MindMap Gallery Exacerbation of Congestive Cardiac Failure
Exacerbation of congestive cardiac failure, also known as a heart failure exacerbation, is a critical condition that requires careful management and understanding. Congestive cardiac failure occurs when the heart is unable to pump blood efficiently, leading to a buildup of fluid in the body. This mind map aims to explore the various factors and interventions involved in the exacerbation of congestive cardiac failure. By examining this topic through a mind map, we can gain a comprehensive understanding of the key aspects that contribute to the exacerbation of congestive cardiac failure.
Edited at 2023-02-10 00:59:09Exacerbation of Congestive Cardiac Failure
Aetiology
Risk Factors
Male
(Greenberg & Barnard, 2010)
Age
(Chatterjee, 2014) (Greenberg & Barnard, 2010)
Risk of plaque build in arteries
(Heart health and aging 2018)
Stiffness and hardening of arteries
(Heart health and aging 2018)
Blood flow
(Heart health and aging 2018)
Oxygen to heart
(Heart health and aging 2018)
Heart weakens and damages
(Heart health and aging 2018)
Smoking
(Chatterjee, 2014) (Hajouli & Ludhwani, 2022) (Greenberg & Barnard, 2010)
risk of HF
(Greenberg & Barnard, 2010)
Alcohol
(Greenberg & Barnard, 2010)
risk of hypertension
(Greenberg & Barnard, 2010)
Risk of HF
(Greenberg & Barnard, 2010)
Obesity
(Malik et al., 2022)
Work of heart
(Greenberg & Barnard, 2010)
Sleep apnea
(Greenberg & Barnard, 2010)
Cardiomyopathy
(Khattak et al., 2018)
Work of heart
(Khattak et al., 2018)
risk of HF
(Greenberg & Barnard, 2010)
Hypertrophy
(Khattak et al., 2018)
Afterload
(Khattak et al., 2018)
LV filling
(Khattak et al., 2018)
Causes
Hypertension disease
(Malik et al., 2022) (Tackling & Borhade, 2022)
Workload of heart
(What causes heart failure? 2023) (Tackling & Borhade, 2022)
ability of heart to blood
Heart chambers increase
(What causes heart failure? 2023)\ (Tackling & Borhade, 2022)
Heart chambers weaken
(What causes heart failure? 2023) (Tackling & Borhade, 2022)
Myocardial hypertrophy
(Greenberg & Barnard, 2010)\ (Tackling & Borhade, 2022)
Oxygen demand
(Chatterjee, 2014) (Tackling & Borhade, 2022)
Blood supply to tissue
Leads to weaker contractions
Chronic obstructive pulmonary disease
(Fonarow & Ziaeian, 2016)
Hyperinflation
(Rabe et al., 2018)
Left ventricle dysfunction
(Rabe et al., 2018)
Impaired filling of ventricle
(Rabe et al., 2018)
Cardiac output
(Rabe et al., 2018)
Hypoxemia
(Rabe et al., 2018)
Pulmonary vasocontriction
(Rabe et al., 2018)
Right ventricle dysfunction
(Rabe et al., 2018)
Ischaemic heart disease
(Fonarow & Ziaeian, 2016)
Narrowed arteries
(Severino et al., 2020)
Blood and oxygen to heart
(Severino et al., 2020)
Damage to myocardium
(Severino et al., 2020)
contractibility and output
(Severino et al., 2020)
Myocardial infarction
(Malik et al., 2022) (Severino et al., 2020)
Heart muscle damage
(What causes heart failure? 2023)
Contraction
(What causes heart failure? 2023)
Weakens heart to pump
(What causes heart failure? 2023)
Coronary artery disease
(Malik et al., 2022) (Chatterjee, 2014)
Blood pressure
(What causes heart failure? 2023)
Risk of heart failure
(What causes heart failure? 2023)
Damage to myocardium
