Be an Excellent Cardiac Nurse with these Heart Failure Core Measures

Heart Failure Core Measures

Heart Failure is caused by the inability of the heart to supply the needed blood and oxygen to various body organs. It is sad that heart failure is a prevalent disease.  It affects as many as 5.1 million Americans.  Once diagnosed, heart failure patients usually die within 5 years.
Early diagnosis and treatment are pivotal in lengthening and improving the quality of life of the said individuals. Joint Commission drafted core measures that will help medical personnel provide quality health care. Here are some pointers that should help you provide effective heart failure nursing care:

Normal vs Congestive Heart

Discharge Instructions

Since heart failure can be complicated by unhealthy lifestyle choices, it is your role as a registered nurse to provide comprehensive health instructions prior to the patient’s discharge. Guidelines that you should include in your discharge teaching are the following:

  • Healthy diet – low in salt and low in fat
  • Weight monitoring
  • Healthy levels of activity
  • Medication compliance
  • Signs of worsening symptoms: DANGER!

o   Dyspnea
o   Anxiety
o   Nocturnal Paroxysmal Dyspnea
o   Gain in weight – 2 pounds/day, or 5 pound-change from baseline weight
o   Edema of the lower extremities
o   Respiratory distress – nasal flaring and use of accessory respiratory muscles

  • Importance of follow-up treatments

Assessment of Left Ventricular Systolic Function

Left ventricular systolic (LVS) function is a measure of the pumping ability of the left ventricle (lower left heart chamber.) It also shows how well the ventricle can deliver blood to other parts of the body. This diagnostic test is an urgent care measure, as it is a foremost sign of heart failure. The goal of Joint Commission is for all hospitals to carry out this exam and deliver a higher level of patient care.

Apart from LVS function, the doctor or nurse should obtain the patient’s medical history and physical exam. Other exams that should be obtained include blood tests, chest x-ray, ECG and echocardiogram. As a nurse, you should ensure that the LVS function test and other exams are undertaken. At the same time, you should facilitate the needed heart failure procedure/s in a timely manner.

ACE Inhibitors and ARBs at Discharge

Since high blood pressure can lead to worsening heart failure, Obama care core measures emphasize the importance of prescribing ACE inhibitors and Angiotensin Receptor Blockers (ARB) at discharge. These medications block hormones that can lead to blood vessel constriction, which then leads to hypertension.

As a nurse, you need to make sure that your patient receives the appropriate medications upon discharge. Clients with decreased heart functions should receive ARBs at discharge. Those with heart failure/heart attack, on the other hand, should be prescribed with ACE inhibitors.

Heart failure might be fatal, but the patient can live a longer, better life with these core measures. Learn more about these care standards at nclexpreceptor.com.

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Resources:

http://www.jointcommission.org/heart_failure/

http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm

http://www.rn.com/getpdf.php/1859.pdf?Main_Session=4c1ab3e6289683a53c9ce44479f6a95d

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