Nursing case study for heart failure
Coronary heart disease case study
Lower-extremity edema is a classic indicator of fluid overload in patients with HF. Received Apr 14; Accepted Apr In the ICU, bilevel positive airway pressure treatment continued and the patient was given an IV bumetanide infusion for aggressive diuresis. She had suffered from dyspepsia, increasing over recent weeks, and the general practitioner had noted a new murmur. Higher education levels of family members are also related to decreased levels of satisfaction with care. Guideline-directed medical therapy, management of comorbid conditions and precipitating risk factors, and health promotion and self-care education should be incorporated in the plan of care, starting with admission and reinforced along the continuum of care. Nurses must be able to recognize data that indicate fluid overload and be able to assess conditions that could potentially cause such findings. Previous Section Next Section Discussion Important aspects of HF management are recognition of risk factors and early signs and symptoms, correlation of assessment findings with laboratory data, and differentiation of HF from other conditions with similar symptoms. Acute stabilization and chronic management of systolic failure Case history A year-old female patient was admitted from home with progressive increase in breathlessness, orthopnoea and ankle oedema over the previous 3 weeks. Next Section Abstract Heart failure, a complex clinical syndrome affecting millions of Americans, is associated with high morbidity and mortality and a significant financial burden on the health care system. The purpose of this in-depth analysis is to discuss the role of bedside nurses and advanced practice nurses in managing heart failure, describe the challenges of identifying secondary heart failure in patients with complex conditions, and suggest methods of improving health-related outcomes to prevent hospital readmissions. The apex beat was in the anterior axillary line and a parasternal lift was prominent. Patients can quickly progress to acutely decompensated heart failure if early signs and symptoms of heart failure are not identified in a timely manner.
Such risk factors include hypertension, coronary artery disease, diabetes, arrhythmias, congenital heart defects, previous history of myocardial infarction, and cardiomyopathy. Although many modalities exist for managing HF, nurses should develop realistic goals, including advanced-care planning, with patients and families.
Lower-extremity edema is a classic indicator of fluid overload in patients with HF. Additionally, when patients with complex conditions are transferred among multiple hospital units, nurses should be familiar with the course of hospitalization to avoid missing critical data and prevent fragmentation of care.
It most commonly manifests as vascular congestion in the pulmonary and systemic circulation and produces symptoms of circulatory insufficiency. Our patient had multiple cardiac risk factors for HF, including hypertension, moderate aortic stenosis, coronary artery disease, and a history of coronary artery bypass grafting.
The hydralazine lowered his SBP to around mm Hg for only a brief time after administration.
Financial Disclosures None reported. These trends may be due to increased awareness of heart disease, improvements in diagnosis, increased incidence of HF, a growing population of elderly individuals, or a combination of these and other factors.
Previous Section Next Section Implications for Practice Various conditions, such as systemic infection, hypertension, and arrhythmias, can cause hemodynamic stress in patients with compromised myocardial function that may rapidly progress to ADHF.
based on 61 review