Case Study 2

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Conidering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

� Describe your approach to care.

� Recommend a treatment plan.

� Describe a method for providing both the patient and family with education and explain your rationale.

� Provide a teaching plan (avoid using terminology that the patient and family may not understand).

 

Case Study #2     

Cardiomyopathy is a heart condition involving deterioration of the heart muscles functioning. It predisposes one to various heart conditions such Chronic Heart Failure (CHF) in Mr. P. The symptoms include; edema, labored breathing, due to fluid accumulation in the lungs, and moist crackles within the lungs. Treatment is expensive hence, the high medical bills and the condition is also accompanied by psychological disturbances for the patient and the caregiver (Heart Foundation, 2010).

Approach to Care

 A multi-disciplinary approach will be undertaken that is limited to biomedical care, self-care education and support, psychosocial care, and palliative care. This will be holistic involving an overlap of the 4 approaches stated above suited to meet the needs of not only Mr. P, but also his wife. (Heart Foundation, 2010).

Treatment Plan

 The proper diagnosis has been provided by the symptoms above and it is evident that the heart failure is due to the cardiomyopathy. Therefore, treatment should involve treating the symptoms (Heart Foundation, 2010). The patient has the necessary drugs; therefore, the initial approach is to provide adherence counseling to ensure that Mr. P is taking the drugs as required. Second, counseling should also be provided to ensure that the patient is taking his meals (Heart Foundation, 2010).

The patients should then be educated on the disease and its effects on the body including its prognosis. This education should include the treatment approaches for the disease. This will promote acceptance and help them cope with the condition while promoting self-care (Heart Foundation, 2010). The couple should then be connected to a support group to where they can gain social support. Constant monitoring of the disease progress should be done, and medication altered to provide palliative care (Heart Foundation, 2010).

Method and Rationale of Providing Patient and Family Education

            The patient education will first be individualized with Mr. P alone on the condition. This will be to impart him with the necessary knowledge regarding, the condition he is suffering from, its symptoms, progress, treatment methods including the one he is on currently, and its disease progress.  The rationale for this is to help him accept the condition and participate in self-management. This will be followed by individual education of Mrs. on the same then education for both in form of group therapy. This will promote acceptance and proper management of the disease.

Teaching Plan

            Cardiomyopathy is a heart condition that involves the deterioration of the heart muscles functioning and is common in old age. The causes of Cardiac myopathy include: long-term high blood pressure, heart valves defects, and problems with muscles of the heart especially prevalent when with patients who have had a previous heart attack. The symptoms include; shortness of breath, weakness fatigue, weight gain, and dry cough at night (Home Choice Partners, 2011).

Cardiac myopathy results into other heart diseases like chronic heart failure that further, worsens the symptoms of the condition. Prevention is usually best and involves regular exercise, low sodium diet, low alcohol intake, and quitting smoking. However, heart medications are also available that reduce the symptoms (Home Choice Partners, 2011). Carry your medication list and know their doses. Ensure you take medication at the required time and keep your medication in the same container. Use a weekly pillbox to help avoid missing your dose. Intravenous doses assist in managing the heart failure (Home Choice Partners, 2011). Monitor your weight and call the pharmacist or nurse if you gain 2-5 pounds in 2 days or 5 pounds in a week. Maintain a salt intake of 2 grams and 1 liter water intake per day and always include fluids in your meals. Always remember you are the most important person (Home Choice Partners, 2011). 

References

Heart Foundation. (2010). Multidisciplinary Care for People with Chronic Heart Failure:                          Principles and Recommendations for Best Practice. Melbourne: National Heart                             Foundation of Australia.

Home Choice Partners. (2011). Home Choice Partners.