APPROACH TO CARE:
People are human beings with their own values, beliefs and cultural practices. Therefore, as an individual, a patient with heart failure should be provided ethical, safe, and professional care. In this regard, the ethical principle of justice, autonomy and respect for a person, fairness, kindness and the principle of no harm should be appreciated. Regarding justice, nursing interventions ought to be planned and implemented per the demands for care for which the illness calls. The heart provides for the most basic need for life, delivering oxygen to the body to sustain life. Therefore, it is rationally acceptable to prioritize, providing the care to a patient with heart failure, to meet the most crucial need. However,
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If you have diabetes or high blood pressure, work with your health care team to control these conditions. Have your blood sugar level and blood pressure checked. Talk with your doctor about when you should have tests and how often to take measurements at home. Try to avoid respiratory infections like the flu and pneumonia. Talk with your doctor or nurse about getting flu and pneumonia vaccines.
(13) Educate the client about worsening of heart failure, lifestyle changes and medicines may no longer control your symptoms. A medical procedure or surgery may be necessary at this point.
In heart failure, the right and left sides of the heart may no longer contract at the same time. This disrupts the heart’s pumping. To correct this problem, a cardiac resynchronization therapy device may need to be placed near your heart. This device helps both sides of your heart contract at the same time, which can decrease heart failure symptoms.
(14) Some people have tachycardia, and if not controlled, sudden cardiac arrest could occur. Irregular heartbeats can cause sudden cardiac arrest. An ICD (implantable cardioverter defibrillator) could possibly have to be placed. An ICD checks your heart rate and uses electrical pulses to correct irregular heart
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This way your patient will have time to absorb the information ask questions. By starting early on with discharge planning, you will have time to see if the patient understands and have time to reinforce what they don’t. Using an interdisciplinary approach will allow her more time to interact with different members of the medical team.
Weight Monitoring – Patients are weighed every day in the hospital on the same scale. Make sure they have a scale at home and stress the importance of daily weights on the same scale. They need to weight at the same time every day, before eating and after emptying the bladder Try and wear the same clothes and report a weight gain of more than 3 pounds in one day or 5 pounds a week (or as prescribed by physician). Let he/she know that daily monitoring helps the physical know whether the diuretics are working or not.
Medications – Make sure that the patient has any changes that were made at the hospital as far as their medications. While taking a diuretic, the patient often thinks that they can adjust their own dose. Let the know that when taking diuretics, their lab values are monitored, Specific changes can cause a drastic change in the heart rate and
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
...so discuss making a exercise plan that will work for the patient, and will not cause him/her any pain. If all of the correct measures are taken, and the patient is taking care of themselves, they can prevent more serious complications from occurring. They must know that they are serious complications from one not taking care of themselves, or living a unhealthy life style. It does involve a lifelong commitment to change. Medication will help, but one must also be willing to change.
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)
These causes will change the heart significantly. The pathophysiology of heart failure is described differently as: (1) an oedematous disorder, by means of which the deviations in renal hemodynamics and excretory ability lead to salt and water holding; (2) a hemodynamic disorder, considered by peripheral vasoconstriction and decreased cardiac output; (3) a neurohormonal disorder, mainly by stimulation of the renin-angiotensin-aldosterone system and adrenergic nervous system; (4) an inflammatory syndrome, related with amplified local and circulation pro-inflammatory cytokines; (5) a myocardial disease, started with an damage to the heart trailed by pathological ventricular transformation. In heart failure, the heart sustains either a sudden or longstanding structural injury. When damage occurs, sequences of firstly compensatory but consequently maladaptive mechanisms follow (Henry & Abraham, ).
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P wave and an irregular QRS complex (Ignatavicius & Workman, 2013). Basically, it means that the atria, the upper chambers of the heart, are contracting too quickly and no clear P wave is identified because of this ‘fibrillation’ (Ignatavicius & Workman, 2013).
