Parma Community General Hospital Congestive Heart Failure Re-Engineered Hospital Discharge Patient Education Teaching Module By: Cindy Grindstaff RN BSN, 4/2011 The University of Akron, College of Nursing

Congestive Heart Failure Patient Education Teaching Module Instructions: -The following tutorial is on heart failure. -Press ENTER to continue to next slide, OR click left mouse button. This key is located to the right of the computer Or use left button of the mouse to proceed Created by: Cindy Grindstaff RN BSN

Congestive Heart Failure Patient Education Teaching Module Introduction Congestive Heart Failure is the most common medical diagnosis which requires readmission to the hospital within 30 days. Created by: Cindy Grindstaff RN BSN

Congestive Heart Failure Patient Education Teaching Module Introduction Heart Failure is a common condition that affects nearly 5,000,000 people. Created by: Cindy Grindstaff RN BSN

Congestive Heart Failure Patient Education Teaching Module Introduction Older people are most affected by heart failure, but it can occur at any age. Created by: Cindy Grindstaff RN BSN

Heart Failure Heart Failure is a condition where the heart cannot pump blood effectively. Created by: Cindy Grindstaff RN BSN

Heart Failure When the heart cannot pump blood effectively, the blood in the heart may back up into the lungs or other parts of the body. Created by: Cindy Grindstaff RN BSN

Heart Failure When this happens the lungs become filled with fluid and become congested. This is why it’s called Congestive Heart Failure. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure As we get older, our hearts can become weaker. Heart failure can occur at any age. Heart Attacks can cause damage to the heart that results in heart failure. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure Heart Valve diseases can also cause heart failure. High Blood Pressure or Hypertension can also cause heart failure, by increasing the workload of the heart. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure Coronary Artery Disease can also cause heart failure by fatty plaques that sticks to the walls of the arteries in the heart. This can also increase the workload of the heart, resulting in heart failure. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure Coronary Artery Disease can progress until the arteries of the heart become completely clogged, which results in heart attack. This can later can progress into heart failure. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure The first symptom of Coronary Artery Disease is chest pain or also called Angina. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure When heart attacks occur they cause damage to the heart muscle, which decreases it’s ability to pump effectively. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure Over time, the heart will weaken and become enlarged which is also known as cardiomyopathy. Created by: Cindy Grindstaff RN BSN

Causes of Heart Failure Other causes of cardiomyopathy that eventually result in heart failure are: -Cancer, certain chemotherapy drugs, & radiation -Cocaine and Illegal drug use -Alcohol abuse -Diabetes -HIV or AIDS -Thyroid Disease Created by: Cindy Grindstaff RN BSN

Certain risk factors predispose to certain people to heart failure. Being older than 65 yrs. old Being of African American descent Males are at greater risk than females Congenital heart disease Created by: Cindy Grindstaff RN BSN

Symptoms Weight gain is one of the first signs a person will have with heart failure. This can happen quickly or more slowly. Over a period of several days to several weeks. Created by: Cindy Grindstaff RN BSN

Symptoms This happens because fluid begins to collect or build up in the legs, ankles, feet, hands, or stomach area. Created by: Cindy Grindstaff RN BSN

Symptoms People with heart failure can become easily tired or remain tired all the time. Created by: Cindy Grindstaff RN BSN

Symptoms People with heart failure can become short of breath while doing normal things, like walking distances or climbing stairs. Created by: Cindy Grindstaff RN BSN

Symptoms As heart failure gets worse, it becomes harder to do walk or perform daily activities. Created by: Cindy Grindstaff RN BSN

Symptoms When fluid in the heart backs up into the lungs, the person with heart failure may find it harder to breathe. Created by: Cindy Grindstaff RN BSN

Symptoms The person with heart failure may wake up during the night choking or gasping for air. Created by: Cindy Grindstaff RN BSN

Symptoms As heart failure becomes worse, the person with heart failure can even begin cough up pink frothy sputum. Created by: Cindy Grindstaff RN BSN

