Congestive Heart Failure

What is CHF?  With heart failure, oxygenated blood enters the left side of the heart from the lungs, but the ventricle can’t pump hard enough to push all the blood out to the body, so some is left behind.  The blood backs up, causing fluid to leak back into the lungs. This is known as LEFT-SIDED HEART FAILURE.  Heart failure can happen on the right side, too.  Blood enters the right ventricle as it should, but the ventricle can’t pump hard enough to get the blood into the lungs, so some is left behind.  This is called RIGHT-SIDED HEART FAILURE.

The main symptoms of CONGESTIVE HEART FAILURE

FATIGUE:  Fatigue is often the first symptom of CHF.  However, it usually goes un-reported until it becomes severe. 

SUDDEN WEIGHT GAIN:  It is not unusual for people with CHF to gain weight in a short period of time due to fluid retention.

SHORTNESS OF BREATH:  Some people with CHF become short of breath at rest and some only with exertion.  Others feel short of breath when they lie down.

EDEMA:  Extra fluid causes swelling, especially in the legs, feel and abdomen.

How can you help clients who have CHF?

• Weigh your clients according to the care plan.  Be sure to weigh them on the same scale, at the same time of day, and wearing the same amount of clothing.
• Some medication doses are adjusted daily based on blood pressure results taken by you.  Be sure to get accurate and timely results, and report your findings to the nurse.
• People with CHF who take in more fluids than they excrete will develop edema.  Because fluid balance is so important for CHF clients, you may be asked to record I & O amounts.
• Be sure to tell your supervisor if you notice your CHF clients adding salt to their food, taking over-the-counter medications, or not taking their prescribed medications.
• Note any activities that seem to bring on, or worsen, a client’s fatigue.  Avoid or modify those types of activities, if possible.
• Ask your clients to rate their fatigue from “zero” (no fatigue) to “ten” (the worst possible fatigue).  Report the response to your supervisor so that the entire health care team is aware of the problem.