Med/Surg Left or Right-Sided Heart Failure
Left
Adventitious breath sounds, crackles.
Left
Cough initially dry/nonproductive (dry hacking cough misleading for asthma or COPD). Becomes moist overtime, frothy pink/tan sputum.
Left
Decrease SV: sympathetic sys to increase HR - palpitations.
Left
Decrease urine output. Renal perfusion fall stimulates increase BP.
Left
Decreased GI perfusion: altered digestion.
Left
Decreased brain perfusion: dizziness, lightheadedness, confusion, restlessness and anxiety d/t decreased oxygen and blood flow .
Left
Diminished CO, inadequate tissue perfusion, decrease SV - sympathetic NS release catecholamines impeding perfusion.
Left
Weak peripheral pulses.
Left
orthopnea (difficulty breathing when lying flat)
Left
Dyspnea/SOB may be precipitated by minimal to moderate activity.
Right
Edema gradually progress up the legs/thighs eventually into genitalia and lower trunk.
Right
Edema of the lower extremities worsens when the pt stands or sits for long periods
Right
Generalized weakness results from reduced CO and impaired circulation.
Right
Hepatomegaly (enlarged liver) and tenderness in the upper right quadrant - result from venous engorgement of the liver. Increased pressure may interfere liver's ability to function.
Right
May cause increase pressure on the diaphragm - respiratory distress.
Left
Stimulation of the SNS causes peripheral blood vessels to constrict: skin pale and feels cool and clammy.
Right
Anorexia, nausea, and abdominal pain may result from venous engorgement and venous stasis within the abdominal organs.
Left
Anxiety and dyspnea increase (cyclic)
Right
Ascites may increase pressure on the stomach and intestines and cause GI distress.
Right
Increased jugular venous distension
Left
Pressure in the pulmonary circulation increases, shift fluid into the alveoli - cannot exchange oxygen and CO2. w/o sufficient O2 the pt experience dyspnea and difficulty sleeping.
Left
Skin pale and feels cool and clammy.
Right
ascites (accumulation of fluid in the peritoneal cavity) - aeb increased abdominal girth.
Left
dyspnea, cough, pulmonary crackles, low oxygen saturation levels, extra heart sound (S3 or ventricular gallop) may be detected on auscultation.
Left
inability of the left ventricle to fill or eject sufficient blood into the systemic circulation, results in pulmonary congestion.
Right
inability of the right ventricle to fill or eject sufficient blood into the pulmonary circulation, results in congestion in the peripheral tissues and the viscera.
