Heart Failure: A Case Study

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1. What are the compensatory mechanisms that occur when a patient has heart failure?
Sympathetic nervous stimulation: This compensatory mechanism is the first one. Epinephrine (adrenaline) and norepinephrine (noradrenaline) are released which causes an increase in BP and the heart to pump faster and more powerfully. They also increase cardiac output in this way it temporally helps compensate for the hearts reduced ability to pump blood. This is not good long term as it increased the amount of oxygen the myocardium needs.
Renin angiotensin system activation: Because of decreased blood flow to the kidneys the compensatory mechanisms activate to hold on to sodium and water. When the Blood flow is decreased Angiotensin II is released causing vasoconstriction …show more content…

This also caused an increase in demand of oxygen to the cardiac muscle so it’s not a good thing (Ignatavicius &Workman, 2013, p. 747).

2. What are 3 things that can worsen heart failure and why?
High sodium diet: Too much sodium causes fluid retention which increases the workload of the heart. The reason sodium causes water retention is because water moves from low concentrations to high concentrations. Water follows salt so when too much salt is consumed it draws the water from the blood into the tissue.
Not taking the prescribed medication: Medications are prescribed to decrease the workload of the heart, prevent fluid retention and decrease the amount of harmful hormones that are released. When the patient fails to comply with prescribed medications all these things are not managed.
Not staying active: Because it has been proven that activity can help with weight loss, lower blood pressure, reduce LDL cholesterol and increase HDL cholesterol, all of these can decrease the workload of the …show more content…

It occurs because of repetitive electrical activity. This can occur in a patient with early or late heart failure, because there is damage to the heart tissue and the heart beats faster to try to supply the body with blood. Recommended treatment is elective cardioversion. Drugs used include an antidysrhythmic such as Mexitil or Sotalol (Ignatavicius &Workman, p. 728-729).

4. What are the primary assessments for a patient in heart failure?
A cardiac assessment: Listen to heart sounds listening for extra heart sounds, fast heartbeat, and monitor EKG looking for dysthymias. Assess vitals especially BP, BP should be kept low in heart failure patients to put less stress on the heart. Assess the patient for edema as a result of fluid retention. Listen for crackles in the lungs due to fluid built up. Watch I&O’s and weight the patient to assess for edema, ask about activity intolerance. Assess for changes in mental status, cool extremities, pale or cyanotic, fatigue, and JVD (Indications of poor perfusion) (Ignatavicius &Workman, p.756).

5. What is the primary nursing diagnosis for this

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