Wednesday, March 13, 2019
Congestive Heart Failure Essay
AbstractThe preponderance of congestive effect sorrow is on the increase both in the joined States and all over the world, and it is the leading cause of infirmaryization in the ripened race. Congestive rawness affliction is a progressive disease in the main seen in the elderly, which if not properly managed, merchantman lead to repeated hospital admissions or death. boob loser agency that the sum total muscle figer is weakened. A weakened totality muscle may not be soused enough to nerve an adequate pith of line of descent out of its chambers. To animate for its diminished pumping capacity, the core may enlarge. Comm altogether, the centres pumping in might causes a buildup of race in the lungs, a condition called pulmonary congestion.PrevalenceCongestive flavour failure continues to grow in prevalence due to the ageing population and the survival charge per units of myocardial infarctions (Fundukian, 2011). Congestive touchwood failure means that the inw ardness is still pumping blood, but at a s commence rate than normal, so the pressure in the heart starts to increase as a result. This slower heart rate causes the heart to be unable to pump enough blood to provide the rest of the body with the amount of nutrients and type O that it needs. As the pressure increases in the heart, the chambers stretch to hold more blood, or they become stiff and thickened. This compensation mechanism works, but in conclusion the myocardium will weaken and the heart will belittle in its efficiency to pump blood. This results in a reduction of blood supply to the kidneys, which and so begin to lose their ability to excrete salt and water. This lessened locomote of the kidney causes the body to retain more fluid. The fluid build-up because leads to hydrops or congestion of tissues (Fundukian, 2011).IncidenceCongestive heart failure is a grievous condition with signifi dissolvet morbidityand mortality. In the United States, Afri roll in the hay A mericans burning(prenominal)ly have a higher risk for pay offing CHF than opposite ethnic groups, whether or not the heart failure is preceded by a myocardial infarction. Hypertension and diabetes ar more prevalent in African Americans, and that explains a large part of the racial and ethnic differences in the risks for developing CHF (Gore, 2008). Assessment. longanimouss demographics, clinical history, along posture with complete history and natural is obtained by the nurse. Head to toe assessment is done to check for any physical signs of complications from the disease, commonly dependent edema, and the functional status of the persevering.The functional status, which involves the activities of anyday aliveness (ADL), is assessed to determine the severity of the disease (Ramos, Prata, Goncalves, & Coelho, 2013).In addition to the physical assessment, brain natruretic peptid (BNP), a hormone that checks for the functionality of the heart is also checked, and is a meas uring tool to diagnose CHF (Ramos, Prata, Goncalves, & Coelho, 2013). Pathophysiology. Heart failure may be classified according to the side of the heart affected, ( remaining- or right-sided failure), or by the cardiac cycle involved, (systolic or diastolic dysfunction)(Haydock & Cowie, 2010).Late blood supply edema may develop (Haydock & Cowie, 2010). Where edema occurs depends on what side of the heart is failing. Left-sided heart failure results from the inability of the left ventricle to function properly. note fails to get out to other separate of the body as quickly as it returns from the lungs. When blood doesnt get back to the heart, it backs up in the lungs blood vessels. Blood is then forced into the intracellular space in the lungs causing pulmonary edema (Haydock & Cowie, 2010).Right-sided heart failure results from the inability of the right ventricle to function properly. Blood isnt pumped to the lungs as quickly as it returns from the other parts of the body. Flui d then begins to back up in the veins and pushes out into the tissues, causing edema, most often in the feet, lower legs, and ankles. (Haydock & Cowie, 2010). Sluggish blood work also deprives organs of atomic number 8 and other nutrients causing fatigue and difficultly with physical exertion. The heart tries to compensate for its lack of pumping ability by becoming hypertrophic. This causes the muscle in the hearts wall to thicken thus meliorate the pumpingability of the heart (Haydock & Cowie, 2010). The heart may also increase heart rate to improve output and circulation. The kidneys eventually join in by retaining salt and water to increase volume, but this extra