mental health exam

Left-sided heart failure is the most common type of heart failure, and it is a result of left-ventricular dysfunction. This disease poses a significant threat to patients because the primary function of the left side of the heart is to provide sufficient oxygenated blood to satisfy the metabolic demands of the body’s cells. Understanding the main function of this portion of the heart will help with the understanding of other complications associated with this diseased. Left-sided heart failure is usually the result of the loss of heart muscle function, specifically in the left ventricle secondary to coronary artery disease, prolonged hypertension, or myocardial infection (Lewis et al. 2014, 766). The

The client’s name is Keisha, she is a female, single, sixteen years old, African American, high school student. She was transferred recently to a nontraditional high school, to complete the required credits needed to receive her high school diploma. According to her transcripts she is passing her classes satisfactorily. Keisha is scheduled to graduate on time by the summer of 2018. The client was referred to mental health counseling by her grandmother because she appears to be depressed. The grandmother stated that “student lost her mother when she was seven years old, and thinks she is sad about that” .The school psychiatric social worker referred the client to me in order to conduct a mental health assessment. Per her

There are several possible risk factors that increase your chance in getting left sided heart failure. Things such as anemia, overactive thyroid, underactive thyroid, and emphysema, leading a sedentary lifestyle, and malnutrition or eating a high-fat diet all are possible contributing factors (Heart Failure, 2014).

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

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.

Apical pulse should be checked before giving digoxin. The student nurse must observe for indicators of decreased cardiac output like bradycardia. Consequently, digoxin should not be given and physician should be notified if heart rate is below 60 bpm. Report manifestations of digoxin toxicity such as anorexia, nausea, vomiting, abdominal pain, weakness, vision changes and new-onset arrhythmias. Assess potassium, magnesium, calcium and serum digoxin levels before giving digoxin for complication of hypokalaemia. Angiotensin-converting enzyme inhibitors act on the renin-angiotensin-aldosterone system (RAAS), playing an important role in blood pressure, blood volume and electrolyte balance. By inhibiting the conversion of angiotensin I to angiotensin II, it permits vasodilation and reduced salt and water retention. Hence, it reduces preload and afterload of the heart causing a decrease in left-ventricular workload thereby improving cardiac performance and symptoms (Godden, J., & Waite, M., 2014). Sylvie’s blood pressure should be monitored closely following initial dose of the drug since it causes hypotension. ACE inhibitors can cause hyperkalaemia therefore serum potassium levels should be monitored as well as white blood cell (WBC) count for

When the heart is no longer able to pump enough blood to sustain the body’s metabolic needs, it is referred to as heart failure or cardiac insufficiency. The most recent definition is that heart failure should be viewed as a neurohormonal problem that progresses as a result of chronic release in the body of substances such as catecholamines (epinephrine and norepinephrine). Epinephrine and norepinephrine are hormones of the sympathetic nervous system and produce negative effects on the failing heart and circulatory system. Circulatory congestion and compensatory mechanisms will occur. Heart failure may develop after a Myocardial Infarction in response to prolonged hypertension or diabetes mellitus, or in relation to vulvar or inflammatory heart disease.

In addition, individuals should monitor their weight. In other words, they should weigh themselves every morning after using the toilet and report any weight gain of two kilograms in three days. Health providers should emphasize the importance of eating small, frequent meals, as dyspnea and gastrointestinal disturbance may arise. Moreover, individuals with congestive heart failure should limit salt and fluid intake. Nurses should educate individuals about the amount of fluid that each cup, mug, or glass can hold in order to monitor their fluid intake. Smoking and alcohol cessation should be emphasized. Individuals with stable heart failure should be advised to carry out their daily activities; however, they should avoid activities that could strain their heart. Individuals with unstable heart failure should be advised to perform passive range of motion exercise in order to decrease the development of blood clots and pressure ulcers. Furthermore, pneumococcal and influenza vaccines should be offered. These vaccines could help decrease lung infections. Health providers should teach individuals how to take their medication and the amount of medication to be administered. Individuals with heart failure should manage their diabetes and hypertension as well. Psychological support should be

