Why Can't You Breathe?!

What happens to our respiratory system during cardiac compromise (heart failure)?

As nurses on any unit it is important to monitor for signs and symptoms of cardiac compromise or heart failure. One of the most common sign and symptom is related to the respiratory system is shortness of breath. This should be monitored during routine nursing assessments by using auscultation and percussion. If patients are on a cardiac monitor (which they should be!) then it will be easy to monitor oxygen saturation in the blood and respiratory rate.

Take a listen...

 Nurses need to practice and become comfortable with the different lung sounds. In pulmonary edema secondary to heart failure, crackles can be heard throughout the lungs noting fluid in the pulmonary tissue. The Auscultation Assistant is a great resource for listening to all types of lung sounds!

What it looks like...

Normal Chest X-ray

Chest X-ray with severe Pulmonary Edema

Ahhh...it is making sense why our patients struggle to breathe! Throw a history of COPD, emphysema and/or asthma into the mix and our patients end up suffering even more. Make sure to get a thorough health history!

As nurses what can we do?

• Monitor, assess, monitor, assess and repeat!
• Administer medications such as Lasix or spironolactone 
• Patients will most likely need a foley catheter for strict measuring of intake and outputs! 
• Apply O2 via nasal cannula
• Incentive spirometer teaching
• Monitoring a diet low in sodium
• Activity as tolerated
• Staying on top of daily medications (especially cardiac medications and nebulizers)

Not only will your patients be able to breathe easy but so will you, knowing that you were able to take such great care of the patient!

Who is at Risk?

This week I would like to focus on those who are at risk for cardiovascular compromise/disease and tips with how to treat it!

Modifiable Risk Factors:

• Smoking
• Diabetes
• Obesity
• Decreased physical activity
• Lifestyle choices
• Diet high in fat and sodium
• Sleep Apnea
• The Media*
• Hypertension
• High Cholesterol

Non-modifiable Risk Factors:

• Race (African Americans)
• Family History
• Age
• Preeclampsia 

Treating Cardiovascular Disease:

• Quit Smoking!
• Get diabetes under control
• Healthy Diet (Do not eat at the Heart Attack Grill*)
• Manage Stress
• Increase physical activity
• Patients may be put on medications to help lower cholesterol such as Simvastatin; may be placed on anti-hypertensives such as Lopressor; diuretics such as Lasix and anti platelet therapy such as Aspirin (this will be talked about in weeks to come).
• Some may need cardiac rehab, angioplasty, bypass and hormone therapy
• See the NIH website for more detailed information

*See how the media plays into a real problem that Americans are facing. Unhealthy eating habits are glorified and the medical/nursing fields are made to look glamorous (as if you were being rewarded for bad decisions). What are your thoughts after seeing this clip?

 

Take a look at this quick YouTube video on the blood flow of the heart. This is a great visual for those that learn better "seeing" rather than just "reading." These two images are to reiterate knowledge that you know already.

Here is where we will begin! This is considered Normal Sinus Rhythm, keep in mind the different parts and wave forms of each heart beat during our blogging!

This blog is created intended for nurses and those aspiring to be nurses. Here we will discuss how cardiovascular compromise affects the rest of the body. Each week we will target different body organs and discuss the following: signs and symptoms of cardiovascular compromise, medications to treat them, important patient teaching and other comfort measures. This should be a space where interaction and activity takes place! Enjoy!