Management of Heart failure

Question 1

What are the goals when caring for a patient with heart failure (HF)?

Answer 1

Goals include:
* Decrease respiratory distress and work of breathing
* Maintain adequate oxygenation and perfusion
* Direct supportive efforts toward decreasing the workload of the heart
* Work quickly to help relieve the patient’s symptoms
* Place the patient in a position of comfort

Question 2

What position should be used for a patient with pulmonary congestion if their blood pressure tolerates it?

Answer 2

Place the patient in a sitting position with the feet dangling

Question 3

What is the purpose of placing a pulse oximeter on a patient with heart failure?

Answer 3

To maintain the patient’s SpO2 at 94% or higher

Question 4

What is NIPPV and its role in heart failure management?

Answer 4

Noninvasive positive-pressure ventilation (NIPPV) is an effective tool for managing pulmonary edema associated with heart failure

Question 5

List the benefits of NIPPV in managing heart failure.

Answer 5

Benefits include:
* Improves oxygenation and perfusion
* Maintains alveolar inflation
* Improves pulmonary compliance
* Slows respiratory rate
* Facilitates delivery of bronchodilators
* Reduces preload and afterload

Question 6

When should NIPPV not be used?

Answer 6

Do not use NIPPV if the patient has:
* Compromised airway
* Altered mental status
* Risk of aspiration
* Pneumothorax
* SBP of less than 90 mm Hg

Question 7

What should be assessed before and after each intervention in heart failure management?

Answer 7

Assess breath sounds

Question 8

What method should be used to monitor the patient’s respiratory status?

Answer 8

Use waveform capnography

Question 9

What should be limited in patients with heart failure?

Answer 9

Limit the patient’s physical activity

Question 10

What monitoring equipment should be placed on a heart failure patient?

Answer 10

Place the patient on a cardiac monitor and obtain a 12-lead ECG

Question 11

What is the recommended IV infusion rate if local protocol requires IV bag and tubing?

Answer 11

Infuse the fluid at a ‘to keep open’ (TKO) rate of 30 mL/hr

Question 12

What should be documented when starting an IV line for a heart failure patient?

Answer 12

Document the amount of fluid in the bag at the start and the amount remaining when transferring patient care