Congestive Heart Failure CHF

Congestive Heart Failure is a condition or patophysiology when the heart as pump is no longer able to provide a good blood supply for the tissue metabolism.
Congestive Heart Failure symptoms often ends up as a fatal condition, because patients with congestive heart failure are just like entering a no-way-out phase. Congestive Heart Failure is the only one disease where the morbidity and mortality increases, even some researches have done to know the patophysiology and the proper treatments. In fact, 50% of patients will die in 5 years. According to the World Health Organization (WHO), the prevalence of congestive heart disease is 22 million at 2002.
There are congestive heart failure symptoms :
  1. The cardinal signs are weakness and shortness of breath.
  2. Dyspneu d'effort: hard to breath (dyspnea) while having activities
  3. Orthopnea: dyspnea while lying
  4. Paroxysmal nocturnal dyspnea: an acute episode of heavy dyspnea, occurs at midnight or while sleeping and make patients awake, followed by dry cough and sometimes wheezing.
  5. Anorexia, nauseous, and a full feeling of the stomach are non specifics complains of the patients.

Congestive heart failure treatments:
There are three basic points of managing patients with congestive heart failure (congestive heart failure symptoms): treatments to the heart itself, treatments of underlying diseases, and treatments to the triggering factors. Medical treatments' goal is to reduce sodium and fluid retention, to increase contractility and to decrease heart preload. General treatments include bed rest, regulation of temperature and humidity, oxygen administration when needed, and diet. Drugs like inotropics (digitalis, digoxine), vasodilators (hidralazine), venodilator (nitrat, nitroglycerines, ISDN), mixed dilators (prazosine, captopril, nitroprusid), diuretics, and antiarythmia drugs. Surgery will be done for some congenital cases (for palliative, corrective) and acquired heart disease (valvuloplasty, valve replacement).

Nursing Care Plan : Nursing Diagnosis for Congestive Heart Failure (CHF)
  1. Decrease Cardiac Output related to :
    • Changes in myocardial contractility or inotropic changes
    • Changes in frequency, rhythm, cardiac conduction
    • Structural changes (eg, valve abnormalities, ventricular aneurysm)
  2. Activity Intolerance related to :
    • Weakness, weakness
    • Changes in vital signs, dysritmia
    • Dyspnea
    • Pale
    • Sweating
  3. Excess Fluid Volume related to
    • The reduced glomerular filtration rate (decrease in cardiac output) or increased production of ADH and sodium and water retention.
  4. Risk for Impaired Skin Integrity related to
    • Bed rest
    • Edema, decreased tissue perfusion.