Heart Failure Guidelines
The 2009 revision of the ACC/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults contains a number of evidence-based updates, revised text, and a new section called "hospitalized patient" (Hunt et al. e395). These revisions are the result of a task force that convened in 2008 and represent new findings published between 2005 and 2008.
Four stages along a continuum of heart failure are described, with the first two stages representing patients having medical conditions that increase the risk of heart failure (Hunt et al. e396). Stage A patients may have atherosclerosis, diabetes, hypertension, obesity, metabolic syndrome, or have a family history of heart failure, but without structural heart disease (Hunt et al. e405-e408). Treatment strategies for Stage A patients include aggressive management of medical conditions and encouraging lifestyle changes. Stage A patients with vascular disease or diabetes may also benefit from ACE inhibitors…… [Read More]
Heart failure has been described as a "complex clinical syndrome that results from either structural or functional impairment of ventricular filling or ejection," (Alspach, 2014, p. 1). Because of the multifaceted nature of heart failure, it is important to recognize its various symptoms and dimensions. Heart failure in general presents a major public health concern, with current prevalence at over five million adults in the United States and over 650,000 new cases being diagnosed each year (Alspach, 2014). Incidences are higher for persons aged 65 or older, and among certain ethnic groups as well. However, heart failure affects young children and accounts for as many as 10% of all pediatric cardiac transplants (Burch, 2002). Morbidity rates are likewise high, and heart failure is a leading cause of death in the United States. Because of this, heart failure has been described also as an "enormous clinical burden," (Burch, 2002).
isk factors…… [Read More]
Literature Critique of Articles concerning Heart Failure
The two articles in this literature review are concerned with different aspects of care for patients diagnosed with some stage of heart failure (HF). Heart failure is one of the most prevalent and debilitating diseases worldwide and is the leading cause for hospitalizations for people older than 65 years (Schwarz, Mion, Hudock & Litman, 2007). These two articles look at ways of monitoring patients and the decision-making process involved with the care of HF patients.
A Process of Decision Making by Caregivers of Family Members with Heart Failure
The purpose of this research study was to determine the decision making process of caregivers of family members with heart failure. The authors sought to examine the different factors that influence decisions and the pathway that caregivers follow in coming to decisions. The research question, explicitly stated by the authors, is "how do…… [Read More]
Heart Failure Medication
The purpose of the article by Gordin and Fonarow (2016) entitled “New Medications for Heart Failure” is to examine and discuss established guidelines for medical treatment for heart failure. Specifically, the article examines pharmacological interventions for heart failure with regard to ACE inhibitors, beta blockers, aldosterone antagonists and reduced ejection fraction. It looks at recent studies that have allowed new therapeutic methods to be developed using ivabradine and valsartan, the former of which decreases heart rate and the latter of which elevates vasodilatory peptides that have an angiotensin receptor antagonist. The article was chosen because it is timely and evaluates the “first new-in-class medications” designed to further help provide quality care for patients suffering from heart failure (Gordin & Fonarow, 2016, p. 491). By examining several trials conducted for the drugs, the study shows that both ivabradine and valsartan are effective in decreasing hospitalizations for patients with…… [Read More]
Heart failure is a serious medical condition that is brought by the failure of the heart to pump sufficient blood throughout the body at the right pressure. Generally, this condition is a progressive and chronic disease in which the heart muscle is incapable to pump adequate blood for all blood and oxygen needs of the body. Since the heart cannot keep up with its workload under this condition, it attempts to make up for the failure through enlarging, developing more muscle mass, and pumping faster. Enlarging involves stretching the heart chamber more in order to pump more blood while developing more muscle mass occurs because of increase in size of the contracting cells and pumping faster helps to enhance the heart's output ("About Heart Failure," n.d.). As a major health problem, potential solutions for heart failure is a nursing focused plan that incorporates identifying nursing goals, monitoring the patient, and…… [Read More]
Elders Delay Responding to Heart Failure Symptoms?
"Heart failure (HF) is the most common admission diagnosis in the United States for persons over 65 years of age, with readmission often occurring within 60 days of discharge… Part of the reason for repeated admissions is that patients delay responding to their HF symptoms" (Byrnes et al., 2009, p. 252-253).
"he specific aims of this study were to (a) describe the experience of and the cognitive and emotional response to the symptoms of decompensated HF, (b) determine the influence of sociodemographic, clinical, cognitive, emotional, and social contextual factors on symptom duration during this time, and (c) describe self-care behaviours prior to seeking care for decompensated HF" (Byrnes et al., 2009, p. 255).
"We propose that delay in seeking care is due to the difficulty that HF patients experience in discerning the quality and meaning of their symptoms" (Byrnes et al., 2009,…… [Read More]
One's heart may appear enlarged in heart failure. The X-ray also may reveal whether ther e is any fluid buildup in the person's lungs. X-rays also sometimes show conditions other than heart failure that possibly cause the patient's signs and symptoms (Mayo Clinic Staff, 2009).
Electrocardiogram (ECG): Through electrodes attached to the patient's skin, an ECG records the electrical activity of person's heart and records the impulses. These impulses, displayed on a monitor, may also be printed on paper. From this test, the doctor can diagnose heart rhythm problems and also ascertain damage the person's heart may have experienced from a heart attack that may underlie heart failure (Mayo Clinic Staff, 2009).
Echocardiogram: From this test, the doctor can diagnose and monitor heart failure. "An echocardiogram also helps distinguish systolic heart failure from diastolic heart failure, in which the heart is stiff and can't fill properly. An echocardiogram uses sound…… [Read More]
Pregnant or breastfeeding women, older patients and other patients with certain medical problems are advised to first consult their doctors before using the drugs. These medical problems are heart disease, heart rhythm problems, severe lung disease, kidney disease, liver disease, and thyroid disease (Flanigan).
