Heart Failure (part 2)

Emergency Interventions for Heart Failure:

• Place the patient in high fowler position with the legs in a dependent position to reduce pulmonary congestion and relieve edema
• Give oxygen in high concentration by mask or cannula
• Intubation and ventilator support if needed
• Suction fluids as needed
• Assess and monitor level of consciousness
• Monitor for vital signs closely
• Monitor for hypotension
• Monitor for dysrhythmias (using cardiac monitor)
• Assess for edema in dependent legs
• Insert foley catheter if needed
• Monitor intake and output
• Administer morphine sulfate as prescribed
• Administer diuretics as prescribed
• Administer digitalis as prescribed
• Administer bronchodilator as prescribed
• Administer additional inotropic medications as prescribed
• Administer vasodilator as prescribed
• Monitor weight
• Assess for hepatomegaly and ascites
• Monitor peripheral pulses
• Analyze arterial blood gas
• Monitor potassium level closely

Interventions Following Acute Episode of Heart Failure:

• Assist the patient to identify precipitating risk factors of heart failure
• Encourage patient to verbalize feeling
• Instruct patient in the prescribed medications and notify physician if side effect occurs
• Advice patient to avoid over-the-counter medication
• Avoid large amount of caffeine
• Diet: low sodium, low fat, and low cholesterol diet
• Instruct patient regarding fluid restriction as prescribed
• Avoid isometric activities that increases pressure in the heart
• Provide patient with a list of potassium rich foods because diuretics can cause hypokalemia
• Instruct patient to monitor daily weight and report signs of fluid retention such as edema or weight gain