Question

Scenario 3 GG is 60 years old and has been diagnosed for 1 year with mild right-sided heart failure (congestive heart failure) prescribed furosemide (lasix) 20 mg twice a day. 1. a) Should additional medications be prescribed? b) Why? 2. What other education should be given for G G's congestive heart failure?

Answer 1

#. Age of the GG is 60 years old

Diagnosis - mild right sided heart failure since 1 year

Prescription - Furosemide 20mg BD

a ) Yes , additional medications have to be prescribed like ACE inhibitors and beta blockers .

Rationale for ACE inhibitors usuage :-

While they don't have a direct inotropic benefit, they reduce aldosterone secretion, which leads to a decrease in salt and water retention. This reduces preload and afterload, and also reduces vascular resistance.

Examples of angiotensin antagonists used in CHF therapy :-

ACEIs: Captopril and Lisinopril

ARBs: Losartan

Along with diuretics, these are first line drugs for the treatment of CHF.

Rational for using beta blockers in CHF therapy :-

They are sympathetic antagonists. They produce a negative inotropic effect, reducing the progression of heart failure. They also improve the cardiac metabolic and hemodynamic status by lowering the circulating levels of NE.

Examples of beta blockers used in CHF therapy :-

Carvedilol

Bisoprolol

Metoprolol

b) Health education for Congestive heart failure :-

- Dietary therapy

Construct a written diet plan and a list of permitted and restricted foods.

- The heart failure patient should examine labels to determine

Sodium content not just in food but drugs like laxatives,

cough medicines and antacids

- The heart failure patient should avoid

Using salt and preparing foods or adding salt to foods.

- A heart failure patient should weigh themselves at the

Same time every day preferably in the morning, on the same scale, in the same clothes

- A heart failure patient should report the weight gain of

3lbs/2days

Or 3-5lbs/week

- The heart failure patient should eat

Smaller more frequent meals

- Heart failure patient should increased walking or other activities

Gradually, provided they do not cause fatigue or dyspnea. may need to consider a cardiac rehabilitation program

- Heart failure patient should avoid extremes of

Heat and cold

- Signs and symptoms of worsening heart failure

F A C E S

F fatigue

A Activity limitation

C chest congestion/cough

E edema

S SOB

- Heart failure patient should remember the symptoms experienced .