Congestive Cardiac Failure: Signs, Symptoms, Drugs, and Nursing Care

This article discusses congestive cardiac failure, its signs and symptoms, pathophysiology, two common classes of drugs used for treatment, and nursing care strategies. It also includes a case study of an elderly patient and references for further reading.

Congestive cardiac failure 1
Table of Contents
Congestive cardiac failure......................................................................................................................2
Signs and symptoms with path physiology............................................................................................3
Two common classes of drugs used for congestive cardiac failure patient:..........................................5
Strategies related to nursing care..........................................................................................................6
References.............................................................................................................................................9

Congestive cardiac failure 2
Congestive cardiac failure
Congestive cardiac failure occurs when the muscles of the heart are not able to pump
sufficient blood as required. It is a chronic condition where the arteries of the heart are
narrowed or the gradually high blood pressure results in weakening of the heart or become
stiff and is not able to pump or fill efficiently (Ohuchi & Diller, 2014). Mrs. Sharon
McKenzie was suffering from hypertension that is of high risk which is also one of the
condition which can cause the congestive cardiac failure (Ohuchi & Diller, 2014). Beside
this, the coronary arteries contraction is also one of the causes of congestive cardiac failure in
the case of Mrs. Sharon McKenzie. Mrs. Sharon McKenzie was a 77 year old woman and
was already taking the dose of 250mcg digoxin which was prescribed when she suffered from
Myocardial infarction (MI) around 12 years before which was as a result of the heart muscle
damage (Ohuchi & Diller, 2014). Such a heavy dose of the digoxin results in the higher level
of the digitalis in the body. The human body receives the remedial effect sonner it accumlates
around 8 to 12 mcg/kg with least risk of toxicity amongst patients having the threat of
breathing rhythm, heart failure or normal sinus. In the case of Myocardial infarction (MI)
patients are advised with the diuretics which results in removing the extra fluid form the body
and results in the loss of potassium among the patients and increase the risk of the congestive
cardiac failure. The low level of potassium that is 2.5mmol/l was observed in Mrs. Sharon
McKenzie’s which can also be one of the causes of congestive cardiac failure in the case
(Packer, 2018).

Congestive cardiac failure 3
In the case of Mrs. Sharon McKenzie, congestive cardiac faliure is incident while selling in
the feets and ankles also shortness in the breath was observed which are certain symptoms
that are related to the congestive cardiac failure.
In the elderly age, there is turn down in the renal functioning and hence this results decrease
in the volume of distributing blood. In the case, stage 2 hypertension was experienced which
is the major risk factor as in the case the heart has to work harder (Packer, 2018). The
medications which Mrs. Sharon has also one of the major causes that increases the risk of the
congestive cardiac failure. The inability of breathing in a proper way results in low levels of
the oxygen in the blood with an increased risk of the irregular heart rhythms (Packer, 2018).
Congestive cardiac failure is a condition that is life threatening and rigorously impacts the
patient and the families. Many times the individual suffers from the cardiac failure lack the
social support; increased social support increases the healing rate (Núñez, Núñez, Miñana,
Bayés-Genis & Sanchis, 2016).
Signs and symptoms with path physiology
The common signs and symptoms related to the congestive cardiac failure along with
the pathophysiology are discussed below:
Signs and symptoms pathophysiology
Congestive cardiac failure results in certain
neurologic symptoms and signs such as the
visual disturbances, disorientation, and
confusion (Klapholz, 2003). In certain
Physiologies related to the neurological
symptoms are very complex and identifying
them at most of the time is incomplete them
are mostly incomplete. From the perspective

Congestive cardiac failure 4
instances the bright spots are seen, having the
blurry vision of experiencing blind spots.
In certain cases, the symptoms of more or
less urination are observed as compared to
normal with swelling in certain body parts
(Klapholz, 2003).
of evolutionary, it is easy to judge (Klapholz,
2003).
Severe ventricular arrhythmias:
Dizziness, light-headedness, fluttering,
pounding, chest discomfort, quivering, fast
heart beats with pain and breath shortness, is
normally reported among the patients
(Shavelle, 2016).
Pathophysiology of the said symptoms is
covered by two fundamental mechanisms.
Arrhythmogenesis is one of the common
mechanism which results re entry (Shavelle,
2016).
This results in changes in the state of mind
and mood too (Shavelle, 2016).
Activated action happens after depolarization
and tardy following depolarization
commence numerous depolarization,
impulsive ventricular arrhythmias (Shavelle,
2016)
Hyperkalemia
The elevated pace of potassium in blood
influence the heart functioning.
Hyperkalemia sign include
Hyperkalemia consequence rise of potassium
level in the body and resulting in an
imbalance of emission vs intake or
misdistribution among the intra and extra

