Congestive Heart Failure
Congestive heart failure (CHF) is a condition which occurs when the heart muscle is unable to pump sufficient blood to the body (Grady et al., 2000). The care approach will involve making the right diagnosis and creating an effective treatment plan. Mr. P will undergo diagnostic procedures such as cardiac catheterization, echocardiography and cardiac nuclear stress imaging. The nurse and cardiologist will work closely with Mr. P to ensure that the treatment is effective and also provide information on a healthy lifestyle and diet. The patient will be put on a diet with low fat and sodium and advised not to take stimulants. He will also undergo a change in lifestyle including an exercise program and stress reduction (Grady et al., 2000). Several medications will be administered to ease the symptoms, reduce exertion of the heart muscle, regulate the heartbeat and improve the pumping ability of the heart.
An effective treatment plan for Mr. P includes conducting left ventricle tests, administering appropriate medication, providing him with instructions on caring for himself at home such as a healthy diet, exercise and self-monitoring, and advice on what to avoid such as smoking. Mr. P can undergo several treatment options to strengthen his heart. In order to expand his blood vessels and improve the flow of the blood, vasodilators and ACE inhibitors can be used (Gardetto & Carroll, 2007). The left ventricle’s ability to pump blood can be improved by beta blockers. The ability of the entire heart to pump blood can be improved by digitalis. Excess water and salt in the body can be eliminated by using diuretics. ACE inhibitors are initiated at low doses while monitoring the renal function, blood pressure and serum potassium (Gardetto & Carroll, 2007). Beta blockers are also administered in low doses at an interval of two weeks until the target dose is achieved. Aldosterone antagonists are also administered while monitoring the renal function and potassium level of the patient. Mr. P also needs support from family members in order to cope better with the disease (Quaglietti, Atwood, Ackerman, & Froelicher, 2000).
The education of the patient and his family is essential to ensure better management of CHF. Education will enable Mr. P and his family to understand the condition and its symptoms, the purpose and dosage of different medications, the appropriate diet and exercise (Grady et al., 2000). After undergoing education, Mr. P will learn to cope with the condition and his wife will be able to support him and ensure that he adheres to the treatment plan. A one-on-one method of education involving physicians, home health nurses, advanced practice nurses, pharmacists and registered nurses is appropriate for the patient and his family (Quaglietti et al., 2000). A one-on-one teaching method is the most suitable as the healthcare providers will be able to explain all the relevant information in a clear language and also answer any questions that the patient and his family may have. They will also give further clarifications on the areas that are not well understood and also give reassurance to the patient and his family. This method can be supplemented by video tapes and written materials to ensure that the patient and his family access all the information regarding the condition (Grady et al., 2000).
A proper teaching plan for the patient and his family is essential in order to achieve the intended outcomes (Grady et al., 2000). It should be simple and understandable to the patient and his family. A teaching plan will include several topics:
| General information about CHF | The meaning of CHF, symptoms, psychological responses, probable outcome of the CHF, actions to take when symptoms increase and how to do self-monitoring. |
| Dietary recommendations | Restriction of sodium, alcohol, fluid and compliance strategies. |
| Exercise | Leisure activities, work, sexual activity, exercise program and compliance strategies. |
| Medication | Purpose of drugs, dosage and their side effects, interaction of multiple medications, cost issues, how to cope with complicated prescriptions and compliance strategies. |
References
Gardetto, N.J. & Carroll, K.C. (2007). Management strategies to meet the core heart failure measures for acute decompensated heart failure: A nursing perspective. Critical Care Nursing Quarterly, 30(4), 307-320.
Grady, K.L., Dracup, K., Kennedy, G., Moser, D.K., Piano, M., Stevenson, L.W., & Young, J.B. (2000). Team management of patients with heart failure: A statement for healthcare professionals from the Cardiovascular Nursing Council of the American Heart Association. Circulation, 102, 2443-2456.
Quaglietti, S.E., Atwood, J.E., Ackerman, L., & Froelicher, V. (2000). Management of the patient with congestive heart failure using outpatient, home and palliative care. Progress in Cardiovascular Diseases, 43(3), 259-274.
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