Right and left heart failure
Left-sided heart failure occurs when the heart’s left ventricle cannot pump enough blood to the body. It means that the heart has not enough force to contract normally, and “blood builds up in the pulmonary veins” (InformedHealth.org, 2018, p. 1). This type of left-sided heart failure is called systolic failure. A different kind of left-sided heart failure, diastolic failure, occurs when the left ventricle cannot relax normally because of the stiffness of the muscle. The heart cannot fill with blood during the resting period. As a result, a person feels shortness of breath and cannot breathe normally. Sometimes, coughing occurs, especially when a person is physically active.
Right-sided heart failure occurs when the right chamber of the heart has not enough power to pump blood to the lungs. Consequently, blood builds up in the veins, causing congestion or swelling in the legs and ankles or swelling in the genital area, abdomen, and organs. It happens because the increased pressure in the veins does not allow pushing fluid out of the veins into surrounding tissues (InformedHealth.org, 2018, p. 1).
The signs and symptoms right and left heart failure
The main symptoms of left-sided heart failure are related to physiological changes. A person may awaken at night with shortness of breath and difficulty breathing during physical activities, coughs, and wheezes. In addition, such a person may feel fatigued, have problems with concentration, lack of appetite, edema in the legs and ankles, irregular or rapid heartbeat, and sudden weight gain (Left-Sided Heart Failure, n.d.). Some other symptoms of left-sided heart failure are tiredness, weakness, and frequent urination at night.
The signs and symptoms of right-sided heart failure are as follows. The first and most noticeable symptom is swelling or edema. One may feel that their legs, feet, and ankles are heavy and swollen. Frequent urination is another symptom of right-sided heart failure, and it is caused by fluid buildup (Bazemore, 2021, para. 16). In addition, a person may find it hard to breathe and feel pain in the chest. The pulse is fast or feels “off,” and the skin is cold and sweaty (Bazemore, 2021, para. 17).
A person is tired and confused and can even forget things. A lack of appetite and weight gaining are other signs of right-sided heart failure. The main difference between left-sided heart failure and right-sided heart failure is that in the first case, fluid backs up in the lungs, causing shortness of breath, while in the second case, fluid backs up in legs, organs, or abdomen causing swelling.
Treatments for the heart failure
Treatments for heart failure consist of the changes in a lifestyle, medical treatment, surgery, and, sometimes, devices implanted in a patient’s chest to control their heart rhythm. First, a patient should receive a detailed care plan for the next six months, and this care plan should be reconsidered every six months according to the patient’s health condition (Treatment, 2018). A person with heart failure should have a healthy lifestyle, eat a balanced diet, do physical exercises, and overcome such bad habits as smoking and alcohol abuse.
The main medicines used for heart failure treatment are “inotropic agents, vasodilators, and loop diuretics,” as well as angiotensin-converting-enzyme (ACE) inhibitors and beta-blockers (Machaj et al., 2019, p. 147). Examples of ACE inhibitors are captopril, enalapril, ramipril, lisinopril, and perindopril (Treatment, 2018). Their role is to relax and open blood vessels, making it easier for the heart to pump blood. Beta-blockers, such as nebivolol, bisoprolol, and carvedilol, slow down the heart and protect it from adrenaline and noradrenaline effects (Treatment, 2018). Diuretics, for example, furosemide or bumetanide, are aimed to decrease swelling (Treatment, 2018).
Inotropes are used to “improve heart pumping function and maintain blood pressure” (Heart Failure, 2020). Moreover, a patient may need to take blood-thinning medications or drugs needed to lower cholesterol, and some other medications, depending on the diagnosis.
Sometimes, medical treatment is not enough, and a person may need surgery or medical devices implantation. Some treatments include coronary bypass surgery, heart valve repair or replacement, implantable cardioverter-defibrillators (ICDs), ventricular assist devices (VADs), and heart transplant (Heart Failure, 2020). Pacemakers are needed when a patient’s heart is beating too slowly or irregularly. ICDs help to normalize heart rhythm when it is too fast, giving it a small electrical shock. VADs are implantable devices that help pump blood from the heart to the body. Each of these treatments aims to improve a patient’s health condition and quality of life.
Nursing interventions for each of the heart failure
The role of a nurse is to assess and educate a patient with heart failure and administer medications. First, a nurse should determine whether the symptoms of right-sided or left-sided heart failure have worsened. If a patient has right-sided heart failure, a nurse should assess whether peripheral swelling is going down or getting worse. A nurse should assess pulmonary issues, such as a patient’s ability to breathe, in left-sided heart failure.
Second, a patient’s responsiveness to the medications should be evaluated, by checking blood pressure, heart rhythm, and volume status. Laboratory assessments, such as “Full Blood Count (FBC), Urea and Electrolytes (U&E),” are also needed to monitor any imbalances that can cause arrhythmia and heart arrest (Amakali, 2015, p. 3). A nurse should assess whether a patient is following their cardiac and fluid restriction diet. The next step is to educate patients, teaching them how to prevent readmission and worsening of heart failure. Finally, a nurse should administer medications and oxygen therapy according to the physician’s prescription.
References
Amakali, K. (2015). Clinical care for the patient with heart failure: A nursing care perspective. Cardiovascular pharmacology, 4(2), 1-5. Web.
Bazemore, N. (2021). What is right-side heart failure? WebMD. Web.
Heart failure. (2020). Mayo Clinic. Web.
InformedHealth. (2018). Types of heart failure. Institute for Quality and Efficiency in Health Care (IQWiG). Web.
Left-sided heart failure. (n.d.). Baptist health. Web.
Machaj, F., Dembowska, E., Rosisk, J., Szostak, B., Mazurek-Mochol, M., & Pawlik, A. (2019). New therapies for the treatment of heart failure: A summary of recent accomplishments. Therapeutics and Clinical Risk Management, 15, 147-155. Web.
Treatment: Heart failure. (2018). NHS. Web.