Question

GERONTOLOGY NURSING: CARDIOVASCULAR SYSTEM

Major sign and symptoms of congestive heart failure

-Shortness of Breath

-Edema

-Coughing or wheezing

-Fatigue

-Lack of appetite or nausea

-Confusion

-Increased heart rate

1. Give nursing interventions for each sign and symptoms of congestive heart failure.

Answer 1

Nursing interventions for signs and symptoms of Congestive Heart Failure

• Shortness Of Breath: ​​​​​​

1. Grading the severity based on dyspnoea severity scale.
2. Listen to breath sounds; crepitations may indicate fluid buildup in the lungs which may be the cause of shortness of breath.
3. Monitor O2 saturation and provide oxygen therapy if the saturation is less than 92 percent.
4. Fowler's position may improve breathing so encourage them to sit up rather than lying on the bed.
5. Administer diuretics according to physician's advice, usually loop diuretics are used.

• Edema:

1. Administering diuretics play a major role in reducing edema.
2. Restrict Sodium intake and advice patient to adhere to low sodium diet.
3. Strict monitoring of input and output of fluids.

• Coughing and Wheezing:

1. ​​​​​​​These are indications of fluid buildup in the lungs.
2. Synergistic interventions which include those for shortness of breath and edema are sufficient for controlling cough in congestive heart failure patient.

• Fatigue:

1. ​​​​​​​noting daily energy patterns and establishing realistic activity goals.
2. Planning interventions to allow the patient adequate rest period.
3. Providing supplemental oxygen if needed (hypoxemia contributes to fatigue) assisting with self care needs and ambulation of the patient; helps conserve energy for other tasks.

• Lack of appetite and Nausea

1. ​​​​​​​Lack of appetite and Nausea are common, the patient often feels full after a few bites of food which results in reduced caloric intake.
2. Nursing intervention mainly aims at helping the patient with their choice of food and educating the patient about adequate nutritional balance required.

• Confusion:

1. Anxiety, fear and confusion are common in these patients which may lead to exacerbation of symptoms.
2. Interacting with the patient, educating him about his condition and stressing the fact that staying calm and positive is the way forward.
3. Teaching ways to control anxiety and confusion and avoiding anxiety provoking situations.

• Increasing Heart Rate:

1. ​​​​​​​Observing the frequency and regularity of the pulse and analyzing the immediate threat of arrhythmias.
2. Reducing physical exertion.
3. Being prepared for any adverse outcomes like arrhythmias and cardiogenic shock.