NRSG 353 Assessment 2 case study 1
1. Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family
Congestive cardiac failure (CCF) is a complex and lethal clinical syndrome with high morbidity (Australian Institute of Health and Welfare, 2011). The specific data about incidence of chronic heart failure is unknown due to difficulties in collecting self-reporting data (Australian Institute of Health and Welfare, 2011). Some patients may not report their conditions, because it is mildly symptomatic and difficult to realize the symptoms when they are on the early stage of CCF (Urden, 2014). Therefore, the estimated data on incidence of CCF from National health Survey may be
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Elderly people like Sharon who is on regular digoxin and frusemide are at high risk of digoxin toxicity (Skidmore-Roth, 2013). Frusemide is a loop diuretic which could effectively help her to get rid of the excessive fluid in her body as well as electrolytes (Skidmore-Roth, 2013). As a result, Sharon might experience hypokalemia, which could induce digoxin toxicity (Skidmore-Roth, 2013).
In addition, Sharon has hypotension, which could also be related to the side effects of medications such as enalarapril, digoxin and frusemide (Skidmore-Roth, 2013).
The impacts of CCF on Sharon and her family might be both physical and psychosocial (LeMone & Burke, 2011). Firstly, patient’s activities of daily living (ADLs) could be affected due to her easily getting fatigue (Urden, 2014). Patient’s social life could also be restricted due to her limited mobility, which may lead to isolation, low self-esteem and further mental problems (LeMone & Burke, 2011). In addition Sharon’s family might suffer burdens related to Sharon’s frequent hospitalization and decreased functional level (LeMone & Burke, 2011). Furthermore, Sharon’s caregiver might feel overwhelmed by her complex care needs (LeMone & Burke, 2011).
2. Common signs & symptoms and pathophysiology of CCF a.Myocardial hypertrophy (Morton & Fontaine, 2013; Perrin, 2009; Swearingen, 2008)
Myocardial hypertrophy is enlargement of heart chambers, which is caused by ventricular
The prevalence of congestive heart failure is on the increase both in the United States and all over the world, and it is the leading cause of hospitalization in the elderly population. Congestive heart failure is a progressive disease generally seen in the elderly, which if not properly managed, can lead to repeated hospital admissions or death. Heart failure means that the heart muscle is weakened. A weakened heart muscle may not be strong enough to pump an adequate amount of blood out of its chambers. To compensate for its diminished pumping capacity, the heart may enlarge. Commonly, the heart's pumping inefficiency causes a buildup of blood in the
Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).
Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).
Nearly 5.1 million people in the United States have been diagnosed with heart failure. Yet so many people don’t have a clue what it is until they have been diagnosed with it. Congestive Heart Failure, or CHF, is a disease that has many symptoms, can be tested and treated, has several causes, and can be avoided.
Congestive Heart Failure, also known as "cardiac decompensation, cardiac insufficiency, and cardiac incompetence," (Basic Nursing 1111) is an imbalance in pump function in which the heart is failing and unable to do its work pumping enough blood to meet the needs of the body's other organs. To some people, heart failure is defined as a sudden and complete stoppage of heart activityi.e. that the heart just stops beating. This is an inaccuracy. Heart failure usually develops slowly, often over years, as the heart gradually loses its pumping ability and works less efficiently. CHF is a syndrome that affects individuals in different ways and to different degrees. It is usually a chronic disease. It gradually
I am concerned with the drug to drug interaction with Mrs. Cynthia. She has hypertension, type II diabetes, and she is old. Her body mechanism metabolism the medication at a slower rate or it may metabolism too quickly. Cynthia labs result closely because she is also diabetic and is taking Lisinopril. I am concerned with her taking a potassium-sparing diuretic, potassium supplement, and aspirin. Patients who are taking potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes should not be placed on Lisinopril (mmm ) Lisinopril is
Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart
According to the American Heart Association (2015), heart failure is defined as “a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload”. Congestive heart failure is a progressive illness that effects millions of Americans every year. Many other illnesses can lead to the development of congestive heart failure. Examples of these diseases include: coronary artery disease, past heart attack, high blood pressure, abnormal heart valve, heart muscle disease such as hypertrophic cardiomyopathy, dilated cardiomyopathy or inflammation such as myocarditis, congenital heart disease, severe lung disease, diabetes, obesity and asthma. (American Heart Association, 2015 (Centers for
Heart failure (HF) is defined as a multifaceted clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. In HF, the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion1. In the United States, HF is increasing in incidence with about 5.1 million people suffering from HF and half of people who develop HF die within 5years 2. Over 75% of existing and new cases occurred in individuals over 65 years of age, < 1% in individuals below 60 years, nearly 10% in those over 80 years of age. HF costs the
Nearly everyone knows something about heart disease. From high blood pressure & cholesterol to bypass surgery to heart attacks, heart disease is top-of-mind for most older adults and their loved ones. However, one lesser-known area of heart disease is congestive heart failure.
She reported feeling sleepy, abdominal pain, and muscle weakness. It was noted that she was seen by an MS doctor and was told that her current symptoms were not an MS flare up. She had hyperthyroxinemia symptoms that include palpitations, anxiety, fatigue, weight loss, and abdominal pain. Her blood pressure was 196/118. Thyroid testing dated 08/04/2017 showed elevated levels of total T3 at 295, thyroxine at 18.7, and T4 free at 2.64 with a low TSH at <0.005. She was diagnosed with Graves disease, hyperthyroidism, abnormal TSH, and abnormal thyroid test and thyroid uptake. Methimazole was
Digoxin is being used to treat Mrs A's CCF. The dose of 250 micrograms daily far exceeds the regular maintenance dose for a patient of her age. It is thus almost certain that Mrs A is suffering from digoxin toxicity which is most likely being compounded by taking frusemide. Mrs A's symptoms of confusion, fatigue, irritability and visual disturbance are symptomatic of digoxin poisoning. Mylanta (also being taken by the patient) can suppress the effectiveness of digoxin however in this case the digoxin dose is so high that Mylanta would be having a minimal impact.
In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.
Congestive heart failure is a chronic disease that requires daily monitoring and life style management. Affecting the elderly, and their family the adjustment is a challenge. Daily life skills include the monitoring of daily weights, intake and output, and a low sodium diet. The person with congestive heart failure is generally admitted to the hospital for medication adjustments when their symptoms increase. The patient is often times short of breath, with a decrease in energy and an increase in their weight. The patients are generally elderly 60-65 years of age or older, and when comparing African Americans to Caucasians the African Americans have a 1.5 greater chance of developing heart failure ("Heart Failure," 2017). The
Ryan is currently on Digoxin 200 micrograms and Furosemide 10 mg q day. He is prescribed Digoxin because this medication increases overall cardiac output as well as slowing the heart rate. This is good for Ryan, because at this point he is not receiving the appropriate amount of output needed for his growth and development. Furosemide is a diuretic that treats fluid retention as well as hypertension. This is important because when there is a defect with the heart, pulmonary issues may occur when fluid retention begins. Also, Ryan is currently predisposed to hypertension because of his condition.