Applying Standardized Terminology in Nursing Essay

Symptoms of congestive heart failure consist of fatigue, dependent edema, fluid build-up in the lungs, increase in urination because of the extra fluid, nausea, vomiting, abdominal pain, and decreased appetite (Fundukian, 2011).  Diagnosis of CHF is done first by physical examination, such as heart rate, and heart sounds or murmurs. If a physician believes more tests are needed, common ones include an electrocardiogram or chest x-ray to detect previous heart attacks, arrhythmia, or heart enlargement, and echocardiogram using ultrasound to image the heart muscle, valves, and blood flow patterns. The physician may also want to do a heart catheterization, to allow the arteries of the heart to be visualized using angiography. Upon getting a diagnosis of CHF, the physician will usually start with asking the patient to change things in their diet, such going to a low sodium diet. They may also want to prescribe medications. Types of medications could include angiotensin converting enzyme (ACE) inhibitors, which block formation of angiotensin II hormone, angiotensin receptor blockers (ARB) to block the action of angiotensin II at the receptor site, and diuretics, just to name a few (Fundukian, 2011).

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

Jonathan is a 63-year-old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was from southern Ontario, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patient’s weight is 95 kilograms; he is 178 centimeters tall and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not exercise enough and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his myocardial infarction (MI) or heart attack. He was transferred from another hospital in the beginning of November and was waiting for more tests to be completed before he could be discharged. Jonathan has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.

Implement measures to improve cardiac output: perform actions to reduce cardiac workload: place client in a semi- to high Fowler's position, instruct client to avoid activities that create a Valsalva response, implement measures to promote emotional and physical rest, implement measures to improve respiratory status, discourage smoking, provide small meals rather than large ones,

My interview with Ms. Carol Baker Cross took place on March 21st, 2015 around 7 p.m. Ms. Cross is an RN who works at Piedmont Fayette Hospital. She earned her BSN from Troy University and graduated in 2011.The most common health care condition/problem that Ms. Cross encounters is Congestive Heart Failure and she identified this health care condition because she is an RN on the cardiac floor of the hospital. According to Ms. Cross, Congestive Heart Failure is seen when the heart doesn't have a lot of output. The heart is not strong and because the ventricles do not pump blood in a sufficient volume, fluid buildup can be seen

Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) core measures in relation to Heart Failure (HF) was examined using empirical-based nursing research. Findings suggest that lack of understanding by nurses contributes significantly to the privation of core measure implementation. A significant number of Americans suffer from HF, so patient quality of care assessment was necessitated. Identifying factors were: nurse-patient education resulting in follow-up appointments, left ventricular performance or left ventricular systolic (LVS) function, treatment medications, and smoking cessation programs. Nurses provide an important role in the education of patients with HF. The Nurse is integral in providing documentation in relation to LVS. Nurses play an important role in the administration of HF medication. Smoking, a major cause of HF, requires special nursing intervention. Nursing results in improved quality of care if HF core measures are implemented properly. Additionally, Orem’s universal requisites are fundamental in the nursing process.

Working on a cardiac unit for seven years has given me the opportunity to become familiar with congestive heart failure. This is a complicated condition that is sometimes difficult to manage. Your first questions is an excellent question, one that is extremely important when caring for these individuals with congestive heart failure. Without complete understanding of congestion heart failure, patients are frequently readmitted due to poor medical management. Caring for these individuals usually focus on treatments including the delicate balance of intake and output, medications and diagnostic testing. Your question regarding how CHF has impacted a person’s life focuses on the psychological aspect of this condition. Although

I liked this article, it did give me some new information, like the improvement of adherence to dietary restrictions and appropriate use of pharmacological therapy. The fact that all the literature points to CHF patients benefitting from advanced care and outpatient follow-up, seals my notions of the need for a CHF clinic. Increasing quality of life was also another important finding gained from this study.

The patient described in this paper will be referred to as Jonathan Toews to ensure patients confidentiality. Jonathan Toews, is a sixty three year old man, born on August 23rd 1956, and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was not born here, he moved here shortly following his second divorce. He is of Italian decent and is a practicing catholic. The patient weights 95kgs, is 178cm tall and has a body mas index (BMI) of 28.3. He said he used to play soccer when he was younger but since does not keep active or get the recommended amount of daily activity. Jonathan says he smokes around one pack or cigarettes a day and has a alcoholic drink roughly three to four drinks per week, he also describes that he eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his MI. He was transferred from another hospital at the beginning of November and currently is waiting for more testing before he can be discharged from the hospital or moved to another facility. The patient has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.

This study is aimed at reviewing the literature to find evidence-based interventions that results in a decrease in CHF readmission rates. Elderly, African American, and low socioeconomic status patients have the highest risk for hospital readmission. (Joynt, Orav, and Jah, 2011). Interventions being examined include: screening for individuals at high risk for readmission, administering beta blockers to receive the maximum therapeutic effect, and implementing effective educational programs to improve patient compliance.

Submitted to Instructor Terry Lee, MSN, RN, in partial fulfillment of NR410 Introduction to the Profession of Nursing

As part of my HNC Care and Administrative Practice (Nursing Route) course, I am required to complete the Graded Unit, this involves choosing a current health issue in Scotland and participating in a relevant activity. The health issue I have chosen is Chronic Heart Disease (CHD) as this relates to my clinical placement which is in ward 4E, a cardiology ward at Crosshouse Hospital. The activity I have chosen is to assist a patient with their personal care routine. Chronic Heart Disease (CHD), previously called Ischaemic heart disease, is when your coronary arteries become narrowed by a gradual build-up of fatty material within their walls.

It is during the second phase that the nurse must establish a nursing diagnosis. Only diagnosis approved and listed through The North American Nursing Diagnosis Association (NANDA) may be used. Ineffective airway clearance, risk for impaired skin integrity, risk for infection and ineffective coping are just a few examples of NANDA approved diagnosis. A nursing diagnosis is a clinical judgment about actual or potential individual, family, or community experiences/responses to health problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability (Defining the Knowledge,” 2012).

The first nursing diagnosis is activity intolerance related to imbalance between oxygen supply and demand secondary to congestive heart failure as evidence by CPK 480, MB fraction positive, Troponin 25, EKG NSR 96, ST elevations I, AVL, V4-V6; rare unifocal PVC’s, requirement of two-pillows to sleep, SOB when walking two blocks, ankle edema worse when standing for prolonged periods of time and sub-sternal pain. Ms. J.K. is expected to keep activity level within tolerated means with gradual improvement of tolerance. Tolerance will be monitored by absence of SOB, fatigue and dyspnea on exertion as well as HR, BP and RR. The goal is for Ms. J.K. to perform activities without complications and gradually improve her activity level.