(^46) Medical-Surgical Nursing Demystified
TREATMENT
Treatment may continue at home unless a worsening change in condition merits
hospitalization. Immediate treatment of heart failure, while searching for underly-
ing correctable conditions, is necessary.
- Administer supplemental oxygen, which increases arterial pO 2. Mechanical
ventilation may be necessary. - Administer morphine, which lowers left atrial pressure, decreases myocar-
dial oxygen demand, lowers anxiety, and relieves pain. - Administer diuretics to remove excess fluid:
- furosemide, bumetanide, meolazone
- Administer cardiac glycosides to increase contractions of the heart:
- digoxin
- Administer cardiac inotropics to strengthen the heart:
- dobutamine
- inamrinone
- milrinone
- Administer nitrates to decrease BP, and left ventricular filling pressures:
- isosorbide dinitrate
NURSING DIAGNOSES
- Impaired gas exchange
- Anxiety
- Excess fluid volume
NURSING INTERVENTION
- Place the patient in full Fowler’s position to enhance air exchange and
diaphragmatic movement, sitting with legs dangling over sides of bed. - Monitor cardiovascular function for changes in heart sounds, extra sounds,
murmurs. - Monitor respirations for changes in lung sounds, chest expansion.