Nurses Know! - Congestive Heart Failure

By: Michael Lane RN
Congestive Heart Failure (CHF) is a condition that impairs the pumping of the heart (Lewis, Heitkemper, and Dirksen 2004). The heart is unable to pump enough blood to meet the body’s needs. Any number of underlying heart conditions can lead to heart failure (http://www.mayoclinic.com). Its called “congestive” from the fact that one or both of the heart's lower chambers fail. This failure causes blood to back up into,or congests, the liver, abdomen, lower extremities, and lungs, causing symptoms such as shortness of breath, fatigue, and leg swelling (www.mayoclinic.com).
Currently over 5 million people in the United States have CHF. It is the most rapidly increasing form of Cardiovascular Disease. The American heart association estimates that close to 500,000 new cases are diagnosed a year. CHF increases with advancing age. Approximately 1 in 100 older adults have some form of CHF. The incidence is the same in both women and men. The annual cost of the disease exceeds $57 billion dollars (Lewis, Heitkemper, and Dirksen 2004).
The care is multi-faceted and the community nurse is essential in educating this community. Lifestyle changes are critical brcause CHF is a progressive disease. Transplants are a possible option for younger sufferers of CHF but are not often offered to most older adults with CHF. The key is slowing the progression of the disease and improving the overall heart function. Some people can live for years with CHF if managed properly.
Severe cases will require closer monitoring. The use of oxygen and BiPap machines to aid in breathing and combating dypsnea and apnea while sleeping will help improve quality of life. Medication therapy is essential to keep heart working efficiently and keep fluids from accumulating. Diet and weight management is critical to the patient. Salt and water must be measured on a daily basis. Abstinence from smoking and alcohol consumption should be strictly adhered to. Daily weights should be done to detect complications of fluid retention early.
Patient teaching should include the family and support structure. Everyone needs to know that this disease is progressive and requires strict guidelines to ensure medication is taken properly. Patients needs to be aware of early signs of exacerbations and side affects of medicines.
Patients must learn the importance of frequent blood test and doctor visits. Encourage patients to write down questions so they can remembered them when calling the doctor. Home health and counseling should be in place for monitoring and psychological problems stemming from the disease.
Prognosis is good with proper management. The future holds promise with things like ventricular devices, balloon pumps, and new medications in research as we speak management will become much easier

Note: This blog post reflects the work of Michael Lane RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.