Congestive Heart Failure

-is the inability of the heart to pump enough blood to meet the oxygen and nutrient neeed of the tissues resulting to decreased cardiac output.

RIGHT-Sided Failure - SYSTEMIC	LEFT-Sided Failure -LUNGS
jugular vein distention, distended neck veins	non-productive cough
ascites	dyspnea, orthopnea
peripheral pitting edema	bilateral crackles
anorexia	tachycardia, possible S3
weight gain	bronchial wheezing, rales
bounding pulses	cyanosis, pallor
hepatomegaly	weight gain
cool extremities
oliguria	* high-fowlers position

Management:

CARDIAC GLYCOSIDE - anti-arrhythmic agent
Digoxin (lanoxin) side effects: Double vision, loss of appetite, and nausea are early signs of digoxin toxicity.  Bradycardia, difficulty reading, visual alterations such as green and yellow vision or seeing spots or halos, confusion, vomiting, diarrhea, decreased libido, and impotence.	Normal level 0.8 – 2.0 ng/mL

                         

DIURETICS (-mide, -zide)   - increase urine output
Thiazides Side effect: hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.	Loop diuretic Side effect: hypokalemia	Potassium Sparing
-increase potassium loss		-does not produce Hypokalemia
Hydrochlorothiazide (esidrix)	Furosemide (lasix)	Spironolactone (aldactone)
	Ethacrynic acid (edecrin)	Triamterene (dyrenium)
	Demadex (torsemide)	Midamor (amiloride HCl)

VASODILATOR

Nitroglycerine

Sodium nitroprusside (nipride)