Nursing Field Notes / CARDIO · Pathophysiology Course
Heart Failure 💔
NG-038CARDIOADHD-friendly visual edition
The heart fails to maintain adequate cardiac output (oxygenated blood pumped OUT to the body) due to impaired pumping ability.Blood that can't go forward has to go somewhere — it backs up.
Ask one question: where did the fluid land? Lungs = left. Body = right.
💧 Left vs Right — follow the backup
🧠 “LEFT = Lungs. RIGHT = the Rest of you.” The left heart sits next to the lungs, so left failure floods the lungs. The right heart collects from the body, so right failure floods the body.
⚖️ Signs & symptoms — left vs right side by side
💧 LEFT-sided HF
🧍 RIGHT-sided HF
Memory trick 🧠
L = LUNG fluid
R = ROCKS BODY with fluid
Fluid lands in 💧
Pulmonary Edema — the lungs
The body & the periphery
Breathing 🎧
Crackles in lungs — “Rales that don't clear with a cough” Pink Frothy “blood tinged” sputum Orthopnea — difficulty breathing when lying flat
🧠 B = Broken ventricles (BNP) · “55 to 70 is heaven, 40 or less is a mess” (EF) · “Over 8 and you're late” (PA pressure).
🩺
CARE
STEP 3 · ACT IN ORDER
Pulmonary edema crisis (lung fluid) — the order is the exam question.
🆘 Priority interventions — spell H.O.P.E.
H
🛏️ HOB 45 degree or higher Semi-Fowler's, High-Fowler's, orthopneic position
O
💨 Oxygen
P
💊 Push Furosemide + Morphine, Positive inotropes drain the fluid, calm the work of breathing, help the squeeze
E
🧂 End sodium & fluids — Sodium Swells the body NO drinking fluids + STOP IV fluids
🧠 Give the drowning patient H.O.P.E. — HOB up · Oxygen · Push furosemide / morphine / positive inotropes · End sodium & fluids. And Furosemide = “Body Dried”
🚫 The fluid rules — non-negotiable
🧂 Sodium Swells the body — every gram of salt drags water back in.
❌ NO drinking fluids
❌ STOP IV fluids
You are trying to dry this patient out — do not pour more in.
⚖️ Daily weights tell you if it's working: Weight Gain = Water Gain.
🍟 Food: which item should the HF patient avoid?
❌ Chips — NO SODIUM!
❌ Grilled chicken & fries — NO!
❌ Canned beans — NO!
✅ Fruits ✅ Veggies ✅ Bread
🧠 “Canned, Crunchy, or Fried → tell it goodbye.” Salt hides in the bag, the box and the can — not in the produce aisle.
🚽 The constipated heart failure patient
✅ Walking
✅ Increase fiber
✅ Stool softeners
❌ Drink extra water — NO!
Normally you'd push fluids for constipation — but this heart is already drowning, and fluids are restricted.
🧠 Move it and fiber it — don't flood it.
🎯 3 common EXAM questions
Q1. A client with chronic heart failure took cold medicine for her flu. She presents with a new productive cough with pink frothy sputum and worsening crackles. What action should the nurse take first?
✅ Give bumetanide IV push — YES. (Not: assess lung sounds · notify the HCP · clock out for lunch.) “New, sudden, worsening, rapid symptoms” → dry the body out.
Q2. Which food item should the heart failure patient avoid? Select all that apply.