Page 60 - Critical Care Notes

4223_Tab02_045-106 29/08/14 10:00 AM Page 54

CV
■ Ascites or anasarca
■ Nocturia
■ HTN
■ Anorexia, nausea
Diagnostic Tests
■ B-type natriuretic peptide (BNP) level
■ CBC
■ BMP, lipid profile, iron studies, renal and liver function tests
■ TSH levels
■ Urinalysis
■ Chest x-ray
■ ABGs or pulse oximetry. Pulmonary function tests.
■ ECG
■ 2-D echocardiogram
■ MUGA scan
■ Hemodynamic studies using a PAP catheter
■ Stress test (noninvasive) if possible
Management

The following serves only as a guide to the treatment of heart failure. For
a full discussion and criteria for the administration of medications, refer to the
2013 American College of Cardiology Foundation/American Heart Association
Guideline for the Management of Heart Failure at http://circ.ahajournals.org/
content/early/2013/06/03/CIR.0b013e31829e8776
■ Primary goal in managing heart failure is to maintain cardiac output.
■ Secondary goal is to decrease venous (capillary) pressure to limit edema.
■ Monitor cardiac, respiratory, renal, and neurological status.
■ Place patient in Fowler’s position
■ Administer O 2 via cannula or mask. Intubate if necessary. Consider
noninvasive positive pressure ventilation first.
■ Monitor O 2 saturation.
■ Provide continuous ECG monitoring.
■ Monitor hemodynamic status.
■ Weigh daily. Assess edema.
■ Provide sodium and fluid restrictions.
■ Assess fluid and electrolyte balance.
■ Provide maximum rest. Cluster activities.
■ Administer diuretics to control edema and fluid retention: furosemide
(Lasix), bumetanide, torsemide (Demadex).
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