Heart Failure. Understanding How the Works. Chronic Disease Support Education for PSAs and their Caregivers

Transcription

1 Heart Failure Chronic Disease Support Education for PSAs and their Caregivers Understanding How the Works Veins blood goes to the heart from the body Blood needs to go to heart to be pumped to the lungs Lungs provide oxygen Arteries oxygenated blood goes from the heart to the body The heart is a pump 1

2 Statistics Most common reason for hospitalization for 65+ Costs $34.4 billion a year 570,000 cases diagnosed every year More prevalent in men Women in 70s and 80s increasing More common in African Americans What Is It? Hearts pumping power is weaker than normal Occurs over a long period of time Heart enlarges, increases in muscle mass, pumps faster to compensate Failure to get needed O2 and nutrients to the body Fluid pools in lungs, legs, abdomen Causes of Heart Failure Coronary artery disease Past heart attack Heart muscle disease High B/P Heart valve disease Abnormal heart rhythms Heart birth defects Diabetes Severe anemia Overactive thyroid Severe lung disease 2

3 Symptoms Shortness of breath Difficulty with ADLs Frequent, dry hacking cough, esp. when lying down Tiredness, weakness Dizziness or fainting Weight gain Nausea Confusion, memory loss, disorientation Increase pulse, palpitations Managing Heart Failure Medications Diet/nutrition Watching weight O2 therapy Daily activities Medications ACE inhibitors makes heart pump easier Vasodilators expands blood vessels & lowers B/P Diuretics helps remove excess H2O and salt from body Digitalis strengthens each heart beat, allowing more blood to be pumped Beta Blockers decrease heart s tendency to beat too fast Calcium channel Blockers lowers B/P & improve circulation 3

4 Medications Side Effects Low B/P, headache, dizziness, confusion Low potassium change in heart rhythm, muscle weakness/ leg cramps Incontinence Gout Skin rash Nausea loss of appetite Blurred/yellow colored vision Taking Medications Have a system set up Know medication and when to take Know what each pill looks like Keep medicines refilled Let healthcare provider know OTCs Diet and Nutrition healthy foods Decrease salt and limit red meats, butter, dairy products, eggs, shortening certain oils (coconut & palm) Increase high fiber food such as oat bran, beans, whole grain breads, fruits and vegetables, fish and skinless chicken Limit or restrict salt fluid build up making heart work harder Read labels 1 tsp salt is total amount allowed per day 4

5 Sodium Enters the body as salt Necessary mineral in the body Consumed in prepared foods or added to foods when cooking Can cause fluid to be retained and blood pressure to rise Recommended ,300 mg/ day Reference: one teaspoon= 2,000 mg sodium Salt Case Study Question: Which do you think has more salt, pretzel or Fritos? Case Study Which has more Salt? 5

6 Foods to Avoid Canned or frozen soups or meals Fast food Processed meats Nuts, peanut butter Snack foods Cheese Caffeinated beverages stimulants Fluid Intake Some clients will be on restricted fluids Even yogurt, pudding, low fat milk, Jello counts Watch Clients Weight Two pounds overnight Five pounds in a week Needs medical attention 6

7 Daily weights Weight gain can indicate the body is retaining fluid, which is dangerous for a person with heart failure makes the heart work harder might mean the person needs a change in treatment Tips for accurate daily weights Weigh every day at the same time on the same scale in the same type of clothing Record weights Notify if weight out of range Monitoring for swelling Check the body: Legs and feet Hips and buttocks (if sitting a lot) Stomach and back (if in the bed a lot) Check their clothes and shoes Tight (marking the skin) Modified (cut) Ask the person 7

8 Oxygen Therapy Oxygen is a medication and has a prescribed flow rate Do not change Make sure tanks are not empty Daily Activities Follow doctor s recommendation Moderate exercise helps strengthen heart Stop & rest if needed Rest is Important Sit down with feet up, especially after meals allows heart to pump more easily May have to elevate head during night Take diuretic in morning 8

9 Contributing Causes to Decompensated Heart Failure Missed/skipped meds: 54%% Ran out of medications: 30% Lapses in low salt diet: 41% Worry or stress: 50% Got sick: 46% Warning symptoms Increasing shortness of breath Increasing coughing Chest pain Leg swelling/shoes tight Weight gain Increased pillows at night Fatigue, weakness Warning signs Decreased oxygen level Increased heart rate (pulse) Increased respiratory rate Edema in the extremities Weight gain of more than three pounds over three days Not taking medications *ALL vital parameters are determined by RN supervisor and are patient specific 9

10 Observation of the patient with CHF Observing Recording observations Reporting to supervisor in accordance with the care plan for the patient Why Don t Client s Recognize Symptoms? Symptoms are vague/bothersome Not aware Don t understand reasons for monitoring weight, salt, diet, fluids Don t perceive the need to seek help Don t believe they can control Case study 65 year old male He has had two heart attacks in the past History of hypertension Tells you he has heart failure He tries to take his medications as recommended by his doctor He is 50+ pounds overweight 10

11 Case study He tells you that his doctor wants him to eat a diet low in sodium and fat He then opens up a bag of salted chips and pack of fried chicken Case study What might have caused his heart failure? Case study What might have caused his heart failure? 2 heart attacks in past Tries to take his meds is he? Age Diet high in salt and fat 11

12 Case study What types of lifestyle modifications are important? Case study What types of lifestyle modifications are important? Reduce salt and fat in his diet Increase levels of physical activity/exercise Take meds as prescribed by physician What observations will be important for this client? 12