Congenital heart disease
(Malik et al., 2022)
Defects in chambers
(What causes heart failure? 2023)
Rest of heart compensates
(What causes heart failure? 2023)
Rheumatic hearrt disease
(Fonarow & Ziaeian, 2016)
Diabetes mellitus
(Malik et al., 2022) (Chatterjee, 2014)
Risk of HTN
(What causes heart failure? 2023)
Structural abnormalities
(Malik et al., 2022)
Valvular heart disease
(Malik et al., 2022)
Uncontrolled arrthymias
(Malik et al., 2022)
Myocarditis
(Malik et al., 2022)
Pathophysiology
Heart unable to supply adequate blood and oxygen to meet body's needs
(What is heart failure? 2017)
Systolic heart failure
Unable to pump effectively
(Chatterjee, 2014)
Left ventricular dysfunction
(Malik et al., 2022)
Hypertrophy
(Deedwania & Mather, 2014)
Heart wall thickens
(Deedwania & Mather, 2014)
Blood pressure elevates
(What is left ventricular hypertrophy (LVH)? 2017)
Walls weaken, stiffen and reduced elasticity
(What is left ventricular hypertrophy (LVH)? 2017)
Dilatation
(Deedwania & Mather, 2014)
Chamber enlarges
(Deedwania & Mather, 2014)
Wall stretches
(What is left ventricular hypertrophy (LVH)? 2017)
Weakens and thins
(What is left ventricular hypertrophy (LVH)? 2017)
Cardiac output
(Chatterjee, 2014)
Blood pressure
(Bullock & Manias, 2016)
Blood flow to organs
(Bullock & Manias, 2016)
blood to kidneys
(Malik et al., 2022)
Activates renin-angiotensin aldosterone system
(Malik et al., 2022)
Fluid in vessels
(Bullock & Hales, 2019)
Leaking into tissues
(Bullock & Hales, 2019)
Fluid buildup in lungs
(Bullock & Hales, 2019)
Rentetion of sodium and water
(Malik et al., 2022) (Bullock & Hales, 2019)
Contraction
(Bullock & Hales, 2019)
Diastolic heart failure
Unable to fill heart properly
(Aziz et al., 2013)
Wall of heart stiffs and becomes less compliant
(Aziz et al., 2013)
Cardiomyopathy
Hypertrophic
(Chatterjee, 2014)
Restrictive
(Aziz et al., 2013)
abnormal thickenening of ventricular wall
(Chatterjee, 2014)
Left ventricle unable to stretch or fill
(Aziz et al., 2013)
Relaxtion during contraction
(Bullock & Hales, 2019)
Preload
(Bullock & Hales, 2019)
Cardiac output
(Aziz et al., 2013)
Insufficient venous return
(Bullock & Hales, 2019)
Build up of fluid in heart
(Iqbal & Gupta, 2022)
Excess fluid in lungs
(Iqbal & Gupta, 2022)
Pressure in pulmonary arteries
(Iqbal & Gupta, 2022)
Fluid build up
(Iqbal & Gupta, 2022)
Pulmonary oedema
(Iqbal & Gupta, 2022)
Impaired oxygen exchange
(Iqbal & Gupta, 2022)
Congestion
(Iqbal & Gupta, 2022)
Measurement
Normal Ejection Fraction
(Ejection Fraction Heart Failure Measurement, 2017)
50-70% of blood is pumped during contraction
(Ejection Fraction Heart Failure Measurement, 2017)
Amount of blood in heart / amount of blood pumped
(Ejection Fraction Heart Failure Measurement, 2017)
Reduced ejection fraction
(Ejection Fraction Heart Failure Measurement, 2017)
<40% of blood is pumped during contraction
(Ejection Fraction Heart Failure Measurement, 2017)
Systolic heart failure
(Ejection Fraction Heart Failure Measurement, 2017)
Muscle in heart does not contract well
(Ejection Fraction Heart Failure Measurement, 2017)
Cardiac output
(Ejection Fraction Heart Failure Measurement, 2017)
Borderline ejection fraction
(Ejection Fraction Heart Failure Measurement, 2017)
