Heart Failure for Certified Emergency Nursing (CEN)
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Study Tools For Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure Pathochart (Cheatsheet)
R v L Heart Failure (Cheatsheet)
Heart Failure Symptoms (Image)
Pulmonary Edema in Heart Failure (Image)
Heart Failure CHF Cardiac Xray (Image)
Heart Failure-Origin (Mnemonic)
Heart Failure – Right Sided (Mnemonic)
Heart Failure-Left-Sided (Mnemonic)
Left Heart Failure Assessment (Picmonic)
Right Heart Failure Assessment (Picmonic)
Outline
Heart Failure
Definition/Etiology:
Left ventricular ejection fraction (EF) is typically below 40%
- Systolic heart failure: inability to pump effectively
- Diastolic heart failure: inability to adequately fill
Can be a complication of any type of cardiac disease
Most commonly caused by CAD, chronic HTN, and diabetes
Pathophysiology:
Inadequate cardiac output and oxygen delivery to tissues
LV failure -> pulmonary HTN -> RV failure -> venous congestion
Rt sided HF most often caused by Lt sided
Clinical Presentation:
| Right-sided Failure | Left-sided Failure |
| Peripheral edema | Shortness of breath |
| JVD | Dyspnea |
| Ascites | Crackles |
| Hepatomegaly | S3 heart sound |
| Increased CVP | Pulmonary edema |
Collaborative Management:
Assessment:
- Chest X-ray (fluid), 12-lead EKG, labs, BNP (>100), echo
Interventions:
- Support ABCs
- continuous cardiac monitoring
- O2 (SpO2 >90%), may need BiPAP
- Initiate IV access
- Caution with fluids! Watch out for Sepsis Pts
Medication Management:
- Administer loop diuretics (get fluid off!)
- vasodilators (morphine, nitroprusside, nesiritide, ACE inhibitors) as needed (less stress on heart to push against BP)
- cardiogenic shock = positive inotropes
Evaluation | Patient Monitoring | Education:
- Level of consciousness
- Hemodynamic status
- Breath sounds and pulse ox
- Cardiac rate and rhythm
- Respiratory effort
- Intake and output
Linchpins: (Key Points)
- The pump is not pumping effectively
- Think fluid back up
- RV failure = back up right atrium to vena cava
- LV failure = back up left atrium to lungs
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
- Nelson, N. (2017). Cardiovascular Emergencies. In CEN Online Review. Emergency Nurses Association.
Diabetes
Concepts Covered:
- Respiratory Disorders
- Cardiac Disorders
- Disorders of Pancreas
- Substance Abuse Disorders
- Newborn Care
- Renal Disorders
- Endocrine and Metabolic Disorders
- Urinary System
- Intraoperative Nursing
- Pregnancy Risks
- Studying
- Medication Administration
Study Plan Lessons
Albuterol (Ventolin) Nursing Considerations
Angiotensin Receptor Blockers
Antidiabetic Agents
Blood Urea Nitrogen (BUN) Lab Values
Blood Glucose Monitoring
Congestive Heart Failure Concept Map
Creatinine Clearance Lab Values
Day in the Life of a Med-surg Nurse
Dehydration
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Emergencies for Certified Emergency Nursing (CEN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Fluid Volume Deficit
General Anesthesia
Glucose Tolerance Test (GTT) Lab Values
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Hemoglobin A1c (HbA1C)
Heart Failure for Certified Emergency Nursing (CEN)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Mixtures (70/30)