Although side effects of digitalis drugs are rare, patients are urged to consult reactions such as skin rash, hives or other troublesome symptoms (May 2006). Signs of overdose should be observed and also reported promptly. Digitalis drugs may also interact with other medicines and side effects can develop. They may increase the risk of heart rhythm disorders when taken with other heart medicines, amphetamines or diet medicines. Taking calcium channel blockers may increase digitalis level and lead to overdose. Diuretics, which reduce the amount of potassium in the body, may increase the side effects of digitalis medicines. Anti-diarrhea or cholesterol medicines and high-fiber foods can prevent…… [Read More]
Activity is another important concern for many individuals that have congestive heart failure. Some of them will be resentful of the fact that they are no longer are able to perform many of the activities that they once performed, and others will be so afraid to perform any type of activity at all that they will become sedentary, which can also be dangerous. All individuals, regardless of their medical condition, should be encouraged to be as active as they can safely for as long as they can (Legge & Leeper, 2002).
hen nurses work with individuals that have congestive heart failure, they should work towards reassuring them about the activity level that they can handle and what they should be doing to keep themselves as healthy as possible. As has been mentioned, most cases of congestive heart failure are mild to moderate and they can be treated with proper lifestyle…… [Read More]
Congestive Heart Failure
It is a fact that Congestive Heart Failure is an extremely frightening word and an equally frightening concept to comprehend, and when a loved one, or oneself has been diagnosed with this condition, it is quite natural to relapse into a state of depression or panic. However, it is not an untreatable disease, and with the correct and appropriate treatment methods, and with the right physician attending, the patient would be able to live a very productive life in the future, and look forward to living a long life too. This paper deals with 'what is Congestive Heart Failure', and how often does it occur. Who are the people who would be the most prone to this condition, and what can be done to prevent it. What are the various preventive measures that can be taken by other individuals who have been identified to belong to a…… [Read More]
Congestive Heart Failure
Description of the Health Issue
Congestive heart failure does not necessarily mean that the heart has stopped functioning, but it does mean that the heart is not pumping blood as effectively as it should be -- and normally is -- pumping the body's life-sustaining substance. This paper delves into the reasons why a person suffers from congestive heart failure, what actually happens to the heart and to the body, and the medical treatment and clinical manifestations appropriate for this condition.
Literature Review of Health Issue
According to the peer-reviewed Texas Heart Institute Journal, congestive heart failure affects "5.7 million individuals," and there are "700,000 new diagnoses" annually (Mosalpuria, 2014). After the first congestive heart failure event, Mosalpuria explains that there are often "multiple relapses" and about half of those suffering from congestive heart failure will be hospitalized within the first year after the event, and within that…… [Read More]
This severely weakens the heart muscles because it has to pump harder to get the oxygen to flow properly.
Chronic Obstructive Pulmonary Disease (CPOD) is a disease of the lungs that makes it extremely difficult for the patient to breathe. One of the leading causes of this disease is tobacco smoke. This can be from first hand smoke where the patient himself is a smoker, or it can be caused by second hand tobacco smoke. Of the 98 patients in this subpopulation, 39 patients (40%) were also diagnosed with COPD. It is extremely important for the congestive heart failure patient to be a non-smoker and live in a smoke-free environment. Along with ways to manage the existing conditions that the patient has, the case manager must make it a priority to include information to help the patient quit smoking. If the patient is a victim of second hand smoke, simple…… [Read More]
Congestive Heart Failure
TREATMENT and EDUCATION PLAN
Cardiomyopathy and Congestive Heart Failure
Cardiomyopathy is a diseased condition of the heart muscle wherein it enlarges or becomes rigid or thickens (NHLI, 2011). It has many causes, signs and symptoms as well as therapies. In extreme but rare cases, the affected heart muscle is replaced with scar tissue (NHLI). Congestive heart failure or CHF, on the other hand, is a condition wherein the heart becomes unable to pump blood efficiently into the organs of the body. The cause is either the right or left ventricle or both. Usual symptoms are shortness of breath, pooling of blood in the body systems, edema and heart enlargement. Among the causes are coronary artery disease, prolonged alcohol use, heart muscle weakness and high blood pressure (MedicineNet).
Approach in Care
The ideal one is an organized team of specialists, which will aim at improved overall outcome (Jaarsma,…… [Read More]
Congestive Heart Failure Awareness
Creating awareness has over the years been the most effective way of teaching people the emerging trends of the universe. These trends are inclusive of health issues; increasing rates of pandemics and other health-related risks. It has been effectuated in order to counter and reduce the increasing rate of disease, and to provide the necessary information that can be used to prevent and treat such issues. Such issues have led to the introduction and assignment of educating roles in organizations at grass root levels. Such is my organization that has conducted awareness internally to the workforce and to the community.
Topic and scenario discussion
Congestive heart failure has joined the list of diseases that have immensely affected citizens, not only across the United States, but also globally. It is a chronic condition of the inability of heart functionality to deliver blood to other necessitated…… [Read More]
safe Transition • in October 2012, made Medicare payment rules. Hospitals penalized a patient returns 30 days treatment problem. One targeted medical diagnoses payment change heart failure (HF).
