Features of Caring for a Patient With Heart Failure

Introduction

Cardiac failure patients have been identified to possess a low level of physical endurance as well as emotions as a result of certain crucial changes within their lifestyles. This condition could be attributed to the quality of life the patient is subjected to and also the level of attention they receive on medical care. This calls for progressive programs that could be used in educating patients on principles of disease management and improvement on individual lifestyles. The condition described reduces the potential ability of patients towards personal care as a result of the weakening of the cardiac and respiratory systems; the disease is commonly found amongst the elderly of seventy years and above like Mr. Giannopoulos (Asadi-Lari, Packham & Gray, 2003, pp 1-8).

Cardiac Failure

Cardiac failure presents a condition where some dysfunction impairs the normal functioning of the heart and its ability to pump a sufficient amount of blood to the whole body system. The condition may at times be difficult to diagnose due to a lack of clearly stated and universally accepted methods of care concerning the problem. Identifying one major cause of the condition has become a challenge to doctors due to changes experienced in terms of age, problems in diagnosis methods, and differences in patient background. Chronic heart failure occurs when there is an insufficient supply of blood to the heart muscles amongst other causes like diabetes, high blood pressure, and infected heart muscles. The condition of insufficient blood supply is known as Ischaemic heart disease. The treatment of such kind of heart failure always depends on the causal effect (LeMone & Burke, 2004).

Nursing care

Nursing care on this kind of sickness focuses on social, physical, and emotional needs. The kind of care provided is usually dependent on the status of the patient, knowledge of the disease, and the available social support systems. The kind of attention given by the nurse gives the patients the necessary knowledge which helps them manage their diseases. The care to be given by nurses, in this case, includes bathing, dressing, and support in daily chores like supervising every activity the patient gets involved in. The whole care process incorporates a core circle where the patient is given emotional and social support by the nurse.

The hands-on care for Mr. G presents an environment of comfort and trust, compensating for the fact that he is always alone most of the time. This kind of care makes the patient develop a sense of security and freely shares his concerns on the management of the disease in all aspects. This includes the lifestyle changes Mr. Giannopoulos is experiencing in the process of nursing the disease. The nurse addresses some vital questions and concerns that relate to the management of the disease.

The care process is followed by curing processes where the nurse performs physical assessments. The nurse in this case should assess the extent to which the patient can perform daily activities based on his physical fitness; this may range from walking to the conversation. Other conditions are monitored like fatigue level, blood pressure, and the level of oxygen intake. The lung sound should be checked for the presence of any form of congestion. Mr. Giannopoulos should be assessed by the nurse for pulse strength, temperature level to identify circulation status. Educating Mr. Giannopoulos is an important aspect that enables him to understand the disease and improve his level of compliance to medical prescriptions. Adhering to the prescribed diet help improve weight through avoidance of fluid overload.

The problem of Mr. Giannopoulos’ inability to give suitable care due to difficulties in movements owing to weakness could be assisted through assessing his ability to dress as well as to bathe. The nurse should assist him in activities related to daily living as well as ensure that he has enough rest. These will ensure that the patient masters and acknowledges the importance of rest and also improved strength when performing personal activities. Mr. Giannopoulos also has the problem of decreased social interaction because he lives a lonely life.

The nurse should take the intervening process of identifying the cause of his anxiety and provide the necessary comfort; there is a need for an interpreter for communication. This forms a good basis for providing and encouraging open conversation between the nurse and Mr. Giannopoulos. This will help the patient in verbalizing the anxiety he might be experiencing hence reducing the level of fear. The nature of care at this juncture would make the patient feel comforted and hence communicate openly.

In the process of cure, the problem of inability to perform any activity which accompanies the problem of cardiac output should be assessed by the nurse. This involves identifying important signs, assessing the condition of the respiratory organ, and assisting the patient in observing rest amidst performing any activity. Assessment of the necessity of administering oxygen is important (Paris, 2002).

Therapy

Due to the above outcomes, the patient will be required to perform various tasks which include involvement in daily light activities. The patient should also be given food with high potassium content and ensure adequate ventilation and oxygen intake. This means that Mr. Giannopoulos should be advised on the importance of balancing tasks and resting duration. The care should include maintenance of adequate cardiac output and stability of airway channels.

The systematic capillaries seemed congested causing the right-sided backward failure; this could be the result of difficulties in movement. Due to old age, Mr.Giannopoulos should have someone close to him always who could help him improve on his way of leading disciplined life on medication. He should be placed on a good diet with less salt intake, light exercises are recommended to improve blood flow throughout the body system. There should also be a check on the amount of cholesterol in the food served. There should be an improvement in the quality of attention and care given to him because his children live far away and he has no wife.