Congestive heart failure, also called heart failure or CHF, is one of the fastest-growing syndromes in the United States and worldwide. It is a condition with high hospitalization and high mortality rates as well as a compound medical regimen that significantly affects the patient’s lifestyle and that of their family. The term alone, “heart failure”, is enough to scare the bravest client and cause the rise of numberless concerns and questions. Patients may worry and exclaim, “Did my heart stop working? Am I going to die?” Because of the complexity of congestive heart failure and how fatal it may become when it is not well managed, a thorough understanding of the disease process and of evidence-based management guidelines is necessary in order for the nurse practitioner to adequately care for, reassure, and educate the CHF patient, their caregiver and family. This paper aims at providing an overview of heart failure as well as giving the clinician the foundational tools necessary to help improve the quality of life of CHF patients and prolong their days. We will cover the two main types of heart failure (left-sided and right-sided), with a brief look at CHF sub-classifications, systolic and diastolic CHF. We will seek to explain the etiology, pathology, clinical manifestations of this condition as well as explore the current diagnostic tools and pharmaceutical treatments available across the lifespan. We will also look at the dynamic role of the nurse practitioner

First and foremost, before any assessment can take place it is very imperative to conduct a Mental Status Exam (MSE). Simply because this examination will set the foundation in the treatment process. According to research the purpose for this type of examination is to become aware of the clients specific cognitive functions, and to administer a structured assessment which will help forensic professionals and therapist to formulate a diagnostic plan through observation of the patient’s appearance, mood, speech, behavior, and overall cognitive abilities (Martin, 1990).

Heart failure may affect either the systolic or diastolic phase of the cardiac cycle. Alternatively, both phases may be involved. Conceptually it is useful to view this heterogenous condition as a progressive disorder that has an initiating or ‘index’ event where damage is inflicted on the cardiac myocytes.(15) The index event can be acute, such as may be the case in myocardial infarct, or chronic due to haemodynamic pressure or volume overloading. Regardless of the mechanism of injury a decline in pump function is the result. The initial insult will be compensated for in the acute phase by activation of a complex sequence of neurohormonal changes which are recognised to play a pivotal role in the development and progression of heart failure.(15) Whilst

Diet modifications should be recommended to help alleviate future episodes of heart failure. Mrs. Mendez should be advised to increase dietary fiber to prevent constipation. Also it is crucial to maintain adequate fluid intake to prevent dehydration and renal issues. Reinforce the importance of low salt diet and keeping the physical activity continuous as much as tolerated. Regular walking as much as possible is recommended (Hoffman, 2001). Home should be kept safe from hazards to prevent any falls. Daughter and husband should be advised to monitor the hallways for any obstructions and keep the home well lit.

When considering how to properly make a plan of care for a patient in heart failure a clinician must take into account several factors. What type of heart failure? Who is the patient: in a sense of how old, what is their lifestyle, gender, race, socioeconomic background? These factors can determine how a clinician will approach the health issue and what type of changes the clinician will make. It is important to understand the mechanisms behind each type of heart failure before knowing how the drug therapy can help. It is also important to know that a 25 year old is going to be more capable of making physical activity changes than a 70 year old. By knowing the mechanisms of heart failure, and how the drugs work against those mechanisms, the

P (Ponikowski et al., 2016; Tulane University, 2010). The nurse will provide education regarding each of these medications stating a diuretic, also known as a “water pill,” will help him eliminate the excess fluid through urination; oxygen and intravenous morphine will make his breathing easier; and angiotensin converting enzyme inhibitors (ACE-I) and beta blockers help decrease the workload of the heart and increase its ability to pump blood effectively (Ponikowski et al., 2016; Tulane University,

The next consideration would be the determination of the body’s fluid levels. This would be followed by the examination of the body and patient’s regulatory systems which affects the body’s fluid level. The next step will then be the evaluation of the disease status of the patient. Other diseases may have a negative effect to the ability of the heart to pump blood to the various parts of the body and this step will enable the nurse to discover which disease is causing a negative effect to the heart. The evaluation of the family status will reveal any conflicts that may be causing the heart failure while at the same time provide an understanding of the degree of effectiveness of therapeutic regimen management. Through this data, the nurse will be in a position to determine the patient’s current status and aid in determining the level of outcomes that is required to manage the disease effectively.