Elderly Heart Failure Case Study

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Heart Failure affects nearly 5.8 million people in the United States. The American Heart Association reports that the total economic cost of heart disease and stroke in 2011 was $320.1 billion. ("Efforts to Prevent Heart," 2015). More Medicare dollars are spent for the diagnosis and treatment of heart failure than for any other diagnosis (Schneider, O'Donnell, & Dean, 2011). Hospital admissions for heart failure are very common, especially among Medicare aged patients, and heart failure hospital readmissions are a major contributor to rising healthcare costs. Evidence suggests that factors influencing readmission rates for heart failure patients include knowledge deficits in nursing education, standardized patient education, and transitional

When nursing any patient with heart failure it is important to have an understanding of how the heart should work to understand how it stops working correctly. This knowledge is important as writtler (2006) (cited in Jones) feels that district nurses have little knowledge when it comes to heart failure. Patient, Writler (2006) feels that by understanding how the heart works and how it is damaged we, as district nurses will be able to recognise the signs of heart failure earlier7a?.

The heart is an organ that pumps oxygenated blood to the body and deoxygenated blood to the lungs. Heart failure is when the heart can’t pump blood very well. If the heart fails to work properly, a major system called the circulatory system won’t work properly and therefore the whole human body will fail to work properly because the cells won’t be able get oxygenated blood and use the oxygen to undergo cellular respiration and make energy.

established the clinical problem that heart failure is associated with high morbidity and poor prognosis (Hobbs, et al., 2007). She further added that it decreases patients’ quality of life as it places a heavy burden on them, as well as their families, as well as the huge negative impact on health care resources (Iqbal, et al, 2010), contributing to lost productivity from unplanned hospital admissions. The authors presented the research problem strongly, stating that there is a limited study of the role of specialized heart failure nurses in the multidisciplinary team in managing heart failure patients, thus warranting a further investigation to be conducted. Special nurses, as defined by Glogowska et al, are experienced senior nurses who are involved in providing medical, psychological and emotional support that begins at the initial diagnosis of heart failure and continues onward. They provide transitional care in assisting patients manage their heart failure. The research article focus on the experiences and perceptions of clinicians in managing heart failure patients, and it aims to understand the special role of specialized heart failure nurses in the interdisciplinary team. The authors designed to answer the following questions when conducting this study:

Patients with chronic heart failure present with decreased exercise tolerance. It is important that a well-designed exercise prescription is followed at all times and the appropriate health care provider such as the cardiologist is in agreement with your treatment plan. Query the physician if there is any specific exercise precautions or guidelines that are distinct to the patient. Furthermore, these particular patient populations may sometimes overexert themselves. Symptoms such as dyspnea, dizziness or lightheadedness,

currently work on an Interventional Cardiac floor and most of our patients are repeat patients. One of the largest readmission diagnosis is Congestive Heart Failure. In 2009, their were over 750,000 patients admitted for CHF, making it the top 5th reason for admission to the hospital (AARP, 2012, para 3). CHF is al the most common readmission to the hospital (Medscape, 2010, para. 2). This is a topic that has been evaluated many times and is currently one of our Core Measures. Our institution has a very specific protocol for this kind of admission and discharge. Even with this stringent protocol set up for doctors and nurses to adhere too it is still left with the patient to comply after discharge. in my experience, noncompliance has been a

Heart failure is best defined as the heart’s inability to pump an ample supply of blood ultimately disrupting major bodily function. When there is heart failure occurring on the left side both the preceding and following regions of the heart will be affected. The left side of the heart is responsible for pumping blood systemically via the left ventricle. When the left ventricle fails this result in in inadequate amount of blood pumped systemically; in addition, since cardiac output has decreased, the blood will back up causing numerous other problems with the pulmonary system such as pulmonary arterial hypertension (PAH). An increase in the muscles mass of the heart or compromised valves can limit the blood flow into and out of the heart and ultimately cause this heart failure. When this increase in muscles mass is specifically of the left ventricle, this is known as left ventricular hypertrophy (LVH). LHF is very prominent and the best medication to prevent this chronic heart failure is exercise. Pulmonary arterial hypertension is secondary to left-sided heart failure; therefore, PAH can help identify LHF

