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CHF
Medications and nursing interventions for
Question | Answer |
---|---|
Agents that dilates aorta and systemic circulation, decreases workload of the heart, which allows the heart to pump against less pressure. | Afterload reducing agents. |
These agents causes venous pooling, why? | Afteload reducing agents because they decrease blood returning to the heart which allow less workload for the heart. |
Studies indicate that Capoten/Captopril is superior to digitalis and diuretics by improving what in patients with mild to moderate CHF? | exercise tolerance |
These drugs have a positive inotropic effect on the heart; increase contractility; increase the force of contraction and hopefully increase the cardiac output at the same time. | Digoxin and Digitoxin/ cardiac glycosides (digitalis) |
What is the expected effect of digoxin/digitoxin? | to slow the heart rate and increase filling time of the ventricle and again increase the cardiac output. |
Anorexia, nausea, vomiting, bradycardia, color vision-green halos are signs of what? | Digitalis Toxicity |
Digiblind for profound digitalis toxicity is used when? | in life threatening situations |
What is the normal digoxin level? | 2.0 |
Before adm. digoxin, what must the nurse assess and document prior to giving? | Assee apical pulse for 1 full minute, document in med chart. |
Decreases circulating blood volume; increase sodium excretion; diminishes preload. | Diuretics |
Diuretics will decrease pulmonary and venous congestion, leading to decreasing___________. | edema |
This condition may potentiate the digoxin and may induce digitalis toxicity during diuretic therapy. | hypokalemia |
Hydroduril, Lasix, Bumex | Diuretics |
CHF clients are restricted sodium to? | 1-2 g/ day |
A client with CHF are usually ordered potassium supplements why? | Some are on potassium wasting diuretics. |
Fluid restrictions are ordered for which CHF client? | severe CHF clients. |
Oxygen therapy for a client with CHF is used for what reasons? | To maintain a PO2 within normal for client. and for comfort. |
When measuring I &O and weight of a client, what do you need to remember as a nursing intervention? | Record I&O hourly in acute stage, weigh every day at the same time, scale, and amt. of clothing. And that 2.2 lbs or 1 kg = 1 liters of fluid. |
A client with CHF in a high fowlers position, the feet that are dependant should be placed on a stool to decrease risk of____________. | Venous Thrombosis. |
Why should you not elevate the feet while client is in high fowlers position? | It will increase blood return to heart too quickly and increases workload of the heart. |
Rapid fluid shift of plasma of the blood into the interstitial spaces of the lungs, alveoli, and pleural space is known as_________________. | Acute Pulmonary Edema |
Acute Pulmonary Edema is an acute exacerbation of which heart failure? | Left sided failure and is medical emergency. |
What causes Acute Pulmonary Edema? | Not taking Lasix medications or increase salt intake. |
Symptoms of Acute pulmonary edema include... | Pink frothy blood tinged sputum in large quantities, crackles in lower lungs progressing to all lungs, cyanosis, nose flaring, use of accessory muscles and profound dyspnea. |
Vasoconstriction due to profound drop in cardiac output cause ___________. | Hypertension. |
Daily pulse on a person with CHF, before arising from bed and before digoxin med, heart rate should be reported if pulse is____________. | <60 or >120. |
When discharging a patient with CHF, it is important to teach them this about their medication. | Not to skip drug therapy. |
What are some of the concerns when discharging an elderly person with CHF. | they have decreased renal excretion, increased risk for digitalis toxicity and inability to handle complex or multiple drug therapy modalities. |