Symptoms As the lungs become filled with fluid, you may have a persistent moist cough up mucus or blood. Created by: Cindy Grindstaff RN BSN

Symptoms If this occurs the doctor should be contacted immediately, have somebody drive you to the emergency room, or call 911. Created by: Cindy Grindstaff RN BSN

Symptoms Sometimes it may become difficult to lie flat in bed, and you may need several pillows to breathe easier while lying down. Created by: Cindy Grindstaff RN BSN

The doctor should be notified immediately if: -You have difficulty taking medicine as prescribed. -You have an increase in shortness of breath. Created by: Cindy Grindstaff RN BSN

The doctor should be notified immediately if: -Your hands, feet or abdomen begin to swell more than usual. -You have a cough that will not go away. -You suddenly need more pillows to sleep at night. Created by: Cindy Grindstaff RN BSN

The doctor should be notified immediately if: - You wake up at night gasping for air, or because you need to catch your breath. -You suddenly become dizzy, or dizziness worsens. Created by: Cindy Grindstaff RN BSN

The doctor should be notified immediately if: -You gain more than 2 pounds in a day, or 5 pounds within 5 days. Created by: Cindy Grindstaff RN BSN

The doctor should notified immediately if: -You feel an irregularity in your heart, or it begins to beat faster than normal. Created by: Cindy Grindstaff RN BSN

Have Somebody drive you to the emergency room, or call 911 if: -You have SEVERE shortness of breath. -You cough up pink frothy sputum. -You develop chest pain or tightness that is NOT resolved by rest or taking Nitroglycerin. Created by: Cindy Grindstaff RN BSN

A full assessment must be completed by your physician. Diagnosis A full assessment must be completed by your physician. The physician may also ask about your family health history. Created by: Cindy Grindstaff RN BSN

What are your daily activities; are you active or sedentary? Diagnosis What are your daily activities; are you active or sedentary? What are your daily health habits? For example drinking, smoking? Created by: Cindy Grindstaff RN BSN

Diagnosis - A Chest X-Ray Created by: Cindy Grindstaff RN BSN

The doctor will perform a full physical, this may include: Diagnosis The doctor will perform a full physical, this may include: -An EKG also known as an electrocardiogram to record an image of the heart’s electrical activity Created by: Cindy Grindstaff RN BSN

-An echocardiogram which is like an ultrasound of the heart. Diagnosis -An echocardiogram which is like an ultrasound of the heart. Created by: Cindy Grindstaff RN BSN

Diagnosis -Blood work which includes a test called a BNP which rises during heart failure. Created by: Cindy Grindstaff RN BSN

Diagnosis You may be asked to wear a Holter monitor which will record heart activity for a specified amount of time. Created by: Cindy Grindstaff RN BSN

Diagnosis More invasive tests include cardiac catheterization. These tests allow the doctor to visualize any blockages in the artery of the heart. Created by: Cindy Grindstaff RN BSN

Treatments Your doctor will determine the severity of your heart failure. Treatment and medications prescribed will be based on the severity of the disease. Created by: Cindy Grindstaff RN BSN

Some of the possible medications are as follows: Treatments Some of the possible medications are as follows: -Diuretics, also known as water pills, will rid extra fluid in your system, reduce foot and ankle swelling, and help prevent fluid build-up in the lungs. Created by: Cindy Grindstaff RN BSN

Treatments Beta blockers reduce heart rate, lower blood pressure and reduce workload on the heart. Created by: Cindy Grindstaff RN BSN

Treatments ACE inhibitors also reduce blood pressure and workload of the heart. ACE inhibitors can reduce the chance of future heart attacks. Created by: Cindy Grindstaff RN BSN

Digoxin helps make the heart beat stronger and more effectively. Treatments Digoxin helps make the heart beat stronger and more effectively. Created by: Cindy Grindstaff RN BSN