Diagnosed with Congestive cardiomyopathy implies that the patient’s heart muscle has been debilitated by ailment and cannot sufficiently pump blood through the heart, which can lead to heart failure (“Columbia University Medical Center”, 2016). In this case study, the current situation of a male patient Mr. P., who is 76 years old, and frequently hospitalized with CHF is given. The purpose of this paper is to describe an approach to care with treatment plan recommendation, provide education to both the patient and his family, and a teaching plan.

Congestive heart failure is a chronic disease that requires daily monitoring and life style management. Congestive heart failure usually affects the greatest number of adults who are age 65 years or older (Alspach, 2014). Congestive heart failure patients often times end up in the hospital due to their symptoms such as shortness of breath, edema, and lack of energy. These same patients are often times readmitted to the hospital and the readmissions create a hardship for the patient and their finances (Gerdes & Lorenz, 2013). Patient education and developing self-management skills are key interventions to help the patient develop confident decision making skills and improve health outcomes (Gilmour, Strong, Chan, Hanna, & Huntington, 2014).

Amy great post. Acute heart failure after an MI especially left-sided is common (Mattson Porth, 2015). It would be important as providers to know how best to treat this patient. Initially the treatment is going to revolve around making sure that the blood supply to the heart is restored (Epocrates, n.d.). Factors that the provider would want to be watching out for in the H&P are dyspnea, third heart sound (S3), fatigue and weakness, hypotension, tachycardia, jugular venous pressure, cough, and possible wheezing.

I chose my PICO question, “In patients with Congestive Heart Failure, does BNP-guided therapy result in better outcomes than Symptom -guided Therapy?” because of my interest and fascination about the heart and also because of my extensive family history of cardio-vascular issues. According to the American Heart Association and the American College of Cardiology Foundation (2013), heart failure is a “complex clinical syndrome that result from any structural or functional impairments of ventricular filling or ejection of blood” (p. e246). Heart failure is the primary diagnosis for >1 million hospitalizations annually, with > 650,000 newly diagnosed cases per year, and it costs $30 billion annually in overall care for this condition

Heart failure is a condition in which the heart does not pump enough blood and oxygen to support your body and its functions. Daily physical activity is important after heart failure. You may have some activity restrictions, so talk to your health care provider before doing any exercises.

Furthermore, among older adults, heart failure accounts for one of the leading causes of hospitalizations. The complexity of treating older adults involves co-morbidities, which significantly impacts the progression of management and mortality regarding heart failure (Caughey, Roughead, Shakib, Vitry, & Gilbert, 2011). For the elderly chronic heart failure compromises their activities of daily living. This impact on their health leads to a decrease in independent living activities and increase dependence (Norberg, Boman, Löfgren, & Brännström, 2014). Additionally, psychologically and physically the elderly may experience feelings of powerlessness and hopelessness, distressing symptoms, compromising physical functioning, social and role dysfunction

Even though tremendous progress in the studies and treatments of heart failure have been made, heart failure continues to be one of the leaders in the cause of death for many people. There are still high medical costs and still poor patient outcomes that are because of this disease. People who have heart failure, are also suffering from things like edema, shortness of breath and fatigue as well as having the quality of their social and emotional aspects of life being affected. (Stavrianopoulas, 2016). When these symptoms go untreated, then this leads to frequent hospital visits and admissions which also causes a rise in hospital costs. There is also a decrease in day to day life qualities for these patients. (Stavrianopoulas, 2016). By reducing exacerbations of these symptoms and cutting down on the number of repeat hospitalizations with follow up visits with their physicians, nursing led phone calls, early education of the disease will help to increase the quality of life in heart failure patients. (Stavrianopoulas, 2016).