HEART FAILURE

GROUP TWO
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NURUL HIJRIAH AWALIAH

NI KADEK MARIANI
CHAIRUL HISYAM
PRAYOGA ZODHO
TEGUH ADI
ROSITA CAROLINE
DEWI ROSALINDA
AGUS MAULANA
GINANJAR S
JUWANI ISAI
NURHIDAYAH
YOGA KURNIAWAN
FRAGA BATARA
RAUDHATUL ADAWIYAH
BELLA THATA
YUNI ARFIANI
ANNISA JASMINE
MALINDA AGUSTINA
LUSIANA MESSY
IRVANA REZA

DEFINITION
Heart failure is a clinical syndrome not a disease.
Heart failure is a condition in which the heart cant
pump enough blood throughout the body. Heart failure
does not mean that your heart has stopped or is about
to stop working. It means that your heart is not able to
pump blood the way that it should. The heart cant fill
with enough blood or pump with enough force, or both.

SYMPTOMS

ETIOLOGIES

Primary risk factors

Coronary artery disease (CAD)
Advancing age

Contributing risk factors

Hypertension
Diabetes
Tobacco use
Obesity
High serum cholesterol
African American descent
Valvular heart disease
Hypervolemia

COMPLICATIONS
Pleural effusion
Atrial fibrillation (most common dysrhythmia)
High risk of fatal dysrhythmias (sudden cardiac death,
ventricular tachycardia)

HF lead to severe hepatomegaly, especially with RV

failure
Renal insufficiency or failure

DIAGNOSTIC STUDIES
Primary goal- determine underlying cause
o History and physical examination( dyspnea)
o Chest x-ray
o ECG
o Lab studies (e.g., cardiac enzymes, BNP- (beta
natriuretic peptide- normal value less than 100)
electrolytes
o Echocardiogram-TEE best

NURSING CARE PLAN

1. Nursing diagnosis
Activity intolerance related to fatigue secondary to cardiac insufficiency and pulmonary
congestion as manifested by dyspnea, shortness of breath , weakness.
Nursing interventions
Encourage alternate rest and activity periods to reduce cardiac workload
Provide emotional and physical rest to reduce oxygen consumption and to relieve
dyspnea and fatigue
Monitor cardio respiratory response to activity to determine level of activity that can
be performed
Teach patient techniques of self care to minimize oxygen consumption .

2. Nursing diagnosis
Excess fluid volume related to cardiac failure as manifested by edema,
dyspnea on exertion, increased weight gain .
Nursing interventions:
Weigh daily and monitor trends to monitor fluid retention and weight
reduction
Monitor respiratory pattern for symptoms of respiratory difficulty.
Monitor fluid intake and fluid output
Monitor for therapeutic effect of diuretic to assess response to treatment .
Monitor for serum electrolyte levels to assess as a response to treatment

3. Nursing diagnosis
Disturbed sleep pattern related to nocturnal dyspnea, nocturia as manifested by
inability to sleep through the night .
Nursing interventions
Determine patients / activity pattern to establish routine .
Encourage patient to establish a bedtime routine to facilitate transition from
wakefulness to sleep
Adjust environment to promote sleep adjust medication administration schedule to
support patients' sleep cycle
Monitor patients' sleep pattern and number of sleep hours to determine hours of
sleep .

NURSING AND COLLABORATIVE

MANAGEMENT
Improve cardiac function
For patients who do not respond to conventional pharmacotherapy (e.g.- O2, even intubate, high Fowlers, diuretics, vasodilators,
morphine sulfate)
Inotropic therapy
Digitalis
-Adrenergic agonists (e.g., dopamine)
Phosphodiesterase inhibitors (e.g., milrinone)
Caution re- calcium channel blockers- dec. contractility- only
amilodopine (Norvasc) approved even in mild heart failure)
Hemodynamic monitoring

COLLABORATIVE
MANAGEMENT
DRUG THERAPY

Diuretics
Thiazide
Loop
Spironolactone

Vasodilators
ACE inhibitors- pril or ril *first line heart failure
Angiotensin II receptor blockers
Nitrates
-Adrenergic blockers- al or ol
Nesiritide- Natrecor (BNP)

MEDICATIONS
Angiotensin-converting enzyme inhibitors, such as captopril and enalapril, block
conversion of angiotensin I to angiotensin II, a vasoconstrictor that can raise BP. These
drugs alleviate heart failure symptoms by causing vasodilation and decreasing
myocardial workload.
Beta-adrenergic blockers, such as bisoprolol, metoprolol, and carvedilol, reduce
heart rate, peripheral vasoconstriction, and myocardial ischemia.
Diuretics prompt kidneys to excrete sodium, chloride, and water, reducing fluid
volume. Loop diuretics such as furosemide, bumetanide, and torsemide are preferred
first-line diuretics because of efficacy in patients with and without renal impairment.
Low-dose spironolactone may be added to a patient's regimen if he has recent or
recurrent symptoms at rest despite therapy with ACE inhibitors, beta-blockers, digoxin,
and diuretics.
Digoxin increases the heart's ability to contract and improves heart failure symptoms
and exercise tolerance in patients with mild to moderate heart failure

THANKY
OU