Making a safe transition
Heart failure medication
Medications used to treat heart failure and why they are used
Beta adrenergic blockers, diuretics and ACE inhibitors are some of the common classes of drugs used to manage heart failure. Beta adrenergic blockers are used because they are able to slow the heart rate allowing the left ventricle, which is the main pumping chamber, to fill with blood completely. They can also help to open blood vessels wider thus reducing the blood pressure and improving the flow of blood. This helps to improve the percentage of blood that is pumped from the left ventricle per heartbeat, also known as the ejection fraction, and to slow the progression of heart failure. Diuretics are also used…… [Read More]
managing of heart failure is complex as it encompasses a treatment regimen that has to follow a lot of norms. One of the key elements in heart failure care is self-care behaviors that are essentially required to be learnt for patients through self-participation. According to Britz and Dunn, (2010), there are certain self-efficacy norms that need to be followed by heart failure patient rat include regimens like weighing themselves or a regular basis, adhering to the a diet with low sodium, monitoring symptoms for worsening of the hearth conditions, adhering to a regimen that entails restricted fluid consumption and participating in physical activity either alone or in groups (Britz & Dunn, 2010). Moreover the patients with heart failure need to follow a strict regimen of medicines. This complicated pharmacologic regimen is often very critical in continued care for heart patients. Medicines need to be taken at regular intervals and within…… [Read More]
Congestive Heart Failure
As you know, Congestive Heart Failure (CHF) is one of the most common causes of death in the United States. The multifaceted causes and symptoms associated with CHF often leave the health care provider treating the symptoms rather than underlying causes, with near universal need to tailor care to each patient through a sometimes difficult process if elimination. The sometimes-idiosyncratic nature of epidemiology can also leave the provider with limited options for treatment and care. hat is known about the disease is that it is one of the leading chronic conditions associated with mortality and overall healthcare expenditures in the United States, that it strikes most heavily among those over the age of 65 and is more common among black men, white men, black women and white women respectively. (CDC 1994)
Predicting who in the general population or among those with some preexisting cardiac disease…… [Read More]
Health Education on Re-Hospitalization of Patients With Chonic Heat Failue
The heat failue is one of the top health poblems in the United States leading to high ate of mobidity and motality among people aged 60 yeas and above. The complicated health poblems of heat failue makes the eadmission ates to incease within 30 days of patients' dischages. In essence, incease of eadmission ate has been associated with high health healthcae costs in the United States. Based on the coelation between high ate of eadmission and its associated high costs, this pape agues health education is an effective tool that can educe the ate of eadmission. Techniques to cay out the health education include home visit, telephone calls, and tele-monitoing to enhance a geate undestanding of patients on the stategy to cay out an effective self-cae management.
In the contempoay health envionment, the HF (heat failue) is one of…… [Read More]
Readmission of Heart Failure Patients
Re-Hospitalization and Heart Failure Patients
Heart failure is one of the top health problems in the United States leading to high rates of morbidity and mortality among people aged 60 years and above. The complications associated with health heart failure increases the readmission rates within 30 days of patients' discharges. In essence, the increase of readmission rate has been associated with high healthcare costs in the United States. Based on the correlation between high rates of readmission and its associated high costs, this paper argues that health education is an effective and essential tool that can reduce the rate of readmission. Techniques to carry out health education includes: pre-discharge planning, home visits, telephone calls, and tele-health to enhance a greater understanding of patients awareness, and how the implementation of strategies and effective self-care management can help their well-being.
Can health education…… [Read More]
Best Practices in the Management of Congestive Heart Failure
In recent years, diagnostic testing and treatments for cardiovascular diseases have improved survival rates and the quality of life for many patients, with the sole exception of congestive heart failure (CHF), which has experienced increases in both prevalence and incidence (ahnavard & Nodeh, 2014). Moreover, today, coronary heart diseases in general and CHF in particular are among the leading causes of mortality in the United States, and the World Health Organization (WHO) projects that by 2020, cardiovascular diseases and major depression will become the two leading contributors to the global burden of disease (Ai & Bruce, 2010). While the precise causes of these increases remain under investigation, a great deal has been learned concerning the pathophysiological and clinical presentation of the condition, as well as its typical progression trajectory (Ai & Bruce, 2010). The availability of effective diagnostic testing has also…… [Read More]
Alzheimer's (Dementia) Disease Responsible for Congestive Heart Failure?
Approximately four million Americans have been diagnosed with Alzheimer's disease. The disease affects nearly one out of ten Americans over the age of 65 and nearly half of those over 85 (Davis, 1997). Of all Alzheimer's patients, about 28% also have congestive heart failure, leading researchers to pursue studies attempting to correlate Alzheimer's disease directly with congestive heart failure.
About Alzheimer's Disease
Alzheimer's disease is a disorder that causes the gradual loss of brain cells (Davis, 1997). The disease was first described in 1906 by German physician Dr. Alois Alzheimer and was once considered rare. However, today's research shows that it is the leading cause of dementia in older adults.
Alzheimer's disease progresses at various different rates. The duration of the illness could vary from 3 to 20 years. The areas of the brain that control memory and thinking skills are hindered…… [Read More]
Mobile healthcare apps have become common in the modern healthcare sector because of the increased adoption of technology in clinical practice. In cardiac care, mobile healthcare apps are considered as vital tools towards enhancing patients’ clinical outcomes. Given this consideration, mobile healthcare apps are utilized by patients with congestive heart failure as part of their care journey. This increased use of mobile healthcare apps is also fueled by the existence of research evidence, which demonstrates that the use of a mobile phone for emergency services in life-threatening situations is linked to enhanced clinical outcomes (Honeyman et al., 2014). Despite the existence of research evidence, the effectiveness of mobile healthcare apps used by congestive heart failure (CHF) patients remains largely unknown. This is primarily because of the existence of various kinds of mobile healthcare apps for such patients and the fact that it’s a relatively new technology.