The care given should be flexible enough to adapt the patient and caregiver over some time. The approach given should focus on linking the approved existing services with the new prescriptions. New prescriptions should be in line with the gaps created by previous care given by community and health care professionals. The administration of inotropic agents to Mr. Giannopoulos’s condition would help in improving his heart’s pumping abilities. Aldosterone antagonist decreases the level of sodium and repair cardiac muscles leading to activation of the nervous system (Schuster, 2000).

Patient’s Health

The general past health of the patient reveals a negative response towards medical therapy. The nurse involved should be able to identify various practices including the nature of sleep whether there are interruptions produced by shortness of breath. Exploring activities that the patient gets involved in daily, the emotional response the patient has towards losses including the death of a loved one, in this case, the wife. The caregiver should administer coping skills applicable in such situations that might have successfully worked in likened situations (Coelho, 2005, pp 1-3).

The physical examination of nursing care plans for Cardiac failure

The nurse should assess the arterial pulses and identify the quality of heartbeat and rhythm. There should be a check-up on the condition of the precordium, the changes in hemodynamic should be noted as well as weight loss. The nature of sleep patterns and the sleep equipment used by the patients should be identified and other laboratory tests examined (Quaglietti et al, 2000, pp. 259-274).

Medical Intervention

There is a need to reduce the workload of the heart by getting involved in light activities. This should be accompanied by the process of removing excess body water and fluid accumulation and improving the efficiency of myocardial contraction. The patient should be placed under an appropriate diet to control the workings of angiotensin-converting enzyme (ACE) inhibitor therapy. The kind of care administered should include appropriate therapy accompanied by close monitoring of the consequent results.

Assessment of patients’ response to drugs is important, this includes a response to change in weight, nature of organs, and their inclination towards proper functioning. Nurses should be able to administer counseling and education on the issues of physical exercises, the danger of taking too much fluid and sodium. The review should be done on the drugs used before and checking the condition of blood such as level of digoxin. The respiratory therapist should be contacted to administer oxygen therapy based on pulmonary congestion and result hypoxia (Jones, 2009, p 293).

Nursing Interventions and Evaluation, care plan for Cardiac Failure (Schuster, 2002).

Nursing Diagnosis Outcome Interventions Evaluation
Low Cardiac output Improving and maintaining adequate
Cardiac Output
  • The patient should be placed to rest physically and emotionally. This Reduces heart work. Should rest in a sitting position.
  • Monitor decrease in symptoms
  • Check heart sounds and Cardiac rhythm
The rate of heartbeat be normal
Difficulty in breathing This helps in improving oxygen intake
  • The head of the patient should be raised to reduce pulmonary congestion.
  • Feeding in bits, Administering deep breathing
Normal lung and respiratory functioning
High blood pressure and excess fluid Balancing body fluid
  • Administer appropriate diuretic at the right time
  • Check for a reduction in edema and weight loss
  • Check bladder distension signs and monitor diet and level of additives on food
Loss of weight to the recommended level
Activity balance related to oxygen intake improving on the level of light activities
  • control and put in to check the patient’s cardiac reserve by helping in personal care
  • check on pulse rate and disease symptoms
Normal heartbeat at the rate of 72 beats/minute

Conclusion

Nurses should be vigilant in the process of incorporating appropriate knowledge into the health care processes. The issue of cardiovascular failure seems complex, this calls for all those involved in the treatment process to be careful to avoid confusion in the implementation process. Evidence-based practices are preferred in such cases; these may range from the use of identified performance measures and process improvement systems. However, some of the initiatives should also go beyond the medical scope and include all processes which lead to improvement in care services.

References

Asadi-Lari, M., Packham, C., & Gray, D. 2003. Unmet health needs in Patients with Coronary Heart Disease: Implications and Potential for Improvement in Caring Services. Health Quality of Life Outcomes, 1(26), pp. 1-8.

Coelho, R., Ramos, S., Prata, J., Bettercourt, P., Ferreira, A., & Cerqueira-Gomes, M. 2005. Heart Failure and Health-related Quality of Life. Clinical Practice and Epidemiology in Mental Health, 1(19), pp.1-13.

Jones, B. 2009. Planning for Nursing Care. In J. Crisp & C. Taylor (Ed.), Potter and Perry’s Fundamentals of nursing (3ed.). Chatswood, NSW: Elsevier Australia.

LeMone, P., & Burke, K. 2004. Heart Failure. In P. LeMone & K. Burke (Eds.), Medical Surgical Nursing: Critical Thinking in Client Care (3rd Ed). Upper Saddle River: Prentice Hall, Inc. Paris, M. 2002. National Quality Management Program. Web.

Quaglietti, S., Atwood, E., Ackerman, L., & Froelicher, V. 2000. Management of the Patient with Congestive Heart Failure using Outpatient, Home, and Palliative Care. Progress in Cardiovascular Diseases, (43), pp. 259-274.

Schuster, P. 2000. The Key to the Therapeutic Relationship. Philadelphia: FA Davis.

Schuster, P. 2002. Concept Mapping: A critical thinking approach to Care Planning. Philadelphia: FA Davis.

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