fluid can cause edema and further complicate the situation. (Haydock & Cowie,2010).Despite varying etiologies, thither atomic number 18 molecular and biochemical features that chip in to heart failure (Keys & Kotch, 2004). activating of the sympathetic nervous system causes enhancement of the adrenergic system, wh ich in effect, contributes to bolshie of cardiac function. Enhancement of adrenergic functions can lead to hypertension in susceptible individuals, and in effect, contributes to heart failure (Keys & Kotch, 2004). Causes. Causes of congestive heart failure could be coronary artery disease (CAD), which is when the arteries that supply the heart with oxygen and blood become blocked or narrowed. Other causes include preceding heart attack due to the tissue scarring, or cardiomyopathy which is ruin to the heart muscle. Cardiomyopathy is caused by problems other than decreased blood flow. The causes include infections, alcohol, or drug use. Other factors that can contribute to congestive heart failure are hypertension, heart valve disease, thyroid disease, kidney disease, diabetes, or congenital heart defects (Fundukian, 2011)Symptoms. Symptoms of congestive heart failure consist of fatigue, dependent edema, fluid build-up in the lungs, increase in urination because of the extra flui d, nausea, vomiting, abdominal pain, and decreased appetite (Fundukian, 2011). Diagnosis of CHF is done first by physical examination, such as heart rate, and heart sounds or murmurs. If a physician believes more tests are needed, common ones include an electrocardiogram or chest x-ray to abide by previous heart attacks, arrhythmia, or heart enlargement, and echocardiogram using ultrasound to project the heart muscle, valves, and blood flow patterns. The physician may also indispensableness to do a heart catheterization, to allow the arteries of the heart to be see using angiography. Upon getting a diagnosis of CHF, the physician will normally start with asking the patient to change things in their diet, such spillage to a low sodium diet.They may also want to tell medications. Types of medications could include angiotensin converting enzyme (ACE) inhibitors,which block formation of angiotensin II hormone, angiotensin sensory receptor blockers (ARB) to block the action of an giotensin II at the receptor site, and diuretics, just to name a few (Fundukian, 2011). If these primary preachings are unable(p) for the patient, the physician may want to revert to other methods such as surgery. Depending on the specific problem in the heart, the physician could recommend short-circuit surgery, to route blood around the blocked artery, heart valve surgery for replacing or repair of a dysfunctional valve, or infarct excommunication surgery to remove scar tissue that accumulated due to a previous heart attack.The final measures would be placement of a left ventricular assisted device (LVAD), which helps to pump blood throughout the body. This is unremarkably only used in patients who are waiting for a heart transplant. The outcome or prognosis of congestive heart failure is super variable. It is usually related to its functional class. These functional classes are Class 1, patient has a weakened heart but is without symptoms or limitation, Class 2, only limit ation of heavier workloads, Class 3, limitation of e rattlingday activity, and Class 4, severe symptoms at rest or with any degree of effort (Fundukian, 2011).Management of congestive heart failure. Health disturbance workers play an important role in educating patients with congestive heart failure about the disease and how to manage it. According to Garcias and Wright (2010), congestive heart patients who are taught by knowledgeable nurses may have a better understanding of their disease and how to improve their quality of life and decrease mortality and hospital admission rates. Self-care is a complex and multi-faceted phenomenon that needs a comprehensive consideration of patients including their emotional situation, psychological characters, physical abilities, family support, living facilities, comorbidities (especially cognitive function) and their ability for learning. Insufficient knowledge about CHF, symptom recognition and shipway of self-care along with hopelessness an d psychological problems trammel their abilities for an effective self-care.A corroborative environment, motivation and adequate care programs using effective educational methods that build self-care skills, should be recommended to health care providers and families (Siabani, Leeder, & Davidson, 2013) There are several ways to prevent congestive heart failure. Diet management is a profound