Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
Left Heart Failure Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
Heart Failure Interventions
- Echocardiogram
- Invasive Hemodynamic Monitoring
- High Fowler's Position
- Oxygen
- Advanced Airway
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
Digoxin (Lanoxin)
- Increases Inotropy
- Heart Failure
- Atrial Fibrillation
- Bradycardia
- Fatigue
- Heart Block
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
Acute Digoxin Toxicity
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
Patent Ductus Arteriosus
- Continuous
- Machine like murmur
- Often Due to Congenital Rubella
- Prematurity
Mitral Stenosis
- Murmur Follows Opening Snap
- Late Diastolic Murmur
- Enhanced by Expiration
- Low-Pitched Rumbling
- Dilation of Left Atrium (LA)
- Recurrent Attacks of Rheumatic Fever
Aortic Stenosis
- Age-related Calcifications
- Bicuspid Aortic Valve
- Crescendo-decrescendo Murmur
- Systolic Murmur
- Ejection Murmur
- Ejection Click
- Radiates to Carotids and Apex
- Pulsus Parvus et Tardus
- Syncope
- Helmet Cells
Tetralogy of Fallot
- Blue Baby Syndrome (Cyanosis)
- Crying or Feeding
- Pulmonary Stenosis
- Right Ventricular Hypertrophy
- Overriding Aorta
- Ventricular Septal Defect (VSD)
- Boot-Shaped Heart
- Squatting for Tet Spells
- Surgery
Lung Sounds - Rhonchi
- Trachea and Bronchi
- Low Pitched Rumbling
- Gurgling
- Narrowed Airway
- Secretions or Bronchospasm
Lung Sounds - Wheezes
- Throughout Lung
- High Pitched
- Musical
- Air Moving through Narrowed Airways
Lung Sounds - Crackles
- Lower Lobes
- Fine/Coarse
- Fine: Twisting Hair through Fingers
- Coarse: Velcro
- Collapsed Small Airways and Alveoli "Popping Open"
Lung Sounds - Pleural Friction Rub
- Anterior Lateral Lung
- Dry, Rubbing, or Squeaking
- Rubbing a Balloon with Finger
- Inflamed Pleura
Cardiac Catheterization
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
Rheumatic Fever Assessment
- Aschoff Bodies
- Carditis
- Subcutaneous Nodules
- Polyarthritis
- Chorea
- Erythema Marginatum
- Fever
- Arthralgia
- Elevated ESR and C-reactive Protein
- Rheumatic Heart Disease
Rheumatic Fever Interventions
- Antibiotics
- Prophylactic Treatment
- Relieve Joint Pain
- Prevent Cardiac Complications
- Educate Chorea is Temporary
Kawasaki Disease
- Acute Vasculitis
- High Fever
- Conjunctivitis
- Strawberry-Red Tongue and Mucosa
- Erythema and Edema of Hands and Feet
- Desquamative Skin Rash
- Aspirin
- Intravenous Immunoglobulin (IVIG)
- Antipyretics
- Coronary Aneurysm
- Children < 5 Years old