Acute Decompensated Heart Failure

 

Acute Decompensated Heart Failure

Acute Decompensated Heart Failure (ADHF) refers to a condition that leads to the worsening of heart failure symptoms and that requires immediate medical intervention (Neuenschwander & Baliga, 2007). After admission, the nursing interventions suitable for Mrs. J include treatment of symptoms, hemodynamic stabilization, treatment of congestion and long-term therapy initiation. Oxygen should be administered to the patient and pressure should be delivered through a facemask to ensure constant pressure in the respiratory cycle. The administration of IV furosemide (Lasix) is aimed at treating hypertension, shortness of breath and acute volume overload. Enalapril (Vasotec) is an ACE inhibitor which is suitable for the treatment of high blood pressure by relaxing the arteries. Metoprolol (Lopressor) is suitable for treating abnormal heart rhythms, heart pain and high blood pressure. The administration of IV morphine sulfate (Morphine) is aimed at reducing the patient’s anxiety and the cardiac filling pressure (Neuenschwander & Baliga, 2007).

Several cardiovascular conditions can result in heart failure. One of these is coronary artery disease which is caused by the buildup of fatty deposits and cholesterol in the arteries. Consequently, less blood reaches the heart muscle and its flow can be obstructed completely leading to heart failure (American Heart Association, 2014). Vasodilators such as nitroglycerin can be administered to widen the coronary arteries so as to increase the flow of blood to the heart muscle. Beta blockers are administered to reduce the heart rate and improve the flow of blood to the heart. Aspirin prevents blood clotting in the arteries. Lipid management also reduces lipid levels in the blood. Heart muscle disease or cardiomyopathy affects the muscle of the heart by damaging or weakening it (American Heart Association, 2014). Therefore, the heart is unable to pump blood properly. This condition can also result in heart failure. Cardiomyopathy can be managed with medications to ensure a normal heart rhythm, reduce inflammation and decrease the blood pressure to prevent further damage to the heart. Heart failure can also be prevented by maintaining an appropriate diet, healthy weight, sufficient sleep and reducing caffeine intake.

Hypertension is another condition which refers to high pressure in the blood vessels and it requires higher heart rates order to maintain the blood circulation (American Heart Association, 2014). This affects the heart by making the chambers weaker and larger and it may lead to heart failure. Diuretics can be administered to patients with hypertension to prevent the development of heart failure. Diabetes is another condition which increases the levels of lipids in the blood and this may result in the development of atherosclerosis and hypertension (American Heart Association, 2014). This may lead to heart failure. Diabetes can be managed through medication to control sugar levels, reduce blood pressure, improve the levels of cholesterol and reduce the workload of the heart. It is also managed through physical activity, healthy diet and healthy weight to reduce the risk of heart failure.

Most elderly adults suffer from several chronic diseases which require them to take different types of medications at the same time (Marek & Antle, 2008). This puts them at risk of the negative effects of drug interactions. One of the nursing interventions to help the elderly patients is medication reconciliation. This involves reviewing all the patient’s medications and screening for effects of drug interaction. This will facilitate the management of the medication. Another intervention is to assess the limitations and abilities of the patient in organizing and using the medication (Marek & Antle, 2008). The healthcare provider will assist the patient to remember the right time to take each medication through memory-enhancing devices and memory cues. This will ensure that the correct dosage is taken at the right time to reduce the risk of adverse drug reactions. Another intervention is to provide education to the patient regarding the purpose, instructions and names as well as the safe management of each medication. Use of large letters to write instructions and the use of medication charts enables the patients to take the right medication (Marek & Antle, 2008). Another intervention is ongoing monitoring of the patient to ascertain adherence to the dosage, assess side effects of the medication and ascertain effectiveness of the treatment. This will enable the healthcare providers to identify any risk of adverse drug interactions and take remedial action.

 

References

American Heart Association. (2014). Understand your risk of heart failure. Retrieved January 16, 2014 from http://www.heart.org/HEARTORG/Conditions/HeartFailure/UnderstandYourRiskforHeartFailure/Understand-Your-Risk-for-Heart-Failure_UCM_002046_Article.jsp

Marek, K.D. & Antle, L. (2008). Medication management of the community-dwelling older adult. Patient Safety and Quality: An evidence-based handbook for nurses, 1, 499-536.

Neuenschwander, J.F. & Baliga, R.R. (2007). Acute Decompensated Heart Failure. Critical Care Clinics, 23, 737-758.

 

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