Congestive cardiac failure 5
heart rate being slow
heart rhythm being Abnormal
Weakness (Shavelle, 2016)
cellular space (Shavelle, 2016)
Sinus Node Dysfunction:
comprises syncope, weakness, palpitations,
effort intolerance and analysis through ECG
requirement of Pacemaker for the
Symptomatic patients (McDonald, Conlon &
Ledwidge, 2007)
SND grounds irregularity among the
structure of Sinus node impulse and
dissemination so as to causes malformation
among the atrium and also among the
conduction system of the heart (McDonald,
Conlon & Ledwidge, 2007).
Two common classes of drugs used for congestive cardiac failure patient:
The two classes of the drug that is to be used while treating the elderly patients
suffering from the congestive heart failure are discussed below:
The first class of the drug class that is meant to be helpful while treating the congestive
cardiac failure patients is the (ACE) angiotensin-converting enzyme inhibitors that broaden
the blood vessels and additional decreases the work load of the heart. ACE drug resutts in
reducing the angiotensin II production and applies the biologic consequence so as to improve
symptoms, slash hospitalizations, and extend survival (Jeon, Kraus, Jowsey & Glasgow,
2010).
The ACE inhibitors acquire the enhanced outcome between the patients with systolic
dysfunction, quite a few patients with hypertension practice congestive heart collapse as a

Congestive cardiac failure 6
consequence of the diastolic dysfunction which is connected to the left ventricular
hypertrophy. The ACE inhibitors end result in diverting or reversing the left ventricular
hypertrophy between the patients who all are suffering from hypertension (Jeon, Kraus,
Jowsey & Glasgow, 2010). The meta-analysis consequence of assured antihypertensive
agent recommends that ACE inhibitors be the mainly effectual agent in reducing the left
ventricular hypertrophy. The erstwhile class of the medicine that is to be recommended is the
Beta-blockers that reduces the heart tempo and block the needless blockage which is there in
the heart. This classification of the medicine is also helpful in the heart syndromeplus it is
mostly taken into use with the ACE inhibitors for providing an extra advantage. Beta
blockers might also for the time being aggravate indicators but it on the other hand also in the
long-term marks a development in the implementation of the heart (Jeon, Kraus, Jowsey &
Glasgow, 2010).
The Beta blocker set of drugs are helpful to the purpose of the worsening LV plus it also
requires preventing and the reversing progressive LV chamber, dilation, hypertrophy, and
sphericity. The drug Beta stops and also reduces the rate of the heart beat and the anxiety
between the LV walls (Walthall, Jenkinson & Boulton, 2017). The current research in the
labs also proves that the beta blockers please the cardiomyocyte apoptosis refer the heart
breakdowns. Discussed are the essential profits and beneficial for a beta blocker for the refer
the patients at any of the advanced stages (Walthall, Jenkinson & Boulton, 2017).
Strategies related to nursing care
Mrs. Sharon was an aged patient aged 77 years; she wants a due concern and soft
dealing. She is moreover having the precedent record of the MI that is also to be kept in mind

Congestive cardiac failure 7
as suggesting her medication and cure related to the congestive cardiac collapse (Seah, Tan &
Wang, 2015). In case of the congestive cardiac stoppage will have a habitual monitoring of
the continuous renal working with this the edema and the auscultator of the lungs (Seah, Tan
& Wang, 2015). The main aim of the cure is declining of the level of the cardiac collapse plus
comforting the instant remedial help while confronting the inhalation shortness that includes
the wide-ranging accommodating care; discontinue of the digoxin and averting of extra
exposure; organization of the definite antibody fragments like digoxin immune Fab;
treatment of the specific complications like dysrhythmias and electrolyte abnormalities
(Tsujii, 2013).
Supportive care
The compassionate care comprises to connect patients to the cardiac test, providing IV fluid
to the tolerant with volume reduction or hypotension, supplemental oxygen, or the repletion
of the electrolytes in the middle of the patients having the electrolyte abnormalities (Mittal,
Katta & Alpert, 2016).
In case of Mrs. Sharon McKenzie, the hyperkalemia is rectified or corrected with glucose/
insulin in the case calculated as life-threatening, like the consequence of risk constructing
hypokalemia, as the level of potassium in Mrs. Sharon McKenzie case is low down i.e. 2.5
mmol/l . In a learning, it is clear that the insulin acts mutually straight with Na(+)/K(+)
(Bergamini, Cicoira, Rossi & Vassanelli, 2009) ATPase energy and adapt the consequence of
digoxin (Bergamini, Cicoira, Rossi & Vassanelli, 2009). This chains the conclusion that
patients suffering from the problem of diabetes, insulin prove to contain the cardio defensive
effects subsequent to digoxin intoxication (Bergamini, Cicoira, Rossi & Vassanelli,