In this regard, the…… [Read More]
The human body’s Renin-Angiotensin Aldosterone System (RAAS) regulates blood pressure and fluid balances. When a person’s blood pressure or water levels drop, the body’s baroreceptors identify the drop, as do cells in the kidneys, which are responsible for releasing rennin into the body. In the case of a decline in blood pressure, the enzyme Renin transforms angiotensinogen to angiotensin I. Angiotensinogen is a protein in the liver, and, essentially, a chain-reaction process gets under way in which the body’s RAAS acts like a line of dominoes responding to the drop in low blood pressure: the kidney gets the chain reaction underway first, by releasing Renin. Renin converts the protein in the liver to the hormone angiotensin I. Angiotensin I is then converted by an enzyme in the lungs, which is called the angiotensin-converting enzyme (Angiotensin I is transformed into Angiotensin II). So kidneys, liver and lungs all work together in…… [Read More]
How Does the Use of In-home Monitoring for CHF Impact Re-hospitalization Rates?
Impact on In-home Monitoring for CHF on Re-hospitalization Rates
Congestive heart failure (CHF) is one of the major cardiovascular diseases with high global incidence and prevalence in the United States. While numerous advances in evidence-based medical therapy continues to occur, congestive heart failure remains a major problem as it results in significant burden of mortality, morbidity, and costs. The United States has a prevalence of 5.8 million individuals with the condition and more than 960,000 cases annually. It is estimated that approximately one million hospitalizations linked to congestive heart failure occur annually. Most of these hospitalizations arise from worsened congestion among already diagnosed patients. The United States spends approximately $32.7 billion on congestive heart failure annually. Martirosyan et al. (2017) states that readmission rates for this condition remain high as nearly 20% of patients are readmitted within 30…… [Read More]
Questions regarding all three aspects should be asked during intake because this disease should be treated holistically meaning that everything should be factored in.
IV. DISEASE Management MODEL
A disease management plan is necessary for the congestive heart failure patient because so many other illnesses are associated with this disease. The plan is designed to improve the patient's health, while at the same time reducing medical costs.
Disease Management Model
To manage as well as reduce congestive heart failure and the illnesses generally associated with it.
Patients who already have congestive heart failure or those who are at risk.
To reduce the chances of developing other illnesses and diseases associated with congestive heart failure.
To cut down on hospital admissions by ensuring patients follow instructions for at home care as well as regular follow up visits.
To cut down on medical costs by monitoring patients at…… [Read More]
Treatment of Heart Failure in Nursing Home Residents
Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF with LVSD (left ventricular systolic dysfunction) (NCGC, 2010).
In order to treat chronic HF, non-pharmacological as well as pharmacological therapy ought to be utilized for patients. While this condition is quite frequently witnessed among patients living in nursing homes, whether the suggestions put forward in the pharmacological therapy guidelines are implemented within this cluster of patients is unclear (Daamen, et al., 2016).
Owing to the lack of awareness of the precise prevalence of chronic HF, this phenomenon is…… [Read More]
Heart Failure Admission
he project carries out the CCIP (Chronic Care Improvement Program) to alleviate the heart problem of people suffering from heart failure. he time frame of the program is within 6 months between January 1, 2015 and June 30, 2015. he total population consist of 1,606 people, and out of all the 1,606 target population enrolled for the program, 0 is the numerator and the denominator is 45. hus, 45 participants are eligible to receive program interventions. Based on the results of the PBP (Plan Benefit Package), the inpatient PBP 002 diagnosed for heart failure are 1,606 target population and the care management declined by 5% in 2014, representing a total reduction of 5% compared to 7% reduction 3 years ago.
In the additional intervention of the program, the target population selected are 1,606, where 1 meets the inclusion criteria and 11 participants are eligible to receive the…… [Read More]
Alterations of Hematology and Cardiovascular Systems
Mr. P is a despondent 76-year-old patient who is considering death because of his condition of cardiomyopathy and congestive heart failure. The patient's condition is worsened by the fact that he has already been hospitalized a number of times with congestive heart failure symptoms. While Mr. P has obtained different kinds of treatment, he is still struggling to consistently and sufficiently respond to instructions from physicians. As a result, Mr. P needs an effective treatment plan and approach to care that will help improve his condition, which is rapidly deteriorating and affecting his wife who is overwhelmed with huge medical bills.
In light of Mr. P's condition and circumstance, the most suitable approach to care will be an individualized care approach given that the patient has constantly struggled with following doctors' advice consistently and sufficiently. The individualized care approach will be based on correct…… [Read More]
Its use on those with acute PAH should be performed with caution. The complication rate was observed at 2%
in patients with acute PAH. The use of the procedure was deemed relatively safe for chronic pulmonary arterial hypertension. Severely ill patients should be subjected to non-invasive imaging method exhaustively before resorting to pulmonary angiography (Hofman et al.).#
Albert, Nancy M. Caring for Patients with Pulmonary Hypertension. Nursing:
Springhouse Corporation, May 1999. Retrieved on April 25, 2009 from http://findarticles.com/p/articles/mi_qa3689/is_199905/ai_n8846566/?tag=content;col1
adesch, David, et al. Medical Therapy for Pulmonary Arterial Hypertension.
