Heart Failure for Certified Emergency Nursing (CEN)
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Included In This Lesson
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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CVOR
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Circulatory System
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Adult
- Medication Administration
- Vascular Disorders
- Newborn Complications
- Noninfectious Respiratory Disorder
- Eating Disorders
- Intraoperative Nursing
- Cardiovascular Disorders
- Terminology
- Pregnancy Risks
- Urinary System
- Upper GI Disorders
- Studying
- Disorders of Pancreas
- Communication
- Perioperative Nursing Roles
- Substance Abuse Disorders
- Acute & Chronic Renal Disorders
- Pediatric
- Respiratory Emergencies
- Postoperative Nursing
- Emergency Care of the Respiratory Patient
- Neurological Emergencies
- Disorders of the Posterior Pituitary Gland
Study Plan Lessons
02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Adenosine (Adenocard) Nursing Considerations
Advanced Cardiovascular Life Support (ACLS)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Blood Flow Through The Heart
Blood Pressure (BP) Control
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Digoxin (Lanoxin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hemodynamics
Hiatal Hernia
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Obstructive Heart (Cardiac) Defects
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pacemakers
Pediatric Advanced Life Support (PALS)
Performing Cardiac (Heart) Monitoring
Pericardial Tamponade for Certified Emergency Nursing (CEN)
Pleural Effusion for Certified Emergency Nursing (CEN)
Post-Anesthesia Recovery
Preload and Afterload
Premature Ventricular Contraction (PVC)
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Sepsis Labs
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia (SVT)
The Heart
Thrombolytics
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Troponin I (cTNL) Lab Values
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vasopressin
Ventilator Settings
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)