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Congestive Heart Failure (CHF) Presented by: APS Healthcare Southwestern PA Health Care Quality Unit (HCQU). October 2010 sc, mlg. Disclaimer.
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Congestive Heart Failure (CHF)Presented by: APS HealthcareSouthwestern PA Health Care Quality Unit(HCQU) October 2010 sc, mlg
Disclaimer Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented. Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies.
Note of Clarification While mental retardation (MR) is still recognized as a clinical diagnosis, in an effort to support the work of self-advocates, the APS SW PA HCQU will be using the terms intellectual and/or developmental disability (ID/DD) to replace mental retardation (MR) when feasible.
OBJECTIVES The participants will: • 1. Recognize risk factors for CHF • 2. Identify symptoms of CHF • 3. List methods of support for individuals with CHF
Congestive Heart Failure Is… • A decrease in the heart’s pumping ability • Inability of heart to meet the needs of the body • Progressive
Facts About CHF • Affects 1.2-2% of the U.S. population • 75% of individuals are over 65 • 3.5 million hospitalizations per year
Normal Blood Flow TO BODY FROM BODY TO LUNGS FROM LUNGS FROM BODY
Risk Factors for CHF • Injury / damage to heart • Increased strain on heart • Structural problems
CHF and ID/DD • Down Syndrome • Fragile X Syndrome • Williams Syndrome • Prader-Willi Syndrome • Smith-Magenis Syndrome • Velo-cardial Facial Syndrome • Cornelia de Lange Syndrome
Diagnosis of CHF • Medical history • Physical exam • Diagnostic tests
Symptoms of CHF • Shortness of breath • With activity • At rest • Orthopnea • Paroxysmal nocturnal dyspnea • Fatigue / activity intolerance • Dizziness / fainting spells
Symptoms of CHF • Swelling • Pronounced neck veins • Weight gain • Cough
Symptoms of CHF • Rapid heart rate • Depression • Anemia • Lack of appetite
Is There a Cure for CHF? • There is no cure • Slow progression • Minimize symptoms • Improve quality of life • Save lives
Treatment Goals • Treat underlying cause • Improve symptoms and quality of life • Slow progression • Prolong life
Treatment Modes • Medications • Lifestyle Changes • Surgery
Medication Therapy • Diuretics • Digoxin • ACE inhibitors • Beta Blockers • Other Medications
Diuretics • Purpose • Increase urine production • Decrease blood volume • Side Effects • Low potassium • Thirst • Increased urination • Examples: • Lasix, Bumex, Demadex, Zaroxolyn, Aldactone, Hydrochlorthiazide(HCTZ)
Digoxin (Lanoxin) • Purpose • Increases pumping action of heart • Slows heart rate • Side effects • Slow pulse • Digoxin toxicity
ACE Inhibitors • Purpose • Dilation of blood vessels • Side effects • Persistent cough • Dizziness • Weakness • Examples • Capoten, Vasotec, Zestril, Accupril, Monopril,
BETA Blockers • Purpose • Decrease workload of the heart • Side effects • Decreased heart rate • Decreased blood pressure • Fatigue • Insomnia • Examples • Tenormin, Lopressor, Coreg, Betapace, Inderal, Carvedilol
Other Medications • Angiotensin II Receptor Blockers (ARB’s) • Vasodilators • Iron Supplements • Potassium Supplements • Coenzyme Q-10
Over the Counter Interactions • Cold and cough remedies • May increase blood pressure • May increase workload of heart • Anti-inflammatory medications • May cause fluid retention
Lifestyle Changes • Weight loss • Exercise program • Stop smoking • Reduce stress • Avoid alcohol • Dietary changes
Dietary Changes • Increase potassium • Fluid restrictions • Low fat diet • Low sodium diet
Heart Failure Clinics • Active partners in care • Avoid re-hospitalization • Education • Follow-up care
Surgical Interventions • Valve replacement • Bi-ventricular pacemaker • Left ventricular assistive device (LVAD) • Transplant • Artificial heart • Implantable sensors
Monitor symptoms Ensure medications are taken Encourage moderate exercise Encourage rest Elevate lower extremities Read food labels Avoid temperature extremities Encourage appropriate clothing Avoid colds, flu, and pneumonia Listen and be positive Supporting an Individual with CHF
WITH YOUR SUPPORT, AND FOLLOWING THE PLAN OF CARE, INDIVIDUALS WITH CHF CAN LIVE A HAPPY AND FULL LIFE
Suggested Trainings • Heart Disease • Heart: Congenital Abnormalities • Heart Healthy Nutrition
References • Mayo Clinic Staff (2009, December 23). Heart failure. Retrieved October 19, 2010 fromhttp://www.mayoclinic.com/health/heart-failure/DS00061 • Heart Failure Society of America (n.d.). Quick facts and questions about heart failure. Retrieved October 19, 2010 from http://www.hfsa.org/heart_failure_facts.asp • American Heart Association (2009, March 20). Medications commonly used to treat heart failure. Retrieved October 19, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=118 • American Heart Association (2009, April 10). Treating and living with heart failure. Retrieved October 19, 2010 fromhttp://www.americanheart.org/presenter.jhtml?identifier=1579
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Test ReviewThere will be a test review after all tests have beencompleted and turned in to the Instructor.