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NR 601 Week 2 SOAP Note -CHF

NR 601 Week 2 SOAP Note -CHF

NR 601 Week 2 SOAP Note -CHF

NR 601 Week 2 Note

Heart Failure/CHF: inability to pump effectively and pt present with an SOB, dyspnea with or without exertion, frothy sputum due to lungs overload.

Classing signs & Symptoms: fatigue, vertigo, dyspnea at rest or light exertion, orthopnea, tachycardia, edema. (pt. report as tiredness, weakness, lightheadedness, dizziness, trouble breathing, extra pillow to sleep at night, feeling of heart racing even at rest, and swollen leg, scrotum, and belly).NR 601 Week 2 SOAP Note 

Treatment goals of HF and stages:

Stage A: High risk without damage (no symptoms but has other comorbidities such as HTN)

Drugs: ACEI or ARB inappropriate patient for vascular disease or DM and Statin

Stage B: structural damage without s/s

Drugs: ACEI or ARB, beta-blockers as well as revascularization or valvular surgery

Stage C: structural damage

Drugs: Diuresis to relieve symptoms, ACEI or ARB, beta-blockers, aldosterone antagonists

Stage D: refractory damage (is a combination of a systolic and diastolic problem). It needs referral to hospice or palliative care and symptoms management

Objective finding: crackles, dyspnea, lower extremities edema, elevated BNP, EF <45-50%, abnormal EKG, abdominal distension. NR 601 Week 2 SOAP Note 

BNP of >100-400 is suspected of HF and >400 is highly suspicious of HF.



ACE inhibitors (The Perils), ARBS (the Artisans), beta-blockers (the LOL’S), calcium channel blockers, aldosterone antagonist, Hydralazine, and isosorbide diuretic officially benefit African Americans with HF, diuretics, digoxin (R LVEF & afib), statin, ARNI (a new class of medication) Entresto.

Don’t give Entresto if pt on ACE or ARBS due to angioedema. Stop ACE 36 hours before starting it. Never start entresto if pt has a history of angioedema. NR 601 Week 2 SOAP Note 

Education/non-pharm Interventions: Medication compliance, daily weight (notify if weight gain of 2lb in a day or 4-5 lbs in a week or increased SOB/orthopnea), quit smoke, fluid restriction, vaccine, cardiac diet, sodium of 2-3 gm/day. NR 601 Week 2 SOAP Note