...y hired nurses on the heart failure floor since discharge education remains one of the responsibilities. I believe knowledge is an important factor to empower the patients about heart failure care and nurses spend nearly 24 hours a day with hospitalized patients; therefore, nurses can be patient advocates by reinforcing teaching. Most importantly, I believe that catering to the patient’s individual needs and establishing a good nurse-patient relationship enhances trust and learning which in the long run, is very beneficial to both nursing practice and the quality of life of the patient. Overall, what I discovered about heart failure is that there is no simple solution in preventing heart failure hospital readmission. Even with the recommended evidence-based practice suggestions, hospital readmission rates for HF still seem to remain high throughout the country.
-The first teaching point is to teach the patient to avoid eating canned foods. Canned foods have a lot of sodium and this can negatively affect the patient because the patient already has hypertension. As the nurse, I would explain the negative effects of canned food, contact the dietician, explain foods they can eat by telling the patient and providing them with pamphlets or articles, sit and make a diet plan with the patient. Also, I work with the family and explain to the “cook” in the family about what foods are allowed for the patient to eat and plan a diet with them and the patient. I would also allow the patient to express any concerns or questions and try to resolve them. I would also create a diet schedule for a week of what the patient to eat for breakfast, lunch, and dinner. I would also bring snacks to the patient and show them which ones they can eat and how much they can eat. For example, bring unsalted pretzels or grahams crackers and teach the patient how much they should eat and when they should eat
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.
Lesle, S. J., Hartswood, M., Meurig, C., McKee, S. P., & Slack, R. (2006). Clinical Decision Support Software for management of chronic heart failure: Development and Evaluation. Computers in Biology and Medicine vol. 36, 495-506.
Healthcare provider’s perception and judgment in the patient’s well being as well as taking into account the right of the patient in every action is one of the key elements in nursing practice. International Council of Nurses (ICN), (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3). Furthermore, nursing action guided by theory and principles of moral and legal rights complements excellent nursing care. Nurse’s awareness in moral and legal codes helps them control the complicated scenario encountered and direct the nurses in the best possible action answerable by law (Lachman, 2006).
This condition can be treated various ways depending on “the type and frequency of arrhythmias, associated symptoms…, and the presence of structural heart disease” (Cleveland Clinic, 2014). Some patients may not need treatment at all, since they show not symptoms, since sometimes this condition can be naturally eliminated over the first year of life, but may still be required to have regular schedule appointments with the physician so the patients can be monitored. If symptoms are prevalent, the different treatment methods include a pacemaker, defibrillator, surgery, and medicine.
A lot of information has been stipulated concerning how patients should be treated and the legal rights involved in the health care system. Different values are, therefore, involved. In the correctional setting, the patient entirely relies on the nursing service offered and various services are expected to be offered by a nurse. However, in the process of providing these services, a nurse has to uphold all ethics that dictate the profession (National Commission on Correctional Care, 2011). The legal ethics include right to autonomy where the patient’s view should be respected and incorporated in the provision of nursing care. A nurse should always tell the patient the truth according to how he or she is fairing on health wise. The principle of beneficence also allows a nurse to concentrate on provision of services that are beneficial to the patient. A registered nurse also ensures equitability and fairness in the provision of care to the patient (National Commission on Correctional Care, 2011). Another principle that a nurse understands is the principle of fidelity that allows a nurse to remain committed in the process of provision of care. The principles help a nurse in making ethical decisions in the process delivering nursing care to the patient. For instance, having in mind the principle autonomy, one can be able to appreciate an advance of health care directive that enables one to act as per the patient’s
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.
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.
Heart palpitations are often cause irregular heartbeats. While they can be fairly common (occurring in most people at some point in their lives) and many who experience them may not feel symptoms at all, they can be fairly troublesome to patients who do not understand them. Heart palpitations are often caused by an extra beat in the heart. There are two main types of asymptomatic palpitations: premature ventricular contractions (PVCs) and premature atrial contractions (PACs). In this paper, we will look at the difference between PVCs and PACs, how to detect them in patients who are experiencing palpitations, what can cause them, and complications they can cause.