Congestive cardiac failure 8
2009) .Calcium is not functional for treating the hyperkalemia tolerant with understood
digoxin toxicity plus may encourage the cardiac catch (Betihavas et al., 2011).
Bradycardia management
Mrs. Sharon McKenzie’s ECG description reveals sinus bradycardia, that’s to be treated all
the way through atropine. Atropine is advisable after each 3 to 5 minutes till there is an
answer or utmost dose 3mg is achieved or reached (Betihavas et al., 2011).
Hemodynamic compromise management
Refer case of Mrs. Sharon McKenzie, it is shown that the hemodynamic deficiency or the
hypotension, distorted consciousness symbols, dizziness, digoxin resistant Fab is provided as
the most important administration (Ohuchi & Diller, 2014).
The monitoring of the patient along with the alteration in medication is also considered as
one among the main nursing strategies on the occasion of congestive cardiac collapse (Otsu
& Moriyama, 2010). If at all possible, digoxin is to be stopped and an untouched medicine
for proper command of rate or the unlike inotrope is to be approved for arterial tremble or
respectively.

Congestive cardiac failure 9
References
Bergamini, C., Cicoira, M., Rossi, A., & Vassanelli, C. (2009). Oxidative stress and
hyperuricaemia: pathophysiology, clinical relevance, and therapeutic implications in
chronic heart failure. European Journal Of Heart Failure, 11(5), 444-452.
Betihavas, V., Newton, P., Du, H., Macdonald, P., Frost, S., Stewart, S., & Davidson, P.
(2011). Australia's health care reform agenda: Implications for the nurses’ role in chronic
heart failure management. Australian Critical Care, 24(3), 189-197.
Jeon, Y., Kraus, S., Jowsey, T., & Glasgow, N. (2010). The experience of living with chronic
heart failure: a narrative review of qualitative studies. BMC Health Services
Research, 10(1).
Klapholz, M. (2003). Heart Failure in the Elderly. Heart Disease, 5(4), 241-243.
McDonald, K., Conlon, C., & Ledwidge, M. (2007). Disease management programs for heart
failure: Not just for the ‘sick’ heart failure population. European Journal Of Heart
Failure, 9(2), 113-117.
MITTAL, M., KATTA, N., & ALPERT, M. (2016). Role of isolated ultrafiltration in the
management of chronic refractory and acute decompensated heart failure. Hemodialysis
International, 20, S30-S39.
Núñez, J., Núñez, E., Miñana, G., Bayés-Genis, A., & Sanchis, J. (2016). Worsening Renal
Function in Acute Decompensated Heart Failure. JACC: Heart Failure, 4(3), 232-233.

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Ohuchi, H., & Diller, G. (2014). Biomarkers in Adult Congenital Heart Disease Heart
Failure. Heart Failure Clinics, 10(1), 43-56.
OTSU, H., & MORIYAMA, M. (2010). Effectiveness of an educational self-management
program for outpatients with chronic heart failure. Japan Journal Of Nursing
Science, 8(2), 140-152.
Packer, M. (2018). Acute Heart Failure Is an Event Rather Than a Disease. JACC: Heart
Failure, 6(1), 73-75.
Seah, A., Tan, K., & Wang, W. (2015). A Narrative Literature Review of the Experiences of
Patients Living With Heart Failure. Holistic Nursing Practice, 29(5), 280-302.
Shavelle, D. (2016). Coronary Artery Disease. Heart Failure Clinics, 12(1), i.
Tsujii, Y. (2013). Management of the Patients with Chronic Heart Failure; the Role for
Nurses and Team Management. Journal Of Cardiac Failure, 19(10), S112.
Walthall, H., Jenkinson, C., & Boulton, M. (2017). Living with breathlessness in chronic
heart failure: a qualitative study. Journal Of Clinical Nursing, 26(13-14), 2036-2044.