131 (6). Chest: American College of Chest Physicians, July 20, 2007. Retrieved on April 25, 2009 from http://www.medscape.com/viewarticle/560041
Flattery, Maureen P. And Kathy M. aker. Evidence for Racial Disparity in Cardiac
Transplantation Survival Rates. Journal of Cultural Diversity: Tucker Publications,
March 22, 2004. Retrieved on April 26, 2009 from http://findarticles.com/p/articles/mi_m)MJU/is_1_11/ai_n6183827/?tag=content;col1
Hofman, Lawrence V., et al. Safety and Hemodynamic Effects of Pulmonary…… [Read More]
Heart Problems Linked to Those Born with HIV
HIV treatment now improves the longevity of infected persons, and researchers have since shifted their focus to the health-related complications that such persons could face later in life. Cardiovascular disease has been found to be one, and perhaps the most significant, of these complications. esearch has, in fact, established that "children born with HIV are more likely to have heart problems later in life, even if they are treated early with antiretroviral drugs" (McNeil Jr., 2014). Whereas almost no child in America is now born with HIV, owing to the availability of preventive drugs, more than 250, 000 children born every year in the developing world are not as lucky, and have to take antiretroviral drugs their entire lives. This text establishes how the "combination of the effects of HIV itself and the antiretroviral drugs used to treat it" increases the likelihood…… [Read More]
The basic work of the heart is to pump blood to the entire body. It performs two types of functions, electrical and mechanical. The electrical function of the heart is the periodic contraction that is triggered by the pacemaker. The pacemaker generates the pumping effect throughout the heart. This pumping action commonly known as action potential is carried in an electrical conduction system. The mechanical function is the fluidic movement of blood; the heart is a pump. The heart's anatomical features include; ventricle, which is the pump, heart valves; that allow blood to flow one way and the atria, which includes the four chambers of the heart. The heart is susceptible to disease and as a result if unable to pump blood can lead to failure in other body organs.
Treated Heart Conditions
Cardiology is generally a field of medicine focusing on diagnosis and treatment of the heart. Discussed…… [Read More]
Heart disease is something that is negatively impacting 735 thousand Americans annually. Most patients manifest heart failure based upon inactivity and poor diet. This makes it difficult for the body to adequately pump blood to the rest of the body. Older adults will develop the condition based upon an increase in weight and they will have excessive fluid in their legs and arms. Someone who is suffering from heart failure will have blood pressure of 160 / 100 and above. Their arterial pressure will be 179 / 109 and central venous pressure is 180 / 110. This places tremendous amounts of strain on their valves. Once this occurs, is when the damage can become severe and negatively impact the underlying health of the patient causing cardiac arrest. (Silverstein, 2006) To fully understand what is occurring requires focusing on the extent of these injuries, the deformities and impact it…… [Read More]
Failure teaches more than success ever can. My greatest failure reveals the human tendency towards hubris. Luckily the incident happened early enough in my career that my ego was not bruised too badly and I bounced back better than ever. I believed so strongly in the supreme power of my superior technical skills that I was completely unprepared for the major blow that failure would bring. After all, a track record of successfully completed projects had me coasting right along. Moreover, my clients offered no end of positive feedback -- as did my supervisors and my colleagues. I was on top of the world creating and implementing unique networking solutions and services that were used by millions of users.
Why should I, a technical genius, pay attention to boring stuff like returns on investment? That gobbledygook was for finance majors. Capital productivity, customer service, capacity utilization, and process analysis? I…… [Read More]
(NHS Institute for Innovation and Improvement, 2008)
The Angiotensin-converting enzyme inhibitors are stated to be "recommended as first-line treatment in all people with left ventricular systolic dysfunction (LVSD) "with or without symptoms of heart failure." (NHS Institute for Innovation and Improvement, 2008) Additionally it is stated that strong evidence exists that ACE inhibitors "...increase life expectancy in people with LVSD and reduce the risk of hospitalization -- the effect is greatest in those with more severe LVSD or more severe symptoms, but benefit occurs for all degrees of severity." (NHS Institute for Innovation and Improvement, 2008)
Prescribed for individuals who are intolerant of ACE inhibitors due to cough are
Angiotensin-II receptor antagonists which provide an alternative to angiotensin converting enzyme (ACE) inhibitors." (NHS Institute for Innovation and Improvement, 2008) There is stated to be evidence that AIIRAs supports life expectancy improvement and symptoms for those with heart failure due to…… [Read More]
Congestive Cadiac Failue
M Wad is a 71-yea-old male who epots feeling a non-adiating, "heavy" discomfot in the lowe etostenal and epigastic egion paticulaly when he bends ove o walks shot distances. He also epots a futhe 7 days of dyspnoea duing modeate exetion. On examination his blood pessue was 165/95 mm HG, pulse 90 -100 bpm, espiatoy ate of 24 with inspiatoy cackles at both lung bases.
The following blood tests whee odeed: a full blood count (FBC), Uea Electolytes and Ceatinine (UEC), Live Function Tests (LFT), CK and Toponin. All esults wee within nomal limits.
An Ateial Blood Gas was also collected esulting in: pH [HIDDEN], pCO2 38.7mmHg, PO2 69.8mmHg, HCO3 24.0mmol/L, BE -0.7mmol/L and O2 SAT 89.3%
M Wad also has an ECG that showed nomal sinus hythm, and a chest x-ay showing cadiac enlagement and lowe-lobe infiltates, suggesting the pesence of acute exacebation of congestive cadiac…… [Read More]
Acute renal failure is a serious medical condition. The gravity of the condition is manifested itself in the fact that the survival rate for renal failure has not improved for more than forty years. It occurs in 5% of all hospitalized patients and dialysis treatment is required in approximately .5 of cases. Dialysis is required to sustain "fluid and electrolyte balances, minimize nitrogenous waste production and sustain nutrition Infection accounts for 75% of deaths in patients with acute renal failure, and cardiorespiratory complications are the second most common cause of death" (Agrawal & Swartz 2000). Pathophysiology can vary depending upon the type: "patients who develop AKI can be oliguric or nonoliguric, have a rapid or slow rise in creatinine levels, and may have qualitative differences in urine solute concentrations and cellular content.... Oliguria is defined as a daily urine volume of less than 400 mL/d and has a worse prognosis,…… [Read More]
Congestive Cardiac Failure: Nursing Perspective
Congestive heart failure is a congenital condition that affects millions of American's every year. Heart failure often manifests in a chronic condition for victims of the disease.
