Heart failure diagnoses are carried out by a specialized medical practitioner. It comprises of holistic patient health review such as patient medical history, patients symptoms, lungs con-gestion assessment, carrying out physical activity under observation, assessing for fluid re-tention (edema) and also assessing risk factors such as Coronary artery diseases, high blood pressure, Diabetes. According to tansy (2010 1399), heart failure can be diagnosed using different test methods such as Blood tests. This helps to check for any possible diseases in the thyroid, kidney or liver that can cause heart problems (NT-proBNP). N--terminal pro-B-type natriuretic peptide is a chemical checked in the blood. When the heart is under stress BNP is secreted
This study is relevant to the research question because they focused on testing n-terminal pro-b type natriuretic peptide and management of Heart Failure patients, however the patients were in a hospital in Canada. The study started with 534 patients from screening but 34 were excluded, and 17 patients did not participate after the first hospitalization, leaving 483 patients that were followed during the course of the study (Moe, Howlett, Januzzi, Zowall, 2007). The study used receiver-operating characteristic curve was used to analyze the data from the two groups (Moe, Howlett, Januzzi, Zowall, 2007). The tools used were clearly defined, reliable and valid. The researchers measured the proBNP level and physician initial diagnosis and then after they used the “logistic regression model” to predict whether knowledge of the proBNP levels aided in diagnosis and management of HF (Moe, Howlett, Januzzi, Zowall, 2007). The statistics used to analyze the date was relevant to the clinical research question. The study did not “perform age-stratified analysis” which may have an impact on the results, there was also a loss to follow up and the study was performed at multiple sites in Canada where as the patients for the clinical research question are located in Dallas service delivery area in United States of America (Moe, Howlett, Januzzi, Zowall, 2007). According to the researchers, the results of their study supported the “recently published HF consensus guidelines’” view that proBNP supports clinical diagnosis and cost effective care of patients (Moe, Howlett, Januzzi, Zowall, 2007). The implication of this study is that knowing the value of proBNP aids practitioners in the diagnosis and management of HF
A non-ST-elevation myocardial infarction (NSTEMI) is a type of heart attack; its counterpart, STEMI or ST-elevation myocardial infarction, is differentiated based on an EKG (electrocardiogram) test. Four processes are involved in the making of an NSTEMI: unstable plaque in arteries, the constriction of the coronary arteries, insufficient oxygen supply to the heart muscle, and narrowing of the coronary arteries from plaque development.2 It is differentiated from unstable angina, or chest pain, by the rise and fall of troponin levels
A non-ST elevation acute coronary syndrome (NSTE-ACS) is a very common presentation to emergency departments everywhere, as well as primary care practices. Therefore, it is important that all providers be well informed on the effectivity of certain treatment regimens.
Nurses should take care to select the proper outcomes to ensure optimum care is provided to patients with CHF. The plan of care is dependent on the nursing diagnosis and the desired nurse-sensitive outcomes. The priority NOC outcome for the diagnosis of CHF is Fluid Balance and Fluid Overload Severity. Other related NOC outcomes are Knowledge: Cardiac Disease Management, Knowledge: Energy conservation, Knowledge: Medication, Knowledge: Prescribed Activity, Knowledge: Treatment, and Knowledge: Weight Management (Johnson et al., 2012). These are only a select few of the multiple outcomes available; care should be modified as the disease progresses through the problems which evolves over the lifetime of patients diagnoses with CHF. Once all these determinants are established, the nurse will be prepared to determine which level of NOC is essential to effectively manage the disease.
The pathophysiology of ACS includes the stable plaque forms get converted into unstable plaque forms.2 These unstable plaque forms have numerous thin fibrous cap cells, inflammatory cells, activated macrophages, and smooth muscle cells. Sympathetic activity increases myocardial contractility, pulse rate, blood pressure, and coronary blood flow which leads to plaque rupture or fissure. As the artery ruptures, it causes thrombus formation and ischemia in this particular artery. Depending on the condition, different thrombi could form. The unstable angina forms a small thrombus formation, NSTEMI forms a partial thrombus formation, and STEMI forms a complete and persistent thrombus. The risk factors involved in ACS are age, physical inactivity, and history of hypertension, diabetes, or angina. The signs of acute coronary syndromes are an acute heart failure, tachycardia, bradycardia, or heart blockage, and the symptoms of ACS consist of chest pain, pain in the extremities, nausea, shortness of breath, heavy
Also, physicians need the routine lab testing results as this helps them diagnose and initiate treatment plans for patients with heart failure. The lab tests that are recommended by the American Heart Association and others to evaluate for heart failure are: a complete blood count (CBC), which may indicate anemia and possibly an infection as one of the possible causes of heart failure. A basic metabolic panel (BMP) would show serum electrolytes and may help with diagnosing fluid retention or renal failure. Also, B-type natriuretic peptide levels (BNP) are up in heart failure. A twelve lead electrocardiogram (ECG or EKG), shows the electrical activity of the heart and may help reveal arrhythmias, infarctions, or even heart failure (Petersen, M., Wang, Y., Van der Laang., M. & Guzman, D.
Based on Goodman and Fuller (2015), it was estimated that the annual population in the United States with (CHF) congestive heart failure is about five hundred fifty thousand, and approximately five million male and female elderly individual (65 years old and above) is the leading cause of hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death rate and fifteen percent survival rate of patients diagnosed with CHF (Bocchi, Vilas-Boas, Perrone, Caamaño, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al., 2005).
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
Right-sided heart failure can be ruled in. When the heart is backed up it produces an overload of fluid in the lungs and entire body. As fluid accumulates in the lungs it can cause chest tightness, sob, jugular vein distention and coughing which produces a pink frothy colored sputum in which patient is positive for. Although this diagnosis has strong symptomology the BNP is normal and the diagnosis of Heart failure may be ruled out. (Dunphy & Winland-Brown,
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.
As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)