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    Care of The Clients With Problems in Acute Biologic Crisis: Ateneo de Zamboanga University

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    Grant Wynn Arnuco
    This document provides information on cardiac failure, including left-sided and right-sided cardiac failure. It defines cardiac failure as the inability of the heart to pump sufficient blood to meet the needs of tissues. Common causes are discussed such as coronary artery disease, myocardial infarction, and valvular dysfunction. Clinical manifestations are also outlined for left-sided failure such as dyspnea and cough, and for right-sided failure such as edema and hepatomegaly. Nursing diagnoses and management are listed to monitor patients and address issues like activity intolerance, excess fluid volume, and anxiety.

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    Care of The Clients With Problems in Acute Biologic Crisis: Ateneo de Zamboanga University

    Uploaded by

    Grant Wynn Arnuco
    90 views3 pages
    This document provides information on cardiac failure, including left-sided and right-sided cardiac failure. It defines cardiac failure as the inability of the heart to pump sufficient blood to meet the needs of tissues. Common causes are discussed such as coronary artery disease, myocardial infarction, and valvular dysfunction. Clinical manifestations are also outlined for left-sided failure such as dyspnea and cough, and for right-sided failure such as edema and hepatomegaly. Nursing diagnoses and management are listed to monitor patients and address issues like activity intolerance, excess fluid volume, and anxiety.

    Original Title

    ACUTE BIOLOGIC CRISIS

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    This document provides information on cardiac failure, including left-sided and right-sided cardiac failure. It defines cardiac failure as the inability of the heart to pump sufficient blood to meet the needs of tissues. Common causes are discussed such as coronary artery disease, myocardial infarction, and valvular dysfunction. Clinical manifestations are also outlined for left-sided failure such as dyspnea and cough, and for right-sided failure such as edema and hepatomegaly. Nursing diagnoses and management are listed to monitor patients and address issues like activity intolerance, excess fluid volume, and anxiety.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    90 views3 pages

    Care of The Clients With Problems in Acute Biologic Crisis: Ateneo de Zamboanga University

    Uploaded by

    Grant Wynn Arnuco
    This document provides information on cardiac failure, including left-sided and right-sided cardiac failure. It defines cardiac failure as the inability of the heart to pump sufficient blood to meet the needs of tissues. Common causes are discussed such as coronary artery disease, myocardial infarction, and valvular dysfunction. Clinical manifestations are also outlined for left-sided failure such as dyspnea and cough, and for right-sided failure such as edema and hepatomegaly. Nursing diagnoses and management are listed to monitor patients and address issues like activity intolerance, excess fluid volume, and anxiety.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Ateneo de Zamboanga University

    College of Nursing
    st
    1 Semester S.Y. 2018-2019
    NCM 106
    MODULE II
    CARE OF THE CLIENTS WITH PROBLEMS IN ACUTE BIOLOGIC CRISIS

    1. Cardiac Failure

     Is the inability of the heart to pump sufficient blood to meet the


    needs of the tissues for oxygenation and nutrients.
    Description  CHF is most commonly used when referring to left-sided and right-
    sided failure.
     Formerly called Congestive Heart Failure

    Etiologic Factors 1. Increased metabolic rate (eg. fever, thyrotoxicosis)


