1. The pathophysiology of congestive heart failure is a progressive syndrome, it’s the process of remodeling, in which mechanical and biochemical forces alter the size, shape, and function of the ventricle’s ability to pump enough oxygenated blood to meet the body’s needs. (http://nursingcrib.com/pathophysiology/pathophysiology-of-congestive-heart-failure-chf/) 2. Symptoms of CHF: fatigue, dyspnea (SOB) shallow resporations 32-40/min, dry cough, tachycardia (because of diminished Cardiac output), edema (sudden weight gain of more than 3lb in 2 days), nocturia ( voids 6-7 times in the night while lying flat which causes and increase in renal blood flow) skin changes (dusky color, lower extremities are shiny and swollen with diminished or absent hair growth) behavioral changes ( including restlessness, confusion, and decreased attention span may be due to decrease in oxygen) chest pain, weight changes (possible fluid retention) . Signs from assessment are fast or difficult breathing, irregular or fast heartbeat, leg edema, neck veins that are distended, sounds “crackles” from fluid buildup in lungs heard through a stethoscope. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001211/) 3. Diagnostic studies for CHF include an echocardiogram, cardiac stress test, heart catherization, MRI of the heart, Nuclear heart scans. 4. The primary management of CHF are: Limit salt intake, exercise, lose weight (if overweight) lower cholesterol, get enough sleep. Medications taken can help the heart pump more efficiently, anticoagulants, lower cholesterol, vasodilate or slow HR so the heart does not need to work as hard, replace potassium, and rid body of excess fluid and salt. Some medication names are Ibuprofen, Naproxen, Sildenafil, Tadalafil, Vardenafil. There are some surgeries that may be acceptable such as Coronary bypass surgery, heart valve surgery, a pacemaker