The aim of this scenario-based assignment is to discuss the therapeutic intervention in the care of a patient with Congestive Cardiac Failure (CCF). A brief summary of the patient’s medical history will be given while discussing one specific nursing problem in terms of heart rate/ rhythm. Also, an overview of aetiology will be given as well as pathophysiology in order to explain the rationale for treatment and monitoring. Relevant research relating to the literature will be utilised throughout in order to critically analyse the care provided for the patient and determine if the patient received evidence based up-to-date care. In accordance with the statement from the Nursing and Midwifery Council (2008) code of conduct regarding patient confidentiality, no personal details of the patient involved will be disclosed. Therefore, the patient will be identified as Mrs S. Mrs S. is an 88 years old female patient who lives on her own, and was admitted into a rehabilitation ward following a hip operation due to a fall at home. She has a past medical history of Congestive Cardiac Failure (CCF), diverticulitis, and asthma. Also, Mrs S presented with rapid weight loss, palpitation, feeling tired, peripheral oedema, fatigue, difficulty breathing when lying flat in the bed, waking up at night with shortness of breath and anxiety. In addition to all that she had a pressure sore in her bottom that was not broken. In order to have good holistic care of Mrs S, the nursing process was used as identified by Sibson. Sibson (2010) identifies four key steps to the nursing process, which are assessment, planning, implementation and evaluation; which are important for ensuring a quality standard of nursing care. Malik et al (2004) referred to reflecti... ... middle of paper ... ...lt&resnum=2&ved=0CC0Q6AEwAQ#v=onepage&q=pathophysiology%20of%20ccf&f=false [Accessed 15 March 2011] Crumbie, A. (2007) Caring for the patient with a cardiovascular disorder In: Wash, M. & Crumbie, A. Watson’s Clinical Nursing and Related Sciences. 7th Ed. Bailliere Tindall Elsevier. London pg 244 – 324. Malik, M., Hall, C. & Howard, D. (2004) Nursing Knowledge and Practice: a foundation for decision making. 2nd edn. Edinburgh: Bailliere Tindall. Nursing & Midwifery Council (2008) Code of professional conduct: Standards for conduct, performance and ethics. London: NMC Sibson, L. (2010) Assessing needs and the nursing process. In: Paete, I (2nd eds.) Nursing care and the activities of living. London: Wiley-Blackwell. Pp.38-58. Trounce, J. (2000) Clinical pharmacology for nurses: the role of the nurse in drug administration. 16th Ed. London: Churchill Livingstone.
The SSSC codes of conduct contains 10 codes 5 are for employees and other 5 are for employers where as in the NMC there is 4 codes which are, prioritise people, practise effectively, preserve safety and promote professionalism. Both codes are very similar even when dealing with different patient groups both codes state in 1.1 to prioritise people and treat each person as an equal individual. These both codes of conduct should be followed correctly at all times by anyone working in the health and social care. The NMCs aim is there to protect the public and decides if a nurse or midwife is fit to practice up to their high standards. The NMC was published on the 29th January 2015 but didn’t come effective to 31st March 2015.
The systematic review indicated (1) ‘Case management interventions were associated with reduction in all-cause mortality at 12 months follow up, but not at six months’. (Takenda, et al, 2012) The systematic review also went on to state that while case management interventions were not associated with reduced mortality, case management interventions were indicated to reduce the occurrence of patients presenting to hospital with exasperations of chronic heart failure. The benefits of case management based interventions were apparent after 12 months had lapsed. Six of the twenty five studies assessed (2) heart failure clinics, and the evidence for this intervention was less convincing with the review stating ‘there was no real difference in all-cause mortality, readmissions for HF or between patients who attended a clinic and those who received usual care’. (Takenda, et al., 2012)
Scottish Intercollegiate Guideline Network (SIGN) 95 (2007): Management of Chronic Heart Failure (Online). Available at: http://www.sign.ac.uk/pdf/sign95.pdf (Accessed 8th June 2010)
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart failure, and they are Coronary artery disease, Heart attack, Cardiomyopathy, and conditions that overwork the heart.
...Council, M., & Federation, A. N. (2008). Codes of Professional Conduct & Ethics for Nurses & Midwives, 2008: Australian Nursing and Midwifery Council.
NMC, 2010. The code: Standards of conduct, performance and ethics for nurses and midwives. [online] Available at: [Accessed 13 November 2013]
Watson, J. (1985). Nursing: Human Science and Human. Norwalk; CT: Appleton – Century – Crofts.
(9) United Kingdom Central Council for Nursing, Midwifery, and Health Visiting. (UKCC) (1992). Primary Health Care, Code of professional conduct for the nurse, midwife and health visitor. London: UKCC.8 (2)
Nursing and midwifery council (2008) The Code: standard of conduct, performance and ethics for nurses and midwives. London: Nursing and Midwifery council
The Codes of Practice is issues to all registered nurses, midwives and health visitors. The Council i...
Thorne, S. (2010). Theoretical Foundation of Nursing Practice. In P.A, Potter, A.G. Perry, J.C, Ross-Kerr, & M.J. Wood (Eds.). Canadian fundamentals of nursing (Revised 4th ed.). (pp.63-73). Toronto, ON: Elsevier.
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of
NSNA (2003). Code of ethics for nursing students Part I: Code of professional conduct. Retrieved June26, 2011, from: http//www.nsnsa.orgpdf/pubs_CodeofProfessionalConduct.pdf
In the practice of nursing, needs are an everyday phenomenon and are a common theme among many nursing theories accessible today. These nursing theories help implement care planning of the patient needs for the best possible outcome. Some examples of need theories include Virginia Henderson’s Nursing Needs Theory and Abraham Maslow’s Hierarchy of Needs (McEwen & Wills, 2011).