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Acute Decompensated Heart Failure
acute/emergency worsening of HF
ADHF Pathophysiology
LV is less effective→ increase in pulmonary venous pressure → pulmonary vessels engorged→ fluid filled into lungs/alveoli → patient can’t breath properly
ADHF triggers
medication forgotten
arrhythmias
ischemia
lifestyle
uncontrolled HTN
renal failure
embolism
ADHF Progressive Manifestations
Early: pulmonary venous pressure increased causing increased respiratory rate
Later: interstitial edema = tachycardia → respiratory acidemia
ADHF Manifestations
Resp: dyspnea, orthopnea, tachypnea, crackles, wheezes, rhonchi, cough with blood ting sputum
Neuro: anxious, change LOC
Cardiac: tachycardia, hypotension, HTN, cardiogenic shock, pericardial tamponade
Accessory mucles usage
Skin: pale, cool, clammy, cyanotic
ADHF Nursing Assessment
VS
Pulse Ox
Urine Output
Labs
Resp/Cardio/Renal assessment
Position in HIGH FOWLERS
Oxygen >92
ADHF Medications
Diuretics
Vasodilators
Morphine
Positive inotropes