🌟 **Heart Failure: NCLEX Study Guide** 🌟 🔖 **Definition** Heart failure (HF) is a chronic condition where the heart struggles to pump enough blood to meet the body's needs. It is classified into: 🔸 **Left-Sided Heart Failure (LHF)** – Blood accumulates in the lungs 🫁 🔸 **Right-Sided Heart Failure (RHF)** – Blood accumulates in the body 🦵 🔸 **Systolic HF** – Weak heart contraction (⬇️ ejection fraction) 🔸 **Diastolic HF** – Stiff heart, impaired relaxation (preserved EF) ⚠️ **Causes of Heart Failure** 🩸 **Left-Sided HF Causes:** ✔️ **Hypertension (HTN)** – Increases afterload, making pumping harder 💓 ✔️ **Coronary Artery Disease (CAD)** – Blocks blood flow to the heart ❤️ ✔️ **Valvular Disease** – Faulty heart valves increase workload ⚠️ ✔️ **Cardiomyopathy** – Weakens the heart muscle 🫀 🫁 **Right-Sided HF Causes:** ✔️ **Left-sided heart failure** – 🚨 #1 most common cause! ✔️ **Chronic lung diseases (COPD, Pulmonary HTN)** – Lungs increase heart pressure 🫁 ✔️ **Right ventricular MI** – Damages the right heart muscle ❌ ⚠️ **Signs & Symptoms** (NCLEX Focus) 🌬️ **Left-Sided HF ("L" for Lungs)** 🔴 **Pulmonary congestion (fluid in lungs):** ✔️ Dyspnea (shortness of breath) 😮‍💨 ✔️ Orthopnea (trouble breathing when lying down) 🛏️ ✔️ Paroxysmal nocturnal dyspnea (waking up gasping for air) ✔️ Crackles/Wheezing in lungs 🫁 ✔️ Cough with frothy, pink-tinged sputum ❗ 🔴 **Other symptoms:** ✔️ Fatigue & Weakness 💤 ✔️ Confusion & Restlessness (low oxygen to brain 🧠) ✔️ Tachycardia (fast heart rate) 🦵 **Right-Sided HF ("R" for Rest of Body)** 🔵 **Systemic congestion (fluid retention):** ✔️ Peripheral edema (swollen legs & feet) 🦵 ✔️ Ascites (fluid buildup in the abdomen) 🌊 ✔️ Jugular vein distention (JVD) – Bulging neck veins ✔️ Hepatomegaly (enlarged liver) & Splenomegaly ✔️ Weight gain (fluid overload) ⚖️ ✔️ Loss of appetite & Nausea 🧪 **Diagnostic Tests** 📍 **BNP (B-type Natriuretic Peptide):** ✅ BNP >100 = Heart failure indicator! 📊 📍 **Echocardiogram:** ✅ Measures ejection fraction (EF): ➡️ Systolic HF = EF <40% ➡️ Diastolic HF = EF normal (≥50%) 📍 **Chest X-ray:** ✅ Shows pulmonary congestion & enlarged heart 🩻 📍 **Electrocardiogram (ECG):** ✅ Detects arrhythmias or ischemia 📍 **Hemodynamic monitoring:** ✅ Measures pressures in the heart & lungs 👩‍⚕️ **Nursing Interventions (NCLEX Focus)** ✔️ Monitor weight daily – 🚨 Weight gain >2-3 lbs in 24 hours = fluid overload! ✔️ Vital signs: ⬆️ HR, BP changes, O2 saturation ✔️ Assess breath sounds: Crackles = fluid overload ✔️ Monitor I&O (intake & output) 📍 **Positioning & Oxygenation** ✔️ High Fowler’s position – Helps breathing ⬆️🛏️ ✔️ Oxygen therapy – If O2 sat ⬇️ 📍 **Diet & Lifestyle** ✔️ Low-sodium diet 🧂❌ (<2g/day) ✔️ Fluid restriction (if prescribed) 🚰❌ ✔️ Avoid alcohol & smoking 🚬❌ ✔️ Encourage mild exercise as tolerated 🏃 💊 **NCLEX Medications for Heart Failure** 1️⃣ **Diuretics (Remove Extra Fluid 💦)** ✔️ Loop Diuretics (Furosemide, Bumetanide): ➡️ Watch for Hypokalemia (Low K+) ⚠️ ➡️ Risk of Ototoxicity if given too fast IV ✔️ Potassium-Sparing Diuretics (Spironolactone): ➡️ Watch for Hyperkalemia (High K+) 2️⃣ **ACE Inhibitors (-pril: Lisinopril, Enalapril)** ✔️ Action: Lowers BP & decreases heart workload ✔️ Side effects: ➡️ Persistent dry cough – 🚨 Switch to ARB ➡️ Hyperkalemia ➡️ Angioedema (swollen lips/tongue = EMERGENCY ❗) 3️⃣ **ARBs (-sartan: Losartan, Valsartan)** ✔️ Used if ACE inhibitors cause cough 🤧 4️⃣ **Beta-Blockers (-lol: Metoprolol, Carvedilol, Atenolol)** ✔️ Slows heart rate & reduces heart workload ✔️ Side effects: ➡️ Bradycardia (<60 bpm) ❗ ➡️ Hypotension ➡️ Fatigue & Dizziness 5️⃣ **Digoxin (Cardiac Glycoside)** ✔️ Increases heart contractility 💪, slows HR ✔️ Toxicity signs: 🚨 ➡️ Nausea, Vomiting 🤮 ➡️ Vision changes (Halos, yellow-green vision 👀) ➡️ Toxic level: >2.0 ng/mL 6️⃣ **Vasodilators (Hydralazine, Nitroglycerin)** ✔️ Reduce preload & afterload ✔️ Watch for: Headache, Hypotension 🚨 **Key NCLEX Takeaways (Must-Remember Facts!)** ✔️ Left HF = Lungs 🫁 (crackles, dyspnea, pink frothy sputum) ✔️ Right HF = Rest of body 🦵 (edema, JVD, ascites) ✔️ BNP >100 = 🚨 Heart failure indicator ✔️ Diuretics = Reduce fluid overload 💦 (watch potassium!) ✔️ ACE inhibitors = First-line therapy 💊 (watch cough & hyperkalemia) ✔️ Beta-blockers = Protect the heart 🛡️ (watch bradycardia) ✔️ Weight gain >2-3 lbs/day = 🚨 Fluid overload! Must report! ✔️ Pulmonary edema emergency = 🚑 High Fowler’s, Oxygen, IV Diuretics. ‎Follow the NCLEX-RN, MOH, DHA, SNLEs and Jobs Updates, Info with SaMiii-KMU channel on WhatsApp: https://whatsapp.com/channel/0029Vb7ORyT2ZjCmX9sIKP00