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)
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.
Med surge 1
Concepts Covered:
- Respiratory Disorders
- Endocrine and Metabolic Disorders
- Urinary System
- Renal Disorders
- Integumentary Disorders
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Circulatory System
- Intraoperative Nursing
- Vascular Disorders
- Neurological Emergencies
- Disorders of Pancreas
Study Plan Lessons
ABGs Nursing Normal Lab Values
Fluid Volume Deficit
Fluid Volume Overload
Formation & Excretion of Urine
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid & Electrolytes Course Introduction
Heart (Cardiac) Failure Therapeutic Management
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Fluid Volume Overload
Heart (Cardiac) Failure Therapeutic Management
ACE (angiotensin-converting enzyme) Inhibitors
Atrial Fibrillation (A Fib)
Atrial Flutter
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Brain Natriuretic Peptide (BNP) Lab Values
Calcium Channel Blockers
Cardiac (Heart) Enzymes
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Course Introduction
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Coronary Artery Disease Concept Map
Congestive Heart Failure Concept Map
Creatine Phosphokinase (CPK) Lab Values
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart Failure Case Study (45 min)
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure for Certified Emergency Nursing (CEN)
Hypertensive Crisis Case Study (45 min)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
MI Surgical Intervention