Nursing interventions that are appropriate for Mrs. J. at the time of her admission
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.
Nursing interventions that are appropriate for Mrs. J. at the time of her admission includes comprehensive nursing assessment
• Weighing of the patient daily at the same time with the same clothing and on the same scale preferably in the morning time after urination in order to monitor fluid overload level for 2-to-3 pounds gain in a day or five pounds in a week
• Monitoring of intake and output in order to identify and evaluating the negative balance that is more output than input as evidence of pulmonary crackles, distended bilateral jugular vein and decrease breath sound
• Examine the skin turgor and mucous membrane for signs of dehydration
• Monitoring of the vital signs should be closely monitored (pulse, blood pressure, respiration and pulse oximetry
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Burkhardt, M. & Nathaniel, A. (2008). Ethics & issues: In contemporary nursing, (3rd ed.) Clifton Park, NJ: Delmar
Congestive heart failure is an older name for heart failure. Congestive heart failure takes place when the heart is unable to maintain an adequate circulation of blood in the bodily tissues or to pump out the venous blood returned to it by the veins (Merriam-Webster). The heart is split into two distinct pumping structures, the right side of the heart and the left side of the heart. Appropriate cardiac performance involves each ventricle to extract even quantities of blood over intervals. If the volume of blood reimbursed to the heart develops more than both ventricles can manage, the heart can no longer be an efficient pump.
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
The aim of this essay is to explore evidence based nursing intervention in the care and management of chronic obstructive pulmonary disease (COPD) in an acutely ill patient. The acutely ill patient involved in this essay was admitted to hospital due to cerebrovascular accident and had a past medical history of myocardial Infarction, left Ventricular failure, peripheral vascular disease and duodenal ulcer as well as chronic obstructive pulmonary disease. This essay will provide a rationale for the chosen aspect of care (COPD) and reason will be given why it is a priority. In particular the essay will examine the significance of the underlying pathophysiology of the disease relating to the acutely ill patient other
Patients need to understand the role of fluid retention and how the increase in weight is a sign of volume overload. Patients may need to adjust their diuretics and keeping close communication with the physician. The video discusses the importance of weighing daily each morning after urination and before breakfast. Teaching patients to adjust their diuretic dose may be on options to keep the fluid retention under control yet it may be difficult for some patients and or caregivers (Grady et al., 2000). The second part of the questions reflects to the video stressing what to do with weight gain.
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
Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,
The role of the master’s prepared nurse is just unlimited and life changing. I do not see just patient care in one specific route, but patient care in numerous ways. It is so diverse that there are numerous opportunities for me to, directly and indirectly, tend to patient care as well as advocate health care. I see more than just the role in providing direct patient care to be the only way to promote health care because a lot of time, the behind the scene people are the people who continuously help spread knowledge and awareness all over the world. There is a range of career roles I could take on such as clinical nurse leaders, nurse educators, and nurse practitioner and they all provide amazing healthcare in their own specific ways. When people hear delivering patient-centered care, all the focus shifts to
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
Usage of indwelling urinary catheters in critically ill patients can seem to be a permanent fixture in intensive care units. Most critical care nurse expect their patients to have an indwelling urinary catheter (IUC) in place without much regard to the risk of catheter associated urinary tract infections (CAUTI) or the ability to implement IUC alternatives. Critical care patients may require IUC usage due to diagnosis, need for accurate hourly intake and output measurements, or other specified documented reasons. The risk of acquiring a catheter associated urinary tract infections is a result of IUC usage. The Centers for Disease Control and Prevention’s Guideline for Prevention of Catheter-associated
Although most people think they can get away with picking an easy topic for their senior projects it turns out to be a little more complex than that. Growing up my ideas and passions would always seem to be changing but when I finally became set in my ways at least in knowing what I would like to pursue the Nursing Program was up to par. I chose to do mine on Nursing in the ED (emergency department) because this is a field I would love to go into so I can be of service to those in need of any medical care, to always have a stable job to rely on, and further more to be able to excel in the field of medicine. I would love to be one of the people on call to respond to the needs of another individual in their time of need. Anyone could only
Demonstrate stabilized fluid volume with balanced intake and output, breath sounds clear/clearing, vital signs within acceptable range, stable weight, and absence of edema.
This is essay is going to examine the principles of nursing and health. In order to do this it must look at the concept of health then describe the dimensions that make up health. Secondly, an adult individual will be chosen in order to discuss the determinants that affect their health. It will then go on to explain the underpinning professional, ethical and legal principles that would be taken into consideration if the individual were to require nursing care. Finally, it will identify how carrying out this assignment has informed the writers personal concept of nursing.
The nursing intervention can be based on outpatient where the victim receives support from the caregiver or the family. The family member or the caregiver can undergo training to get equipped with the required skills like fundamental therapy as well as identifying risk signs among the patient. The involvement of the nurse can be through communication with the caregiver or the family member responsible for the veteran (California, Bureau of State Audits, 2008). It is worth noting that the nursing intervention can be based on reflective listening and comprehensive engagement. In this case, the veterans can share during sessions of traumas as well as psycho/social issues they are experiencing. Then an informed decision can be made of the required