41-48% of blood is pumped during contraction
(Ejection Fraction Heart Failure Measurement, 2017)
Bruno's EF is 45% so he is borderline ejection fraction
Preserved Ejection Fraction
(Ejection Fraction Heart Failure Measurement, 2017)
Diastolic heart failure
(Ejection Fraction Heart Failure Measurement, 2017)
>50% or more blood is pumped during contraction
(Ejection Fraction Heart Failure Measurement, 2017)
Ventricles cannot relax well when filling
(Ejection Fraction Heart Failure Measurement, 2017)
Bruno
Demographics
Male
75 years old
Lives home with wife in oakleigh
Extensive family
No home/community support
Family business
Lifestyle
Recently ceased working
Ex smoker
Drinks 2-3 drinks a night
Past medical history
Hypertension
Ace inhibitor
Perindopril
Heart Failure
Class II
Symptoms
Nocturia
Weight gain of 2kg
Malaise
Ejection Fraction 45%
Management
1.5L fluid restriction
Medications
Diuretics
Frusemide
Spirolactone
Betablocker
Metoprolol
Nursing Management
CNS
GCS
Confusion
4AT assessment
Esculate any concern to HMO
Urine analysis
Notify doctors any abnormalities
collect MSU if positive
Reorientate to place, person and time
Involve family in care
Restless
Communicate to identify patient concerns
Provide reassurance
CVS
Vitals
HR 103 bpm
Manual radial pulse
Report any abnormalities
Recheck HR within an hour
Rate/rhythm
ECG
Contact HMO to review
Ausculate heart
Report any abnormalities
Pathology orders
Full blood count
Urea and electrolytes
Notify doctors and administer replacement
Recheck pathology
BP 105/70mmHG
Lying/standing BP
Report any postural drop
Patient education
Prevent falls
Administer IVT as ordered by HMO
N/S 1L 24/24
Strict FBC
2L positive
Daily weight
(Deedwania & Mather, 2014)
1.5kg increase
Notify doctor
1.5L FR
(Deedwania & Mather, 2014) (Bullock & Hales, 2019)
Educate patient
JVP
(Deedwania & Mather, 2014)
RESP
Sp02 92%
Oxygen therapy
2L 02 NP
Monitor oxygen saturations
Wean off 02 as tolerated
Encourage deep breaths and coughing
SOOB/up right
RR- 22
Use of accessary muscles
Encourage deep slow breaths
Reassess RR
Increased WOB
Auscultate lungs
Crackles bilateral at base
Encourage SOOB/Sit upright
Encourage deep breathing and cough
Notify doctors for review
Administer medcations as charted
Auscultate lungs daily to monitor change
GIT
Small oral intake
Encourage diet as tolerated
Monitor oral intake
Food chart
Education
(Deedwania & Mather, 2014) (Bullock & Hales, 2019)
low sodium diet
(Deedwania & Mather, 2014)
Reduce alcohol consumption
(Bullock & Hales, 2019)
Dietician referral
(Deedwania & Mather, 2014)
BO yesterday
Ausculate bowels
Notify doctors if bowel sounds not present
Nurse iniate apperients
Stool chart
Palpate abdomen
Distention or tenderness
Notify doctors
Nausea
Notify doctors
Administer antiemetics
RENAL
Amber coloured urine
Urine output 20mls/hour
Notify doctor
Administer dieuretics if charted
(Deedwania & Mather, 2014)
Monitor output
Insertion of catheter
Strict FBC
Hourly balance
Hourly measures
Monitor colour
Monitor output
Obtain pathology if ordered
Monitor kidney function
MOBILITY
Assess mobility/gate
Supervision nil aid
Encourage mobility as tolerated
(Deedwania & Mather, 2014)
Document mobility each shift
Encourage sit out of bed