There are several nursing interventions important for control and maintenance of the condition. Congestive heart failure can result in serious complications including edema, respiratory disorders and can lead to premature death. Treating congestive heart failure appropriately is critical to a patient's outcome. Perhaps even more critical to a patient's outcome is patient education targeted at prevention and healthy living. Nursing management of the condition depends upon appropriate medical evaluation, medication administration, monitoring and patient education. These ideas are explored in greater detail below.
Congestive heart failure is often congenital in nature. Congestive heart failure usually manifests when the cardiac muscle is old and tired and stops circulating properly. This may result from damage to the heart; alternatively myocarditis…… [Read More]
patient most likely manifest hypervolemia?
A patient would most likely develop hypervolemia through eating sodium-based foods, from blood transfusions, medications and diagnostic contrast dyes. (Silverstein, 2006)
What blood pressure, central venous pressure, and arterial pressure would be indicative of hypervolemia?
Any individual who is suffering from hypervolemia would have higher levels of blood (160 / 100), central venous (179 / 109) and arterial pressure (180 / 110). (Silverstein, 2006)
How would a nurse recognize that a hypovolemic patient had received adequate volume replacement?
The way a nurse would recognize a hypovolemic condition is to look for swelling in the legs and arms. At the same time, there will be an increase in the patient's weight. When there is adequate replacement, these levels will come down dramatically. (Silverstein, 2006)
How do neurohormonal mechanisms contribute to the development of heart failure?
Neurohumoral adaptations are impacting the systemic pressure through vasoconstriction. This leads…… [Read More]
Likewise, younger adults tend to consume alcohol in patterns more conducive to the development of heart disease than older adults.
Unfortunately, all indications are that these differences between heart disease rates is only likely to increase in the next generation, owing to the current obesity epidemic among American children. Ultimately, many of these risk factors are under our control, but it appears that various elements of American social culture currently militate against making more responsible choices on the part of many contemporary young adults.
American Heart Association (2007) Risk Factors and Coronary Heart Disease. Retrieved November 20, 2007 from the AHA Homepage, at http://www.americanheart.org/presenter.jhtml?identifier=4726
Edelson, E. (2007) Heart Death Rates orsening for Middle-Aged Adults;
U.S. News & orld Report; Nov. 19 / 07.
Retrieved November 20, 2007 from USNews.com website, at http://health.usnews.com/usnews/health/healthday/071119/heart-death-rates-worsening-for-middle-aged-adults.htm
Gibbs, N, (2007) One Day in America; Time Magazine
Nov. 26 / 07 (Vol. 170 No.…… [Read More]
hearts spend in diastole?
Heart failure is a common concept in the contemporary society and in spite of the fact that the masses are virtually bombarded with information regarding this condition, it appears that many are still unable to take on the attitudes needed in order for them to avoid having heart problems. Until recent years, the majority of people familiarized with heart problems were only acquainted with ideas regarding systolic dysfunctions. This was owed to heart muscles weakening and no longer being able to pump blood efficiently.
In the present, the world of medicine was able to discover much more information about diastolic dysfunctions and about how they affect the body and the heart in particular. In contrast to how many thought, heart failure does not necessarily have to be caused by weakened heart muscles. Instead, it can be caused by stronger heart muscles that are unable…… [Read More]
The client is at risk of heart failure and aside from his physical health issues he carries a great deal of external burdens that contribute to his overall mental and emotional stress. He needs to find some activity that can relieve him of these pressures and volunteering at a local religious organization or charity may provide an outlet as well as a suitable means of making some connection to the community, which could alleviate the internalizing of his pressures as well as provide some spiritual benefit, which researchers have identified as having potential positive effects (Kyziridis, 2005).
An effective nursing intervention customized for the client would be to devise a goal for the client and with the client that would include exercise, stress relief, and community interaction. His triglycerides are high and his cholesterol is borderline high. A diet should be devised so as help with the heart…… [Read More]
Chronic Illness: Coronary Heart Disease
Outline of Coronary Heart Disease
The Coronary Heart Disease (CHD) has been on the increase of late across the globe and this disease, alongside stroke have been the top causes of death in many countries like Australia (Baker Heart and Diabetes Institute, 2017). There have been cases of people succumbing to complications occasioned by the CHD hence the need for any medic or clinician to fully furnish themselves with the CHD and the causes and effects as well as how it can be managed.
CHD is a disuse characterized by the development of a waxy substance called plaque building up in the inner walls of the coronary arteries. These are the arteries responsible for supplying oxygen-rich blood to the heart muscles. The buildup of plaque on the inner walls of the arteries results into atherosclerosis and this takes many years to pile up to harmful…… [Read More]
heumatic heart disease is caused by heumatic Fever or group a streptococci. It consists of "cardiac inflammation" accompanied by scarring which itself is a reaction to the autoimmune system fighting the group A streptococci. The myocardium, endocardium, and epicardium are each affected in turn. In the chronic stage, heumatic heart disease results in valvular fibrosis (Burk, 2013).
The pathophysiology of heumatic heart disease is as follows: The causative agent is group A streptococci. It develops into strep throat, which if untreated can turn into heumatic fever. At this point, the individual suffers inflammation of the layers of the heart as well as the mitral valve. Vegetation also begins to develop. This will lead to valvula regurgitation plus stenosis. The result of all of this is heart failure (Burke, 2010).
heumatic fever typically occurs in individuals between the ages of 5 and 25, so it is neither a newborn's disease nor…… [Read More]
Morbidity and Mortality Statistics:
Hypertension affects around 1 in 3 Americans and according to the CDC only 52% of people have this condition under control (CDC.gov, 2016). In older men, two-thirds have hypertension, and one-third of white men have hypertension. There are nearly 1000 deaths from hypertension daily in the United States, around 360,000 per year. Hypertension is related to first heart attacks, strokes and chronic heart failure.
