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1. Please explain the pathophysiology of right-sided heart failure and left sided heart failure.

2. What are the signs and symptoms of left-sided heart failure vs right-sided heart failure? Explain physical examination findings you would see in both types. Please make two lists.
3. What diagnostic imaging tests would you expect to be performed to diagnose heart failure and why?
4. What are some laboratory tests that might be done to help diagnosis heart failure?
5. What are possible medications that might be ordered for your patient with heart failure? What type of diet would be ordered?
6. What are your nursing priorities and potential concerns for a patient with heart failure?

1 Answer

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Final answer:

Right-sided heart failure results in systemic venous congestion, while left-sided heart failure causes pulmonary congestion. Diagnosis is made through imaging like echocardiography and chest X-ray, plus lab tests such as BNP levels. Treatment includes medications, a low-sodium diet, and careful nursing management.

Step-by-step explanation:

Right-sided heart failure involves the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation, resulting in elevated pressures in the systemic venous system. The left-sided heart failure is characterized by the left ventricle's incapacity to pump enough oxygenated blood to meet the body's demands, leading to increased pressure in the pulmonary circuit. Symptoms and physical findings differ between the two.

Signs and Symptoms

  • Left-sided heart failure: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, pulmonary crackles, and decreased oxygen saturation.
  • Right-sided heart failure: peripheral edema, jugular venous distention, hepatomegaly, and ascites.

Diagnostic Imaging Tests

Diagnostic imaging tests may include echocardiography (to assess heart function), chest X-ray (to observe heart size and pulmonary congestion), and magnetic resonance imaging (MRI) (to evaluate cardiac muscle and function).

Laboratory Tests

Common tests include B-type natriuretic peptide (BNP) levels, complete blood count (CBC), and serum electrolytes, renal function tests, and liver function tests.

Medications and Dietary Management

Treatment could include ACE inhibitors, beta-blockers, diuretics, and aldosterone antagonists. A low-sodium diet is typically recommended.

Nursing Priorities and Concerns

Managing symptoms, monitoring for medication effects, educating about self-care and diet, as well as monitoring for signs of fluid overload or worsening heart function are vital priorities for nursing care in heart failure patients.

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