Congestive Heart Failure: A Case Study

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 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 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

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.

During exacerbations of Congestive Heart Failure (CHF), older patients may receive care in multiple settings; often resulting in fragmented care and poorly-executed care transitions. The negative consequences of fragmented care lead to duplication of services; inappropriate or conflicting discharge instructions, medication errors, patient/caregiver anxiety, and increased costs of care. In light of changes in Medicare reimbursement penalizing hospitals with above set limits for heart failure (HF) readmissions, models of care are being evaluated for their effectiveness in satisfying this change as well as reducing fragmented care in this population. This paper reviews the Transitional Care Model created by Dr. Mary Naylor at the

(Heart Failure Society of America, 2010). HF is accountable for 25% of all readmission within 30 days in the United States and represents an estimated $17 million dollars in healthcare spending (Desai, 2012). HF is most commonly seen in person’s age 65 or greater with common clinical presentations of dyspnea with exertion, orthopnea, edema in lower extremities and weight gain Patients often experience frequent exacerbations and decompensations (Anderson, 2014). The Heart Failure Society of America (2010) published the Comprehensive Heart Failure Practice Guidelines with the underlying goal to improve symptoms and to optimize the patient’s volume status. These guidelines include evidence based recommendations for “prevention, evaluation, disease management, and pharmacologic and device therapy” (Heart Failure Society of America, 2010, p 476). The Institute for Healthcare Improvement (n.d.) supports the balance of evidence based treatment during acute admission but asserts that it is equally as important to assess and provide patient education for self-management after

Strategies to educate in reference to the self-care needs of the congestive heart failure patient seems to be common theme in multiple literature reviews. The educational materials may be presented to the patient by the bedside nurse, physician, pharmacy technician, and the nurse or nurse practitioner who is involved with the patient post discharge. It is suggested by one article that the effective impatient measures should include medication review, one hour of heart failure education, adequate discharge planning and communication between the patient, and health care team (McClintock et al., 2014). Once discharge the article suggests that the effective measures include early follow-up, continued education and health management by clinics,

Congestive heart failure (CHF) is a commonly seen in the hospital setting. CHF results in patients having difficulty breathing and can go in to respiratory arrest. There is decreased cardiac output and labs will show increased BNP. Patients who have CHF history will have chest x-ray and EKG. Therapy for CHF is to correct the abnormal labs and keep the patient from arresting and being placed on a vent. This paper will look at the molecular make up of CHF all the way to how to take care of the patient with advanced CHF. Patients are placed on medications to help with fluid overload and blood pressures. At times patients may have to be placed on cardiac drips. Patients with CHF are prone to pulmonary complications such as pulmonary edema, and

Congestive heart failure which is simply referred to as heart failure is a chronic progressive disease that affects the heart 's ability to pump blood effectively. Specifically, it means the heart is weakened to the point that it is not able to contract and circulate blood adequately. This weakened pump creates a backup of circulation and gives rise to a host of symptoms and debilitating conditions. The word “congestive” heart failure derives its meaning from the blood congesting the lungs, abdomen, liver, and lower extremities.

Systolic and diastolic are two different forms of left-sided heart failure. During systolic heart failure, the cardiac muscle loses its capability to contract normally. The opposite happens during diastolic heart failure; the muscle becomes rigid and fails to relax normally (“Types of Heart Failure,” 2015). Angiotensin converting enzyme inhibitors (ACEI) and Angiotensin II Receptor Blockers (ARBs) have been the go to drugs after these life changing events to assist with the quality of life. At times, a diuretic is also prescribed to the client depending on the situation. The plan of action would be different for both the systolic and diastolic heart failure clients.

The patient is a 73-year-old female who presents to the ED complaining of diffuse abdominal pain that started 3 days prior to admission. Her medical history is significant for atrial fibrillation, however she is not on anticoagulation because of previous GI bleed, type 2 diabetes mellitus, history of congestive failure, a history of uterine cancer, she had a TAH/BSO 8 years ago and postop radiation. She is not a good historian but does believe that she had a colonoscopy few years ago. The patient required narcotics in the emergency room. CT of the abdomen done ER reveals an enlarged heart, coronary artery is that calcifications moderate sized right-sided pleural effusion and small left pleural effusion with adjacent atelectasis, multiple

With breathlessness and fatigue presenting as limiting symptoms of chronic Heart Failure (CHF) the muscle hypothesis has proposed linking such symptoms with the peripheral skeletal muscle changes found abnormal in patients with Chronic Heart Failure (CHF) becoming the source of signals affecting cardiorespiratory control.

It is imperative for nurses to administer a full cardiac assessment of Congestive Heart Failure patients and work in collaboration with a team of health care providers from physicians, pharmacist, physical therapist, occupational therapist and other health care providers to educate Congestive Heart Failure patients and develop an effective care plan to avoid readmission. According to the article, effective communication and education will empower the patient to understand the disease which ultimately can help with self-management and decrease readmission. The patient will have constant communication with a team of multi-disciplinary health care providers that will create a comprehensive plan of care for the patient. Nicholson (2014), stated that health care

In this paper, I would like to discuss the chronic condition of heart failure and the interventions that a family nurse can use to promote the health of the patient and family. Chronic illness is a condition that lasts longer than six months, for most patients it is a lifetime. Per the CDC, chronic disease management accounts for 86% of the U.S. healthcare costs. Some examples of chronic diseases are diabetes, heart disease, cancer, respiratory diseases, and genetic birth disorders. A patient and family that experiences a chronic illness is not faced with one acute episode but encounters challenges of coping with the illness and daily life (van Houtum, Rijken, & Groenewegen, 2015). Health promotion during a chronic illness is essential

Congestive heart failure (CHF) as a disease which nearly five million Americans suffer from and this number is expected to double in prevalence by the year 2030. CHF is the most common reason for hospitalization and emergency department (ED) visits by those 65 years and older in the United States (American Heart Association, 2002). Horowitz, Rein, and Leventhal (2004) wanted to conduct research on problems with self-managing CHF and whether patient had the adequate tools for self-management. The title of Horowitz et al. (2004) article “ A story of maladies, misconceptions and mishaps: Effective management of heart failure” tells us this study recognizes patients do not understand self-care practices to prevent or minimize CHF