The patient also suffers from orthostatic hypotension, which is when blood pressure drops when going from a lying or sitting position to standing. The largest risk for elderly people is the increased risk of falling that this brings. The patient may have fallen because of this condition. It is caused by, or linked to, high blood pressure and prolonged bed rest, as well as other conditions not faced by this patient. Anemia or vitamin B12 deficiency is another potential contributor…… [Read More]
emote Monitoring Systems for Seniors
Content Summary: This article examined the efficacy of remote monitoring systems on a couple of extremely salient factors for older patients who had experienced severe trauma related to heart disease: heart failure. The authors hypothesized that the utilization of these monitoring systems would enhance the treatment of such patients. They were able to produce quantifiable evidence that actually demonstrated the accuracy of their hypothesis in specific categories that included self-care, quality of life, and activation. Activation is defined as "self-care knowledge, skills, and self-efficacy" in administering treatment and dealing with the repercussions of heart failure. The crux of the study was based on data produced by two different populations from the study's sample: one was able to utilize remote monitoring systems while the control was not. For three months of the authors of this work were able to collect data about the heart rate, blood…… [Read More]
Enlarged Cardiac Muscle
In most instances, an enlargement of cardiac muscles produces detrimental effects in the person in which such an occurrence takes place. Depending on how large the muscles and the heart actually gets, the noxious nature of those effects increase. For instance, it is possible to still have the heart function normally and pump blood with a degree of efficacy with minimal or even nominal enlargement of the heart muscles. However, when that enlargement becomes too strong, there are a host of detrimental conditions that take place.
There are many different undesirable results that an enlarged heart can produce. For instance, it can lead to strokes, heart attacks, and various forms of heart failure. Still, there is not a direct correlation between enlarged hearts and these maladies for the simple fact that in most instances, enlarged hearts are produced by some other undesirable conditions such as high blood…… [Read More]
According to Waryasz & McDermott (2009), the global prevalence of diabetes among people aged between 20 and 79 rose to 6.4% affecting 285 million people in 2010 and the rate will rise to 7.7% affecting 439 million people by 2030. Amid 2010 and 2030, the rate of individuals with diabetes will increase by 69% in developing nations, and a twenty percent rate in developed nations. In 2011, the number rose to 366 and it is expected to rise to 552 by 2030. The pervasiveness of diabetes is advanced in males compared to females, yet the number of women with diabetes is more compared to that of men.
Diabetes affects any part of the human body and people with diabetes are likely to die of heart-related problems or stroke. Seventy-percent of individuals with diabetes show signs of high blood pressure which a risk factor for heart-related diseases. The majority of…… [Read More]
Failure to Promise: An Uncommon Path to Professoriate is Dr. C. Moorer's self-help book that aims to motivate the reader and help to establish a series of self-analytical tools that will help the reader achieve his or her goals. As an individual pursuing a degree in aeronautical science, it is difficult to fully relate to Dr. Moorer's journey to become an engineer and professor because of the background that he describes in his book. However, it is interesting to see how Dr. Moorer, through his own experiences, has come to understand strategic concepts that are frequently taught in managerial programs and how many of his concepts can be traced back to theories that have been studied for centuries.
As someone that has worked hard and has been forced to overcome struggles, personally and academically, I find it difficult to take much of Dr. Moorer's struggles to heart because it appears…… [Read More]
Eventually, he switched from pre-med to economics, much to the displeasure of his father. When he could play tennis at a competitive level, his parents allowed him a certain degree of liberty given that he excelled in something they knew they could not understand. When he stopped playing, the pressures to get a good job and to marry a nice Indian girl increased. It was like a double bondage. Why should he have to suffer for the careless actions of those men in the truck?
Worse, he could never move himself to either be wholly bad or wholly good -- he didn't have Western girlfriends in college like his friends, he felt too guilty, as if he was betraying his parents. But he couldn't obey his parents either. When his parents tried to pressure him to marry a young woman, the daughter of a family friend, he would not even…… [Read More]
eart Failure in African-Americans
Cardiovascular diseases (CVD) are among the top killers in the world population and number one in the U.S. eart failure is the number one killer in the U.S. And stroke, number three. The African-American Population has even higher numbers that fall victims to these killers. The main factors that lead to heart failure and stroke are: "high blood pressure, high cholesterol, cigarette smoking, diabetes, poor diet and physical inactivity," with their natural consequences: "overweight and obesity" (http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=21).
Although heart diseases are the number one cause of death in the U.S. today, they are also among the most preventable diseases. An unprecedented opportunity to prevent heart disease and stroke exists today in the United States. "We know what causes these conditions and how to prevent them, largely because of the decades of research supported by NI, the American eart Association, and others" (http://www.cdc.gov/dhdsp/action_plan/pdfs/action_plan_full.pdf ). The African-American Population…… [Read More]
elationship between cardiac arrest and coronary cardiac disease
The heart is an essential organ in the human body, it keeps the individual alive. Understanding how the heart operates and functions is essential to help protect your heart from heart disease. Cardiac arrest and coronary heart disease are significant heart related illness that has a high mortality rate. It is important for individuals with pre-existing heart disease to understand the symptoms of cardiac arrest and coronary heart disease, since these are both leading causes of fatality in the United States. Understanding how the heart works, the individuals risk for heart disease, and how to prevent or delay heart disease is essential. In this paper I will address the relationship between cardiac arrest and coronary heart disease. I will also explain how the heart functions and discuss some ways of preventing cardiac arrest and coronary heart disease.
