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Congestive heart failure

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

Case study 2

2
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

Case study 2

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Case study 2

4

References

Albert, N. (2012). Fluid Management Strategies in Heart Failure. Critical Care Nurse, 32(2),
20-32.
Apostolo,A., Giusti, G., Gargiulo, P., Bussotti, M., and Agostoni, P. (2012) Lungs in Heart
Failure. Pulmonary Medicine Volume 2012, Article ID 952741,

Hughes, R. (2013). Treatments to achieve fluid balance in heart failure. Br J Cardiac
Nursing, 8(11), 537-540.

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