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)
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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

 

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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.

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Nursing Final

Concepts Covered:

  • Peripheral Nervous System Disorders
  • Shock
  • Acute & Chronic Renal Disorders
  • Immunological Disorders
  • Respiratory Emergencies
  • Cardiac Disorders
  • Noninfectious Respiratory Disorder
  • Disorders of Pancreas
  • Hematologic Disorders
  • Central Nervous System Disorders – Brain
  • Neurological Emergencies
  • Vascular Disorders
  • Infectious Respiratory Disorder
  • Upper GI Disorders
  • Renal Disorders
  • Disorders of Thermoregulation
  • Intraoperative Nursing
  • Medication Administration
  • Studying
  • Emergency Care of the Cardiac Patient
  • Respiratory
  • Emergency Care of the Respiratory Patient

Study Plan Lessons

Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Heart Valve Disorders
Ventilator Settings
Systemic Lupus Erythematosus (SLE)
Stroke Assessment (CVA)
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Distributive Shock
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Metabolic Acidosis (interpretation and nursing diagnosis)
Hypothermia (Thermoregulation)
Anesthetic Agents
Anesthetic Agents
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Asthma for Certified Emergency Nursing (CEN)
Chest Tube Management Case Study (60 min)
Dysrhythmias for Certified Emergency Nursing (CEN)
Heart Failure for Certified Emergency Nursing (CEN)
Noncardiac Pulmonary Edema for Certified Emergency Nursing (CEN)
Pancreatitis For PCCN for Progressive Care Certified Nurse (PCCN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Anemia for Progressive Care Certified Nurse (PCCN)
AVPU Mnemonic (The AVPU Scale)