factor in securing a future withoutcongestive heart failure. Maintaining a proper diet is crucial. Being overweight will act as a burden to the heart causing it to work harder to pump blood throughout the body. It is necessary to adulterate sodium intake to avoid retaining fluids. The abutting step would be to increase potassium intake. Individuals who have congestive heart failure are usually prescribed diuretics to help excrete fluids causing a loss of potassium. Potassium can be found in green leafy vegetables and most fruits, particularly bananas, oranges, and dried fruit. Other factors for congestive heart failure prevention would involve exercise, not smoking and limited alcohol consumption. (Haydock & Cowie, 2010). Various drugs are incorporated into treatment for congestive heart failure.The use of drugs is intended for reducing fluids within the body or to reduce blood pressure in the arteries of the body. Typical drugs used for treatment are Ace inhibitors, beta-blockers, digitalis, diuretics and vasodilators. Beta-blockers are intended to improve function for the left lower ventricular pumps. Diuretics are intended to assist in eliminating products that primarily contribute to congestion such as salt and water. Digitalis serves a very important role in strengthening the heart so it can serve as a more efficient, reliable, and effective pump. Treatment may involve surgery if the failure is a result of a unretentive functioning heart valve. Surgery could involve repair or reliever of a heart valve or in drastic cases, replacement of the heart itself (Gore, 2 008).Lifestyle adjustment is necessary to effectively curtail the increasing prevalence of CHF. It is important should therefore optimize control of hypertension and diabetes (Gore, 2008). General treatment will also consist of exercise, weight loss, rest and specific assist to maintaining a suitable diet plan. The Practice Framework of a individual that has congestive heart failure is greatly affected. Individuals must reduce the amount of exertion on their bodies to prevent over stimulating the heart.The limitations caused by the failure make performing even routine tasks more difficult. Some of the activities of daily living (ADLs) that this individual might have issues with might be, getting milled and undressed, toileting, personal hygiene, bathing and eating (Haydock & Cowie, 2010). To reduce hospitalization of the CHF patient, nurses must give lessons patients about illness, symptoms, diet, medication, and energy conservation. The more knowledge a nurse can give to a pati ent concerning CHF, the morethe patient can do to reduce hospitalizations. Gerontological nurses must provide high quality, research-based clinical care for these patients (Bushnell & Lopez, 1992).Conclusion Congestive heart disease is a disease that grows dissipated in prevalence, causing a high rate of hospitalization every year. It is more prevalent in the elderly population. The symptoms of congestive heart failure mimic that of other diseases, but shortness of breath, fatigue, and dependent edema are common in patients. When taking care of patients with congestive heart failure, it is important to incorporate cultural and spiritual considerations.ReferencesBushnell, F.K. & Lopez, E. (1992). Self care teaching for congestive heart failure patients. Journal of Gerontological Nursing. 18(10) 27-32 Fundukian, L. J., (2011). Congestive heart failure. The Gale cyclopedia of Medicine. 4th Ed. 2(4) 1142-1147. Detroit Gale Cengage Learning Garcias, R.E., & Wright, V. R. (2010). Cardiol ogy research and clinical developments Congestive Heart blow Symptoms, Causes and Treatment. . SciTech Book News Dec. 2010. Retrieved from http//go.galegroup.com/ps/i.do?id=GALE%7CA243379576&v=2.1&u=vic_liberty&it=r&p=AONE&sw=w&asid=3d10bca3f720fda0cb553c2548646db8 Gore, J.M. (2008). Ethnicity and incidence of congestive heart failure. Journal Watch.Cardiology. Proquest. Haydock, P.M. & Cowie M.R. (2010). Heart failure classification and pathophysiology. Medicine. 38(9). pp 467- 472. Keys J. R. & Kotch, W. J. (2004). The adrenergic pathway and heart failure. PubMed, 59, 13-30. Retrieved from, http//www.ncbi.nlm.nih.gov/pubmed/14749495. Ramos, S., Prata, J., Goncalves, S.R., & Coelho, R. (2013). Congestive heart failure and quality of life. Applied Research in Quality of Life. impost Netherlands, 9(4)4, pp. 803 817 Siabani, S., Leeder, S.R., & Davidson, P.M. (2013).Barriers and facilitators to self-care in chronic heart failure a meta-synthesis of qualitative studies. SpringerPlu s 2013, 2320 doi10.1186/2193-1801-2-320
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