Congestive Cardiac Failure Research Paper

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

✽ Instructor Note: You could tell the students that the most frequent side effect of ACE inhibitors

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.

ACE inhibitors are important and useful in the medication and treatment for KH due to their effectiveness in treating hypertension. ACE inhibitors will help treat KH by slowing the angiotensin converting enzyme (ACE). Angiotensin II is produced by the body that can cause vasoconstriction of the blood vessels. Angiotensin II is made from Angiotensin I by the ACE. If the production of Angiotensin II is slowed by the ACE inhibitor, the blood vessels will be able to dilate, and blood pressure is able to be lowered (Copstead and Banasik). Thus, it is important for KH to stay on the ACE inhibitors due to his blood pressure readings. KH’s blood pressure is 135/96. His systolic blood pressure is in the pre-hypertensive range, however, his diastolic blood pressure is in the hypertensive range and therefore, his blood pressure is hypertensive. Since his blood pressure is high, it is important for KH to remain taking the

Beta-blockers have been recently reported to decrease mortality in heart failure patients. Mortality and hospitalization rates for patients with the disease are high and continue to rise. Despite the magnitude of the problem, treatment of congestive heart failure is often inadequate. Primary care physicians care for most patients with heart failure. Beta-blocker therapy is appropriate in patients with NYHA class II or class III symptoms resulting from left ventricular systolic dysfunction. Unless contraindicated, beta-blockers should be considered a mainstay of therapy in these patients to improve symptoms and mortality and to decrease hospitalizations. Beta-blockers should not be administered to patients with heart failure who have bradycardia, heart block or hemodynamic instability.

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

Individuals with end stage decompensated congestive heart failure (CHF) will often be admitted to the hospital when complications arise. This is often the case because treatments (such as intravenous medications) needed to deal with the various complications of CHF require interventions that need to be administered by a team of medical staff with close monitoring of the patient. According to the CDC website report Hospitalizations for Congestive Heart Failure: United States 2000 -2010, 5.8 million people suffer from CHF in the United States, and hospitalization rates for individuals under the age of 65 with CHF increased significantly from 23% to 29% with rates for men higher compared to women. Fluid retention that is unresponsive to oral diuretic treatments is one of the most common situations that lead to a hospital admission (Austin, Hockey, Williams, & Hutchison, 2013). Detecting early signs of decompensated heart failure could help reduce the need for a hospital admission and improve the quality of life for those with end stage CHF by allowing treatment to occur in the home setting that might normally be provided in the hospital

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

Congestive heart failure (CHF) is a condition where the heart is unable to efficiently pump blood to supply the body with adequate blood flow and it can cause fluid to build up in the lungs. There are several disease processes and risk factors that predispose an individual to this condition. CHF can be chronic or acute and life threatening, and most of these patients are in the older adult population. Some symptoms of CHF include fatigue, shortness of breath, edema, and diminished exercise capacity. There are several medical management techniques for this condition including lifestyle modifications, medications and surgical intervention. Below, I will summarize two articles on two different medical treatments for CHF.

ACE inhibitors such as Captopril block activity of the enzyme ACE and therefore the conversion of angiotensin I to angiotensin II (the most bio active product of the RAAS), thus inhibiting the actions of angiotensin II and leading to decreased aldosterone production, decrease blood volume and reduced hypertension. ACE inhibitors also work to decrease fibroblast activity as a protective measure against remodelling of the left ventricle (19). Side effects of ACE inhibitors include a dry cough due to the inhibition of bradykinin break down, hypotension and hyperkalemia (due to higher levels of potassium reuptake). ACE inhibitors are currently one of the drugs of choice to treat patients with HF.

The first line choice in patients with heart failure is Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors). ACE inhibitors can help slow progression of heart failure and improve symptoms. ACE inhibitors block the action of a protein (enzyme) that causes blood vessels to narrow. As a result, blood vessels relax and widen. This lowers blood pressure and makes it easier for the heart to pump blood. These medicines also help body release water and sodium, which also helps lower blood pressure. ACE inhibitors relieve heart failure symptoms, such as fluid retention and edema. They may help reduce liver disease and prevent readmission to the hospital. Examples of ACE inhibitors are Captopril, Enalapril, Lisinopril, Quinapril, and Ramipril.

Without the right attitude, nurses would not react effectively to patient care, a situation that may jeopardize the entire nursing profession. Effective nursing care should therefore be incorporated into the nursing development plan as it would save more lives and increase accountability among the graduate nurses.

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.

Atacand HCT (Candesartan celexetil-hydrochlorothiazide) was developed for patients who were unsuccessfully treated with single antihypertensive agents. The proposed benefit is elicited by the drugs action on angiotensin II receptor antagonists, the agent that causes vasoconstriction. Additionally the second ingredient hydrochlorothiazide a diuretic reduces blood pressure by improving the kidneys ability to eliminate salt and fluid from the body (www.centerwatch.com).

Captopril treats HBP and congestive heart failure “Captopril is an oral drug and a member of a class of drugs called angiotensin converting enzyme (ACE) inhibitors” (Ogbru, 2014 ). “Administration of captopril results in a reduction of peripheral arterial resistance in hypertensive patients with either no change, or an increase, in cardiac output”