Falls education
Repeat back learning
Refer to physio
(Deedwania & Mather, 2014)
INTEG
Assess skin
Diaphoretic
Typanic temperature
If febrile notify doctors
Blood cultures
Assess peripheries
Cool
Palpate peripheral pulses
Radial
Dorsal pedal
Capillary refill time
Aim >3 seconds
Assess colour
Pale
Peripheral oedema bilateral legs
(Deedwania & Mather, 2014)
Elevate legs
Administer regular diuretics
Daily weigh
Notify doctors
Asses integrity
Promote pressure area care
Report any wounds or pressure injuries
Skin assessment every shift
Pharmalogical Treatment
Actual
ACE Inhibitors
(Bullock & Hales, 2019)
Indication
Relieves symptoms and progression of HF
(Deedwania & Mather, 2014) (Bullock & Manias, 2016)
Hypertension
(Deedwania & Mather, 2014)
LV dysfunction
(Deedwania & Mather, 2014)
Rationale
cardiac output
(Deedwania & Mather, 2014)
Excretion of sodium/H20
(Bullock & Manias, 2016)
Fluid retention
(Bullock & Manias, 2016)
Arterial/venous dilation
(Bullock & Manias, 2016)
Preload
(Bullock & Manias, 2016)
Afterload
Decreases vascular resistance
(Bullock & Manias, 2016)
LV filling pressure
(Deedwania & Mather, 2014)
Workload of heart
(Bullock & Manias, 2016)
Side effects
Hypotension
(Deedwania & Mather, 2014) (Bullock & Manias, 2016)
Dizziness
(Bullock & Manias, 2016)
Cough
(Deedwania & Mather, 2014) (Bullock & Manias, 2016)
Renal dysfunction
(Deedwania & Mather, 2014) (Bullock & Manias, 2016)
Hypokalemia
(Deedwania & Mather, 2014) (Bullock & Manias, 2016)
Nursing considerations/precaution
Check BP before administration
(Deedwania & Mather, 2014)
Falls education
(Deedwania & Mather, 2014)
Monitor renal function and electrolytes
(Deedwania & Mather, 2014)
Monitor electrolytes
(Deedwania & Mather, 2014)
Caution when used with NSAIDS
(Deedwania & Mather, 2014)
Enhances side effects
(Deedwania & Mather, 2014)
Can decrease ACEi effect
(Deedwania & Mather, 2014)
Betablockers
(Bullock & Hales, 2019)
Indication
Relieves symptoms of HF
(Deedwania & Mather, 2014)
Prevents progression of HF
(Deedwania & Mather, 2014)
Management of hypertension
(Bullock & Manias, 2016)
Rationale
Cardiac remodelling
(Deedwania & Mather, 2014) (Fletcher, Beta blockers in heart failure)
Improves LV function
(Deedwania & Mather, 2014)
Diastolic filling
(Fletcher, Beta blockers in heart failure)
Cardiac workload
Improves ejection fraction
(Fletcher, Beta blockers in heart failure)
Myocardial relaxation
(Fletcher, Beta blockers in heart failure)
Side effects
Fatigue
(Deedwania & Mather, 2014)
Bradycardia
(Deedwania & Mather, 2014)
Hypotension
(Bullock & Manias, 2016)
Nursing precaution/consideration
Check BP and HR before administration
(Deedwania & Mather, 2014)
Falls education
(Deedwania & Mather, 2014)
Diuretics
(Bullock & Hales, 2019)
Indication
Relieves symptoms of HF
Rationale
Urine production
(Deedwania & Mather, 2014)
Blood volume
(Bullock & Manias, 2016)
BP
(Bullock & Manias, 2016)
Build up of fluid
(Deedwania & Mather, 2014) (Bullock & Hales, 2019)
Reduce fluid overload
(Deedwania & Mather, 2014) (Bullock & Hales, 2019)
Maintain normal blood flow
(Bullock & Manias, 2016)
Side effect
Electrolyte disturbance
(Deedwania & Mather, 2014)
Hypotension
(Deedwania & Mather, 2014)
Diuresis
(Deedwania & Mather, 2014)
