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So your hearts pump blood essentially to 2 places. First place is your body so you have your oxygenated blood on the left side and we gotta remember that the lefts and the rights are the switched.
So it pumps o to out of your body and your body gets that oxygen. Your body uses it up and then circulates it back into the right side. Where this time it’s pumped out to the lungs and gets reoxygenated and gets that oxygenated back and then it circulated back to the left side. And the amount of the blood at any time pumped to your body sort of based on this demand that your body has for blood.
Demand Of Blood
You can kind of think of it like you have the gage and that says hey in need more blood to sustain this much activity. And this can change, so if you start working out or something your demand might go up and your heart can accommodate for that and start pumping more blood to that body to meet those new demands.
Heart failure describes this condition where the heart can not meet the demands of the body. So at any given time, the heart is not able to pump enough blood to meet the body’s demands.
Types of Heart Failure
There are essentially two types of heart failure:
- Systolic Heart Failure
- Diastolic Heart Failure
Systolic Heart Failure
The systolic refers to be systole, which is the phase of the cardiac cycle where the blood is pumped out of the heart. So systolic heart failure is when those heart muscles are not pumping blood with enough force.
So this often means that those muscles are weakened and smaller than with a healthy heart. This typically makes look quite a bit different. And when this smaller muscles contract, they do not squeeze as hard as they used to.
This causes less blood to be ejected with each contraction.
Now, we say contraction because the heart muscle (In Picture mention as muscle downside of the heart) so when it contracts, it squeezes. You can kind of think of it like you have the water bottle that you are holding on your hand and squeeze the water bottle and it shoots the water out.
It is the same concept with your heart when those muscles contract they squeeze the blood and that is how you eject blood to both your body and your lungs.
With systolic heart failure since your heat muscle is smaller, think about squeezing the water bottle again, but just pinching it. It is gonna be a lot harder to squeeze the water out.
Well, it is the same thing for the heart with smaller and weaker muscles. It is gonna be way harder for it to squeeze and pump that blood out of the body.
So that was the first type of heart failure.
Diastolic Heart Failure
Instead of being a pumping problem with the muscle being too small, Diastolic Heart Failure is a filling problem which is why called it Diastolic Heart Failure, because it is referred to diastoli which is that phase in the cardiac cycle where the heart fills the blood.
So with this type of failure, your body is not receiving enough blood because your heart is not filling with enough blood to pump out in the first place.
So if we jump back to the water bottle analogy, this time you are it with one hand, just like we were for the healthy heart, but instead the bottle filled with less water, so even if you squeeze it with the same force as a healthy heart, less water is gonna ejected simply because there is less water in the bottle.
And this essentially what’s happening with diastolic failure. Since there is less blood filling in the ventricles even if it is pumping with the same force less blood gonna be ejected to your body.
But why is the less blood filling in the chambers? Well, it is because the muscles are larger in this case and they take up more space.
Heart Failure Nursing Diagnosis
We measure a BNP which means that anything over that 100 is not good, so over 300 is mild, over 600 is moderate and over 900 is really severe. So guys now we know that what is wrong with the patient, what are we gonna do about it? So always ask yourself what is the patient’s most outcome goal.
Well, in this case, what we need to increase the cardiac is gonna increase oxygen to the body. So we use the A, B, C, and D drugs. These are the hallmark cardiac drugs you will always show up on the NCLEX.
These medications calm the heart and drop the blood pressure or the heart rate and the all do in different ways. it is kind of having the big toolbox so we just choose the right tool for right situations.
- ACE Inhibitors
- Calcium Channel Blocker
Now first A is ACE Inhibitors these guys end Pril lisinopril. These guys drop the blood pressure and take the pressure of the heart. so guys remember A is for ACE Inhibitors is A for Antihypertensives and lisinopril ends in pril so you can say it is like chill pril for the heart.
Remember the beta-blockers the block beats in the heart by slowing it down it is kind of like pumping the brakes on the heart so remember Beta Blockers block the beats like pumping the brakes.
Calcium Channel Blocker
Now C is for the Calcium Channel Blocker. Remember Calcium calm the heart our famous one here ending in Dpine like nifedipine or Zam brand name for the Cardizem. So remember guys Dpine helps the blood pressure to decline and zem like Cardizem is kind of like zem yoga for the heart.
Now D for Digoxinis our cardiac glycoside. This guy gives a deep contraction. This is also known as the increased contractility and it also slows the heart rate known as negative tropics.
So far we have shown both types of heart failure. Each time we have shown it is happening on both sides. Well, this is not always the case. it is definitely possible to have isolated heart failure. So you maybe you have only on the left side or you might have only on the right side.
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