Congestive Failure: A Case Study

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

Congestive heart failure (CHF) is a syndrome that occurs when the heart cannot pump sufficient blood to meet the tissues metabolic and oxygen needs. As a result, intravascular/ interstitial volume overload and poor tissue perfusion occurs. An individual with heart failure experiences reduced exercise tolerance, a reduced quality of life and shortened life span. The most common cause of heart failure is coronary artery disease (CAD). The incidence of heart failure increases with age. Approximately 1% of people over the age of 50 and 10% of people over the age of 80 experience heart failure. The prognosis depends on underlying cause and response to treatment. Heart failure may be classified according to the side of the heart affected.

Approximately 2-3 million Americans, more than one percent of the population, are currently affected by this medical problem with numbers increasing frequently (Drug Store News, 1997). Congestive heart failure tends to be more common in the elderly, men, and also African Americans. Congestive heart failure has become the most common cause for current hospital admissions. Among causing prolonged hospital stays congestive heart failure has a very high mortality rate, which has declined since recent medical advancements.

Congestive Heart Failure (CHF) is a chronic dysfunction of the heart’s ability to effectively pump blood throughout the body. Left-sided heart failure is the most common and there are two main types: systolic and diastolic. In simple terms, diastolic heart failure occurs when the left ventricle still pumps effectively, but doesn’t move as much blood as it should due to a filling problem. Systolic heart failure, on the other hand, occurs when the left ventricle does not pump as forcefully as it should, and therefore less blood makes it into circulation per contraction. Researchers and physicians alike are moving away from the classifications of systolic and diastolic as problems with one can produce abnormalities with the other. Instead, they are moving to classifying heart failure as having normal or impaired left ventricular ejection fraction. Impaired ejection fraction (<40%) would be

Congestive heart failure takes place in persons of different origins everyday. The cause of right sided heart

Abnormal heart rhythms, infections in the valves of the heart, and congenital heart disease are other heart problems that can lead to congestive heart failure.

Kim is a 53 year old woman who developed 6/10 (on a 0-10 pain scale) chest pain and shortness of breath in the airport after flying from Chicago, IL to Sioux Falls, SD. She was transported to the hospital by paramedics. She was alert and oriented with stable vital signs and oxygen saturation of 87%. Her electrocardiogram (EKG) showed normal sinus rhythm with no acute abnormalities; heart rate of 90. History included hypertension for 15 years, mild obesity, and hyperlipidemia. She has a 20-pack year history of smoking and no history of alcohol or illicit drug abuse.

management have been shown to help reduce the number of readmissions with the key topic being the education of the patient (Hobbs et al., 2016). In designing this program to reduce the readmission for the heart failure patient a review of the literature was completed and follows.

Congestive Heart Failure, is also known as heart failure cardiac decompensation, cardiac insufficiency, and cardiac incompetence, all having the same meaning; that the heart is failing and is unable to do its work. The heart has lost its pumping efficiency, meaning the heart is decompensating.

Diagnosed with Congestive cardiomyopathy implies that the patient’s heart muscle has been debilitated by ailment and cannot sufficiently pump blood through the heart, which can lead to heart failure (“Columbia University Medical Center”, 2016). In this case study, the current situation of a male patient Mr. P., who is 76 years old, and frequently hospitalized with CHF is given. The purpose of this paper is to describe an approach to care with treatment plan recommendation, provide education to both the patient and his family, and a teaching plan.

Heart failure develops when the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues or is able to do so only with an elevated diastolic filling pressure (Dumitru, I. 2015). Congestive heart failure (CHF), the blockage of the left coronary artery lead to excessive damage to the ventricle and subsequent altered blood pumping. In this paper, the author will discuss the approach of care, treatment plan, teaching in CHF and suggest a teaching plan content for a patient with CHF.

Mr. Pasquarello is a 70-year-old gentleman who was recently discharged from the hospital on 8/7 after being admitted for an acute lower urinary tract infection. He was placed on antibiotics. It is to be noted that his chest x-ray at the time of previous admission had no focal infiltrate or pleural effusion identified. He is known to have atrial fibrillation, anxiety disorder, hypertension, and diabetes mellitus. He is also known to have carcinoma which is metastatic. The patient presents to the ED on 8/10/2017 complaining of shortness of breath at that time he is found to have bilateral pleural effusions and previously treated with yttrium-90 but he appears to be now on a downward spiral. Original CAT scan showed large bilateral effusions,

The patient is a 93-year-old gentleman who presents to the ED complaining of intractable back pain. The The patient said he has had pain present intermittently for a few weeks, but it was mild and suddenly developed severe mid back pain since Friday which is has affected his mobility. He denies any recent trauma. He has had no falls in the past 3 months. He said the last time he fell was 4-5 months a ago. ER CAT scan revealed new compression thoracic fractures. The patient's medical history is significant for a mediastinal mass, ampullary mass which is an interval palmar adenocarcinoma. He has had stenting to the region, chronic kidney disease stage III, coronary disease status, coronary bypass grafting, He has a permanent pacemaker in

The patient is a 59-year-old female who saw Karen Palmer, DO on August 11, 2015. Please see a very detailed note related to this. She comes in for followup. She did undergo the CT scan ordered by Dr. Palmer, which ruled out pulmonary embolism. It did show, however a large hiatal hernia, was increased when compared to prior examination in October of 2012. The majority of the stomach was found to be within the hernia. The stomach does contain an air fluid level.

PRESENTING COMPLAINT: Mr P presents with of sudden onset of chest pain, the pain is constant, feels some tightness, pressure and squeezing in the chest and radiates to lower jaw, neck and right shoulder, has vomited twice, dyspnoeic and some diaphoresis.