    2. Hypoxia
    3. Anemia
     Cardiac failure most commonly occurs with disorders of cardiac muscles
    Pathophysiology that result in decreased contractile properties of the heart.
     Common underlying conditions that lead to decreased myocardial
    contractility include myocardial dysfunction, arterial hypertension, and
    valvular dysfunction.
     Myocardial dysfunction may be due to coronary artery disease, dilated
    cardiomyopathy, or inflammatory and degenerative diseases of the
    myocardium. Atherosclerosis of the coronary arteries is the primary
    cause of heart failure. Ischemia causes myocardial dysfunction because
    of resulting hypoxia and acidosis (from accumulation of lactic acid).
     Myocardial infarction causes focal myocellular necrosis, the death of
    myocardial cells, and a loss of contractility; the extent of the infarction is
    prognostic of the severity of CHF. Dilated cardiomyopathy causes diffuse
    cellular necrosis, leading to decreased contractility.
     Inflammatory and degenerative diseases of the myocardium, such as
    myocarditis, may also damage myocardial fibers, with a resultant
    decrease in contractility.
     Systemic or pulmonary HPN increases afterload which increases the
    workload of the heart and in turn leads to hypertrophy of myocardial
    muscle fibers; this can be considered a compensatory mechanism
    because it increases contractility. Valvular heart disease is also a cause
    of cardiac failure.
     The valves ensure that blood flows in one direction. With valvular
    dysfunction, valve has increasing difficulty moving forward. This
    decreases the amount of blood being ejected, increases pressure within
    the heart, and eventually leads to pulmonary and venous congestion.

    Left-Sided  Pulmonary congestion occurs when the left ventricle cannot pump the
    Cardiac Failure blood out of the chamber. This increases pressure in the left ventricle
    and decreases the blood flow from the left atrium. The pressure in the
    left atrium increases, which decreases the blood flow coming from the
    pulmonary vessels. The resultant increase in pressure in the pulmonary
    circulation forces fluid into the pulmonary tissues and alveoli; which
    impairs gas exchange.

    1|Pag e
    Clinical  Dyspnea on exertion
    Manifestation  Cough
    s  Adventitious breath sounds
     Restless and anxious
     Skin appears pale and ashen and feels cool and clammy
     Tachycardia and palpitations
     Weak, thready pulse
     Easy fatigability and decreased activity tolerance
    Right-Sided  When the right ventricle fails, congestion of the viscera and the
    Cardiac peripheral tissues predominates. This occurs because the right side of
    Failure the heart cannot eject blood and thus cannot accommodate all the
    blood that normally returns to it from the venous circulation.

    Clinical  Edema of the lower extremities (dependent edema)


    Manifestation  Weight gain
    s  Hepatomegaly (enlargement of the liver)
     Distended neck veins
     Ascites (accumulation of fluid in the peritoneal cavity)
     Anorexia and nausea
     Nocturia (need to urinate at night)
     Weakness
    Diagnostics 1. Chest X-ray (may show cardiomegaly or vascular congestion)
    2. Echocardiogram (shows decreased ventricular function and decreased
    ejection fraction)
    3. CVP (elevated in right-sided failure)
    *pulmonary artery pressure monitoring may be used as guide
    treatment in serious case of pulmonary edema.

    Nursing 1. Activity intolerance r/t imbalance between oxygen supply and demand
    Diagnose secondary to decreased CO.
    s 2. Excess fluid volume r/t excess fluid/sodium intake or retention
    secondary to CHF and its medical therapy.
    3. Anxiety r/t breathlessness and restlessness secondary to inadequate
    oxygenation.
    4. Non-compliance r/t to lack of knowledge.
    5. Powerlessness r/t inability to perform role responsibilities secondary to
    chronic illness and hospitalization.

    Nursing a. Acute phase


    Managemen 1. Monitor and record BP, pulse, respirations, ECG and CVP to detect
    t changes in cardiac output.
    2. Maintain client in sitting position to decrease pulmonary congestion and
    facilitate improved gas exchange.
    3. Auscultate heart and lung sounds frequently: increasing crackles,
    increasing dyspnea, decreasing lung sounds indicate worsening failure.
    4. Administer O2 as ordered to improve gas exchange and increase
    oxygenation of blood; monitor arterial blood gases (ABG) as ordered to
    assess oxygenation.
    5. Administer prescribed medications on accurate schedule.
    6. Monitor serum electrolytes to detect hypokalemia secondary to diuretic
    therapy.
    7. Monitor accurate input and output ( may require Foley catheter to allow
    accurate measurement of urine output) to evaluate fluid status.

    2|Pag e
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