primary care sitting American family physician 21(8).1529-1537.
 Sessup, M. & Brozena, S. (2003). Heart Failure New England Journal of
Medicine. 348(20), 2017-2018.

THANK YOU !!