RIGHT SIDED HEART FAILURE

09/09/21 JAAFAR, AR-SHAHAF A.

 01 Assessment

02 Diagnosis

contents 03

04
Planning

Intervention/outcome

05 Evaluation

06 Patient Education
 ASSESSMENT
THE HEART
The heart is a muscular organ
about the size of a fist, located
just behind and slightly left of
the breastbone. The heart
pumps blood through the
network of arteries and veins
called the cardiovascular
system.
 ASSESSMENT
PATHOPHYSIOLOGY RHF
Right-sided heart THE RIGHT SIDE OF THE HEART IS NOT
failure simply means PUMPING EFFECTIVELY
that the right side of
INCREASE BACKFLOW OF BLOOD TO THE
the heart is not
BODY
pumping blood to the
lungs as well as DECREASE BLOOD THAT’S MAKING INTO
normal. THE THE LUNGS

JVD EDEMA
ASSESSMENT
CLINICAL
• Shortness of breath (dyspnea)
• MANIFESTATIONS:
Weakness and lethargy
• Fatigue
• Swelling (edema), that often involves not only the ankles
and lower extremities but also the thighs, abdomen, and
chest
• Swollen, painful liver
• Severe ascites
• Significant loss of appetite
• Fainting (syncope) in response to exercise
• Dizziness
• Sudden weight gain
• Increased urge to urinate
• Swollen neck veins
• Forgetfulness and confusion
 ASSESSMENT
RISK FACTORS:
• Age: Men (50-70)
• Congenital heart defects
• Chronic diseases: COPD, pulmonary fibrosis, diabetes, HIV
• Irregular heartbeats
• Left-sided heart failure
• Left-to-right shunt
• Lung conditions
• Pericardial constriction
• Previous heart attack
• Race: African-American men
• Some chemotherapy and diabetes medications: Certain drugs have been found to
increase the risk of right-sided heart failure.
• Valvular heart disease
• Viral infection
 PLANNING
GOAL OF CARE:
Nursing care plan goals for patients with heart failure
includes support to improve heart pump function by
various nursing interventions, prevention, and
identification of complications, and providing a teaching
plan for lifestyle modifications. Nursing interventions
include promoting activity and reducing fatigue to relieve
the symptoms of fluid overload.

NURSING PROBLEMS:
• Decreased Cardiac Output
• Activity Intolerance
• Excess Fluid Volume
• Risk for Impaired Gas Exchange
• Risk for Impaired Skin Integrity
• Deficient Knowledge
• Acute Pain
 DIAGNOSIS
DIAGNOSTIC TEST:
• Electrocardiogram (ECG) and echocardiogram studies, which can reveal elevated pulmonary artery pressure and
may also reveal valvular heart disease or disease affecting the cardiac muscle2
• Pulmonary function testing to confirm the presence and severity of COPD
• Blood tests to measure substances in the blood released in response to heart failure and to assess kidney, liver,
and thyroid function
• Sleep study to determine if apnea is a factor
• Computerized tomography (CT) scans, which are 3-D X-rays of the heart
• Magnetic Resonance Imaging (MRI) which use radio waves, magnets, and a computer to create detailed pictures
of the heart
• Cardiac catheterization, in which a catheter is inserted into a chamber or vessel of the heart to diagnose blockages
and defects
• Coronary angiography, which involves injecting dye that can be seen on an X-ray into the heart chambers so the
flow of blood through the heart can be visualized
• Chest X-rays to determine whether the heart is enlarged and/or the lungs are congested
• Cardiac stress testing, which assesses heart function during exercise under controlled conditions: Used along with
an EKG, the test can show changes to the heart’s rate, rhythm, or electrical activity as well as blood pressure.
 IMPLEMENTATION
DECREASED CARDIAC OUTPUT
ACTIVITY INTOLERANCE
IMPLEMENTATION
EXCESS FLUID VOLUME
IMPLEMENTATION
 EVALUATION/OUTCOME
DECREASED CARDIAC OUTPUT
At the end of 8 hrs nursing action
• Patient has demonstrated adequate cardiac output as evidenced by vital signs within acceptable limits,
dysrhythmias absent/controlled, and no symptoms of failure (e.g., hemodynamic parameters within
acceptable limits, urinary output adequate).
• Patient has reported decreased episodes of dyspnea, angina.
• Patient has participate in activities that reduce cardiac workload.

ACTIVITY INTOLERANCE
• Patient has participated in desired activities; met own self-care needs.
• Patient has achieved measurable increase in activity tolerance, evidenced by reduced fatigue and
weakness and by vital signs within acceptable limits during activity.

EXCESS FLUID VOLUME

• Patient has demonstrated stabilized fluid volume with balanced intake and output, breath sounds
clear/clearing, vital signs within acceptable range, stable weight, and absence of edema.
• Patient has verbalized understanding of individual dietary/fluid restrictions.
PATIENT EDUCATION
PATIENT EDUCATION
PATIENT EDUCATION
PATIENT EDUCATION
PATIENT EDUCATION
THANK YOU ！