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What are the CNA's Duties When Caring for a Patient with Congestive Heart Failure?

Certified nursing assistants will encounter working with all types of patients and residents.  Learning the conditions of your residents or patients will better help you and them when providing care.  So what should CNAs know about taking care of and the duties involved with those who suffer from congestive heart failure? 

First CNAs need to understand what congestive heart failure is.  Congestive heart failure is when an individuals heart is weakened and cannot pump efficiently.  This causes blood to back up within the heart muscle.  Although heart failure can happen to almost anyone at any age, it is more common in those who are over the age of 65.  Congestive heart failure is more common in men and in African Americans. 

Left Side Failure- This is when the left side of the heart doesn’t pump the blood correctly and it begin to back up into the lungs.  This causes the rest of the body to not get enough blood.  Symptoms can occur from the effects on the other organs.  CNAs will need to watch out for a decrease in out put from the residents/patients as the kidneys can start producing less urine.  Confusion, dizziness and fainting can occur if there is poor blood flow to the brain.  More of the signs that certified nursing assistant need to watch for in left side failure are 

  • Crackles and wheezes in the lungs
  • Coughing
  • Difficulty in breathing
  • Breathing deeply
  • Cyanosis
  • Tachypnea

Right Side Failure- When the right side of the heart is affected, it backs blood into the venous system.  This can cause swelling to occur, especially in the feet and ankles.  It can also cause the neck veins to bulge.  Fluid can accumulate in the abdomen and in the liver causing congestion to occur.  Signs for CNAs to watch for in those with right side heart failure are those with left side failure, with the exception of a few more.

  • Fluid in the abdomen, which will cause swelling to occur
  • Hepatosplenomegaly
  • Oliguria-Urine output is less then 500ml in a 24hr period
  • Weight gain

It is import to tell the nurse when any of these symptoms occur, even if the changes seem small.  These changes even though can seem small can become severe if they are ignored.  Certified nursing assistants need to report when a patient/resident has any of the following signs or symptoms

  • Weight gain
  • Any coughing or chest congestion
  • Patient/resident feels nauseated, has a lack of appetite or starts to vomit
  • Any confusion, dizziness, or feeling of fainting
  • A sudden increase in fatigue, or the inability to partake in normal activities
  • Swelling in stomach.  The patient/resident may complain of bloating or feeling full the in the stomach
  • Decreased urine output.  Or urine that is very dark
  • Chest pain or discomfort
  • Low blood pressure
  • Shortness of breath

These all can be signs of fluid building up in the body and a persons heart failure worsening.  Its extremely import for certified nursing assistants to  report any changes to the nurse. 

Certified nursing assistants taking care of residents/patients with congestive heart failure may have additional duties that they perform more often.  These can include

  • Weighing a patient/resident daily.  CNAs most often weigh residents just once a month.  But those who suffer from congestive heart failure will need to be weighed more often.
  • Checking and recording  02 saturation. This may be done several times throughout your shift.
  • Blood pressure monitoring may be done more frequently on a resident
  • Turning a patient/ resident more often.  With poor circulation from congestive heart failure, resident/ patients are more prone to skin breakdowns.
  • Making sure that the residents/ patients are voiding.
  • Applying and making sure that the elastic stocking are placed on and correctly applied.

With cardiovascular disease being number 1 in the united states for cause of death and disability, it is essential for certified nursing assistants to have a improved knowledge of heart diseases.