In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.
Case study 2
Care Approach
Congestive heart failure (CHF) is a health cardiovascular disorder that affects about 23 million people in the world. The disease is clinically manifested by breathing difficulty, fatigue, general body weakness, peripheral oedema, and moist crackles throughout of the lungs. This is associated with decreased physical endurance and acute distress due to significant changes in their quality. An effective care plan should focus on educating the patient on effective disease management. This will improve the patient quality of life and reduce readmission rates (Hughes, 2013).
In this context, the Neumann’s nursing model is used to develop a care plan for this patient. This is because the recurrent acute CHF is a consequence of suboptimal management. This nursing model ensures that the patient preferences, values and emotions are integrated in the care plan. The theory ensures holistic patient care by assessing the patient physiology variable, sociocultural variable, developmental variable, spiritual variable, and psychological variable. The care plan will also incorporate the family members and care givers to help them understand ways to cope with the illness. The care approach will not only focus on managing the symptoms but will also focus on all patient aspects (Hughes, 2013).
Treatment plan
The treatment plan comprises of therapeutic and non-therapeutic interventions. Therapeutic intervention will include use of ACE inhibitors is prescribed to relax the blood vessels in order to make them wide. This improves blood flow. Aldosterone receptor antagonists are used to remove the excess fluid retained. Angiotensin II receptors is prescribed to ensure better blood flow in the vessels. The non-therapeutic measures will include advice on ways to ensure that medication adherence, financial support available and lifestyle modification for Mr. P’s wife to ensure that she copes with the disease burden (Albert, 2012).
Patient education
The healthcare staff will utilize audio-visual teaching to explain the disease symptoms, management, complications associated with medication non –adherence. This use of audio-visual education method is associated with retention of information than use of verbal education (Apostolo et al., 2012).
Teaching plan
| Teaching approaches | Learning strategies | Assessment | Evaluation | |
| Mr P. (76 y/o) diagnosed CHF Symptoms are shortness of breath, peripheral edema, and irregular heartbeat The patient has difficulty on polypharmacy. The patient have difficulty in maintaining diet restriction Care-giver feels pressurized by patient condition and its financial implication . | The best teaching method is use of video tape. This will help in understanding of the patient disease pathophysiology Patient will be shown a video on strategies to ensure medication adherence and diet restriction The care giver is educated on various options available for support and care | To self-monitor CHF symptoms and signs to ensure to reduce re-hospitalization Simplification of drugs regimen Suggestion of substitutions that equivalent and cost effective Train on ways to administer doses Education on ways medication work. Behavioral objectives to ensure strict adherence to diet | Readiness to learn for both the patient and caregiver Assess patient and caregiver barriers to effective care including age, fears and anxiety | Patient understands the pathophysiology Patient understands the strategies to improve medication adherence Relatives and caregivers understands the various support system available including nursing homes, government geriatric support and American heart association geriatric support |
References
Albert, N. (2012). Fluid Management Strategies in Heart Failure. Critical Care Nurse, 32(2), 20-32. doi:10.4037/ccn2012877
Apostolo,A., Giusti, G., Gargiulo, P., Bussotti, M., and Agostoni, P. (2012) Lungs in Heart Failure. Pulmonary Medicine Volume 2012, Article ID 952741, doi:10.1155/2012/952741 Hughes, R. (2013). Treatments to achieve fluid balance in heart failure. Br J Cardiac