Congestive heart failure (CHF)

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 AssessmentEvaluation
 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 dietReadiness  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

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