Dizziness
Nursing precaution/consideration
Check BP before administration
(Deedwania & Mather, 2014)
Monitor electrolytes
(Deedwania & Mather, 2014)
Falls education
(Deedwania & Mather, 2014)
Monitor weight
(Deedwania & Mather, 2014)
Potential
Angiotensin receptor blockers
(Bullock & Hales, 2019)
Indication
Relieves symptoms of HF
(Bullock & Manias, 2016)
Prevents progression of HF
(Bullock & Manias, 2016)
Hypertension
(Bullock & Manias, 2016)
Rationale
Vasodilation
(Bullock & Manias, 2016)
Blood flow
Blood flow to kidney
(Bullock & Manias, 2016)
GFR
(Bullock & Manias, 2016)
Fluid output
(Bullock & Manias, 2016)
Decreases vascular resistance
(Bullock & Manias, 2016)
Afterload
(Bullock & Manias, 2016)
BP
(Bullock & Manias, 2016)
Side effects
DIzziness
(Bullock & Manias, 2016)
Headaches
(Bullock & Manias, 2016)
Hypotension
(Bullock & Manias, 2016)
Nursing precaution/consideration
Check BP before administration
(Deedwania & Mather, 2014)
Falls education
Monitor renal function and electroytes
(Deedwania & Mather, 2014)
Digoxin
(Bullock & Hales, 2019)
Indication
Improve HF symptoms
(Greenberg & Barnard, 2010)
Rationale
Improves contractabiliity
(Bullock & Manias, 2016)
Increase LV ejection fraction
(Greenberg & Barnard, 2010)
Blood flow
(Bullock & Manias, 2016)
congestion
(Bullock & Manias, 2016)
Urine production
(Bullock & Manias, 2016)
Side effect
Bradycardia
(Bullock & Manias, 2016)
Anorexia and diarrhea
(Bullock & Manias, 2016)
Digoxin serum toxicity
(Bullock & Manias, 2016)
Disorientation
(Bullock & Manias, 2016)
Halluciniation
(Bullock & Manias, 2016)
Electrolyte disturbance
(Bullock & Manias, 2016)
Nursing precaution/consideration
Check manual HR and rhythm before administration
(Bullock & Manias, 2016)
Monitor for signs of toxicity
(Bullock & Manias, 2016)
Monitor renal function and electrolytes
(Bullock & Manias, 2016)
Clinical Manifestations
Decreased cardiac output
(Bullock & Hales, 2019)
Impaired blood circulation
(Bullock & Hales, 2019)
Peripherally cool
(Bullock & Hales, 2019)
Activates RAAS
(Bullock & Hales, 2019)
Increased sodium and water retention
(Bullock & Hales, 2019)
Weight gain
(Bullock & Hales, 2019)
Peripheral oedema
(Bullock & Hales, 2019) (Bullock & Manias, 2016)
Urinary retention
(Bullock & Hales, 2019)
Urine output
Fluid to kidneys
(Bullock & Hales, 2019)
Risk of AKI
(Bullock & Hales, 2019)
function central nervous system
(Bullock & Hales, 2019)
Confusion
(Bullock & Hales, 2019)
Restless
(Bullock & Hales, 2019)
Function sympathetic nervous system
(Bullock & Manias, 2016)
Tachycardia
(Bullock & Manias, 2016)
Vasocontriction
(Bullock & Manias, 2016)
Hypotension
(Bullock & Manias, 2016)
Muscle fatigue
(Bullock & Hales, 2019)
Mobility
(Bullock & Hales, 2019)
Increased cardiac workload
(Bullock & Manias, 2016)
Heart struggles to pump out blood
(Bullock & Manias, 2016)
Pulmonary congestion
(Bullock & Manias, 2016)
Increased work of breathing
(Bullock & Manias, 2016)
Tachypnea
Pulmonary oedema
(Bullock & Manias, 2016)
Crackles in lungs
(Bullock & Manias, 2016)
Myocardial hypertrophy
(Bullock & Manias, 2016)
oxygen demands
(Bullock & Manias, 2016)
Requirement oxygen in myocardium
(Bullock & Manias, 2016)
Oxygen saturations
(Bullock & Manias, 2016)