Download Heart Failure Pathophysiology RN Teaching Script Nurse: What

Heart Failure Pathophysiology RN Teaching Script
Nurse: What does the word Heart Failure mean to you?
Patient: You should expect a variety of responses from the patient. The goal is to define heart failure in
simple terms.
Nurse: The word heart failure does not mean that the heart has “failed” or stopped beating. Heart
failure actually means that the heart muscle is not pumping as well as it should. Understanding
normal heart function will help you understand what happens when you have heart failure.
Let’s review normal heart function.
Normal heart function: The heart is like a pump. The function of your heart is to pump blood
containing oxygen and nutrients to the rest of your body. These nutrients are needed for you to
stay healthy. Blood moves to and from the heart through a system of blood vessels. First the
heart receives blood from the body. It then sends the blood to the lungs to pick up oxygen.
Waste products are also removed from the blood when it moves through the lungs. After it
picks up oxygen rich blood, it goes back to the heart where it is pumped out to the rest of the
body. Your body uses this oxygen rich blood to perform all of its functions.
Note: Use the patient’s Heart Failure Handbook or the EDOCS document About Your Heart as a
teaching aid. This section provides a diagram of the heart and demonstrates the movement of
blood into and out of the heart. Tracing the blood through the heart will help them understand
what happens when the heart is unable to adequately pump the blood out of the heart.
The right atrium receives blood from the body. The blood is low in oxygen because it has
delivered its oxygen to your body. The right atrium sends blood into the right ventricle.
The right ventricle squeezes the blood out to the lungs to pick up fresh oxygen and nutrients and
to remove waste products. Oxygen-rich blood returns from the lungs to the left atrium.
The left atrium sends the blood into the left ventricle.
The left ventricle pumps the oxygen rich blood to your body.
Do you have any questions about normal heart function?
What did we say the function of the heart was?
Can you trace the flow of blood through the heart?
Patient: Based on your patient’s response you will either reinforce further teaching regarding normal
heart function or move on to abnormal heart function. The patient should understand the
forward flow of blood through the heart with emphasis on oxygen and nutrients being carried
out to the body.
Heart Failure Pathophysiology RN Teaching Script
Nurse: Now let’s talk about abnormal heart function and what happens when your heart cannot pump
enough blood throughout the body.
Abnormal Heart Function: Remember we said heart failure means the heart muscle is not
pumping as well as it should. This results in less blood, nutrients, and oxygen going out to your
body. Blood begins to back up in the blood vessels. Because the normal amount of blood is not
moving forward, the extra fluid must go somewhere. It begins to back up in the tissues. When
the blood backs up in the lungs, you may feel like it is hard to breathe. Fluid backing up into
other parts of the body causes swelling. When there is too much fluid in the body, it puts even
more strain on the heart. We will talk about this more when we cover symptoms.
As we said before, your body needs adequate amounts of oxygen and nutrients to remain
healthy. When your body gets these nutrients in less amounts, it has an effect on your body.
Less oxygen and nutrients to:
1. Your brain may result in anxiety, confusion, dizziness, and/or drowsiness.
2. Your kidneys may result in less urine output and hormonal changes
3. Your muscles may result in weakness.
4. Your heart may result in chest pain/heaviness and or palpitations/racing heart.
5. Your stomach may result in nausea and lack of appetite.
6. Your lungs may result in shortness of breath.
7. Your skin may result in a cool and clammy feeling.
So, what happens when the blood begins to back up?
When less oxygen and nutrients is sent out to the body what happens? Can you name at least
two things?
Patient:Expect the patient to talk about blood backing up in the lungs which produces shortness of
breath and the tissues which produces swelling. Expect them to name at least two things from
the list above.
Nurse: Heart Failure is not just a pump problem. It is also a hormonal problem. Your body makes
hormones and other chemicals to help correct for the reduced blood flow to your body. When
less oxygen and nutrients go to your kidneys, there are receptors in your kidneys that say to the
body, “I’m not getting enough blood.” In response they secrete certain hormones that result in
the heart pumping harder to increase the amount of blood flow throughout the body. These
hormones help at first, but over time they further weaken your heart. Many of the medicines
Heart Failure Pathophysiology RN Teaching Script
you take block the harmful effects of these hormones on your heart. We will cover these in
more detail when we talk about your medication.
Remember, heart failure is a chronic disease. You will need to manage it for the rest of your life.
It does not go away but can be treated successfully with your help.
Note: utilize Pathophysiology Quiz to assess effectiveness of teaching and reinforce as needed.