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Chapter 30 Coordinating Care for Patients With Cardiac Disorders
or replacement of valves. Nursing care priorities include assessment for signs of HF, which helps evaluate the effec- tiveness of treatment, and administration of medications as ordered to control the symptoms of HF. Medication management and anticoagulation precaution teaching are essential. Heart failure is present when the heart loses its abil- ity to pump blood effectively and is unable to produce enough cardiac output to meet the body’s metabolic demands. Clinical manifestations of left-sided HF include shortness of breath (SOB), crackles, and poor peripheral perfusion. Symptoms of right-sided HF include jugular
vein distention (JVD), hepatomegaly, ascites, and depen- dent edema. Treatment focuses on decreasing the work- load of the heart by decreasing preload and afterload. Diuretics, angiotensin-converting enzyme (ACE) inhib- itors, angiotensin receptor blockers (ARBs), angiotensin receptor–neprilysin inhibitors (ARNIs), and beta blockers are commonly prescribed. Nursing care priorities include assessment for signs of HF, which helps evaluate the effec- tiveness of treatment, and administration of medications as ordered to control the symptoms of HF. Medication and diet management and the manifestations of worsening HF are essential components of the teaching plan.
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