Cardiac…… [Read More]
Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
eflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction…… [Read More]
Winning the Hearts and Minds in Afghanistan
It has been a common belief among military strategists ever since the time of Clausewitz in the early 19th century that gaining the support of the people is necessary for the success of any military endeavor. (Clausewitz 1873) Modern strategists call this idea "winning the hearts and minds of the people," and generally perform this mission by providing aid to the local people in an effort to win approval for the presence of military troops to conduct counterinsurgency (COIN) operations. However, the recent military conflict in Afghanistan has called into question the validity of this assumption.
One common assertion among military strategists is that there three elements in conflicts: the people, the military, and the government. In order to gain the support for the military to conduct operations the government must gain the support of the people. Without winning the hearts and minds…… [Read More]
In the opinion of Strong, DeVault and Cohen (2010), when it comes to issues marriage, opposites do not often attract. Instead, partners tend to seek each other out on the basis of shared characteristics. It is these shared characteristics that allow couples to foster greater understanding as well as empathy while facilitating or enhancing communication. Hence in that regard, a disconnect of sorts between the personality of couples may be taken to be an indicator of marital failure. Further, still on personality factors, Strong, DeVault and Cohen (2010) note that a clear example of a disconnect between the personality of marriage partners may be evident where one partner has a highly rigid personality. Such a personality may in addition to frustrating conflict resolution also end up clouding negotiations. Similarly, a partner who has a dominating personality may not be willing to cede some level of control so as to give…… [Read More]
As it flows from his heart, the father is free. This image is one that runs counter to the typical image of money bringing all sort of happiness and solving all sorts of problems.
The poem moves full circle by the end with the poet recognizing that the country has become something of a prison for him as well. He admits he is "asleep in America too" (24) and unaware of how to wake himself. This admission at the poem's conclusion demonstrates the shaping of the poet's mind as well as the shaping of generations before and after him. hile the poet feels there is a world of different between him and the student with the tongue stud, he realizes they are both within the same stream of time, doing the same things. This stream becomes the "river of bright merchandise" (31) that is nothing but a source of pleasure…… [Read More]
Main Functions of the Kidneys
The kidneys are bean-shaped organs, 12 centimeters long, which lie at the sides of the spinal column behind the abdominal cavity (Merck 2010). Their main function is to maintain the proper balance of water and minerals in the body. Their other major functions include filtration and elimination of wastes and toxins, regulation of blood pressure and secretion of some hormones. The amount of water taken into the body must match the amount being eliminated. If the balance is not maintained, water will accumulate fast and illness or death may occur. Excess water will dilute the body's electrolyte and inadequate amount will concentrate electrolytes. The kidneys regulate and help maintain the precise concentrations (Merck).
The kidneys' second major function consists of filtration and excretion (Merck 2010). They pass out urea, a main waste product from protein metabolism. Urea moves through the glomerulus and into…… [Read More]
orries of the Heart
How does the concept of gender change the way we think about colonialism in Kenya and Africa? Give specific examples.
Is colonialism 'bad' or 'good?' Conventional wisdom in the 19th century suggested that colonialism was beneficial to the residents of Africa and East Asia, because it was 'civilizing' and was even necessary, to 'carry the white man's burden' of enlightening non-Christians. Then, in the wake of the decolonization process of the 20th century, colonialism was portrayed as an unmitigated evil by nationalists. In her book orries of the Heart: idows, Family, and Community in Kenya, the African-born writer Kenda Mutongi attempts to question such dichotomies. Mutongi notes that when she was growing up, many of the women she met expressed a kind of nostalgia for the colonial era. The authors' mother, for example, remembers the carefully managed, sanitized hospitals of the British, which she said fell…… [Read More]
At the same time, however, citizens use this belief to attempt to get as much as they can from the "system," exhibiting the same qualities that lead them to distrust the government.
There is also a deeper element to the problem, however, in what can most succinctly be described as the bastardization of the system of government and society envisioned by the revolutionaries like Madison, Washington, Jefferson, and Hamilton (Bellah, 250-6). The notion of democracy has come to be equated with individual freedom and truly rampant individualism, where the ability for each individual in society to protect their own interests is seen as the paramount effect of democracy. The framers of the Constitution and of American government and society as a whole, however, established a republic wherein the individual good was tied to the common good, and this was supposed to remain an explicit and conscious part of society (Bellah,…… [Read More]
A sense of futility and deep despondency are the primary drivers of the patient's approach to his self-care. These emotions are mirrored by his wife, and further complicated by the exhausting circumstances of being a primary caregiver to a depressed and declining patient. It is doubtful that either the patient or his wife are getting enough sleep, eating well -- within the dietary restrictions -- or following a healthy regimen of moderate exercise. The pattern of behaviors described and observed indicate that both the patient and his wife are overwhelmed by difficulties of managing the disease and the centrality of the disease in their life.
To address head-on the emotional fatigue and hopelessness that the couple face, it is imperative to provide examples of other patients and their spouses who have or are successfully dealing with the same disease at a comparable level of severity. Examples must show…… [Read More]
6. Identify the collaborative team members pertinent to the care of the geriatric patient in the scenario, including the emergency room nurse's response to changes in the level of consciousness and increasing respiratory distress.
The collaborative team here would consist of a primary care physician / geriatrician, pain management specialist, laboratory specialists, and x-ray team. Additional consultants may be neurologist, neurosurgeon, gastroenterologist, psychologist, and drug and alcohol detoxification specialist.
In the case of increasing respiratory distress, the nurse is advised to continue or modify the interventions: to continue to teach patient how to breath and cough correctly; to summon a productive cough; to attempt to clear lungs to auscultation; and to achieve symmetric chest excursion of at least 4 cm; also that her respirations and pulse beats should be regular, and that she should inhale a normal volume of air. This is done by encouraging Fowler or semi-Fowler's position; monitoring…… [Read More]