Treatments Drugs like nitrates and Hydralzine help relax blood vessels which helps relax blood vessels which may prevent chest pain/angina. Created by: Cindy Grindstaff RN BSN

Treatments Angiotensin Receptor Blockers (Cozaar) relax vessels to lower blood pressure and reduce workload of the heart. Created by: Cindy Grindstaff RN BSN

Healthier Lifestyles Eat a healthy, low fat diet no more than 30% of calories should come from fat. Created by: Cindy Grindstaff RN BSN

Healthier Lifestyles Maintain a diet that is fiber rich and low in salt (less than 1500 mg per day). If you need help choosing healthier selections see a nutritionist. Usually, your doctor can arrange to help you see one. Created by: Cindy Grindstaff RN BSN

Healthier Lifestyles Avoid processed meats that can be high in salt and fat. Do not eat frozen or canned foods they contain high amounts of salt. Created by: Cindy Grindstaff RN BSN

Increase physical activity, but do balance rest with activity. Healthier Lifestyles Increase physical activity, but do balance rest with activity. Do not try to overdo it, stay within the limits the physician prescribes. If you are overweight. attempt to lose weight. Created by: Cindy Grindstaff RN BSN

Healthier Lifestyles Weigh yourself every morning without clothing, after you urinate but before you eat breakfast. Created by: Cindy Grindstaff RN BSN

Healthier Lifestyles Check your blood pressure, and blood sugar levels regularly. Be sure to attend cholesterol screenings, as recommended. Created by: Cindy Grindstaff RN BSN

Do not consume alcohol, smoke or take any illegal drugs. Healthier Lifestyles Do not consume alcohol, smoke or take any illegal drugs. Try to avoid stress, and stressful situations. Created by: Cindy Grindstaff RN BSN

Be sure to get enough sleep at night. Healthier Lifestyles Be sure to get enough sleep at night. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Questions and answers Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Question # 1 Fluid that builds up in the lungs, happens, because the heart cannot pump all the blood it receives? True or False? Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Answer to question # 1 True. Fluid builds up in the lungs, because the heart cannot handle all the blood it receives with Congestive Heart Failure. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Question # 2 Weigh yourself every morning after urinating before you eat breakfast. Should you call your doctor if you weigh more than 2 pounds than you did yesterday? Yes or No? Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Answer to Question # 2 Yes. This more than likely due water weight gain, and you should always call the doctor if you gain 2 pounds in one day or 5 pounds in 5 days. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Question # 3 After a heart attack, a person is more likely to experience heart failure? True or False? Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Answer to Question # 3 True. Heart Attacks can cause damage to the heart muscle which can result in heart failure. This happens because the workload on the heart increases and weakens the heart over time resulting in heart failure. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Question # 4 You must take the prescribed medicine daily to help control heart failure? True or False? Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Answer to Question # 4 True. The medicine your doctor orders must be taken daily as prescribed for it to work effectively. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Question # 5 Patients with heart failure should not exercise? True or False? Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Answer to Question # 5 False. Exercise can help give the heart strength. Make sure any exercise is approved by your physician before exercising. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Discharge Before you leave the hospital, be sure that any questions about medicines are answered. Be sure to call your doctor if you cannot take the medication as prescribed. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Discharge Be sure to call your doctor if you have adverse side effects. If there is something you do not understand ask to speak to your nurse before leaving the hospital. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Discharge Be sure that you have a follow up appointment with a time and date, prior to leaving the hospital. Be sure to keep all scheduled appointments. Created by: Cindy Grindstaff RN BSN

Created by: Cindy Grindstaff RN BSN Discharge If you have trouble breathing, onset of dizziness, or are coughing up pink or blood tinged mucus. Call 911, or have someone drive you to the nearest emergency room. Created by: Cindy Grindstaff RN BSN

References Retrieved on, 18, April 2010 from: http://www.nlm.nih.gov/medlineplus/tutorials/congestiveheartfailure/htm/lesson.htm Created by: Cindy Grindstaff RN BSN