Severe Heart Failure and Diabetes - Research Paper Example

? Case Study Treatment Plan for Severe Heart Failure and Diabetes Introduction The probability of a heart attack in case of diabeticpatient with breathlessness is more than twice, as compared to that of a healthy person. As this is an established fact in medical science, physicians and doctors are found to be more careful in curing breathing difficulty in diabetics, because of their unstable sugar level, it is often difficult to treat their breathlessness. Due to this established fact doctors attempt to control their sugar level prior to the treatment of any other disease. As Mr. Herbert is suffering from respiratory issues, this condition will lead this individual towards sleeplessness which will in turn cause his health to further deteriorate. It is imperative for him to take his situation seriously and consult with his physician on a regular basis, so that, if his health condition worsens, then it can be treated timely. This problem of breathlessness could also be early symptom of lung cancer, due to this possibility; Herbert’s complete physical is strongly recommended that will help in diagnosing any subtle diseases prevailing in his body. Government should also play its due role in saving this man’s life, because he is not in a good financial position, so it is the duty of federal agencies to pay his medical dues. In many cases breathlessness and hypertension are directly responsible for heart failure (Lavine & Gellman, 2002). In the light of this observation, the role of nursing and other medical staff becomes significant in saving the life of a patient. Healthy lifestyle with mild level of exercise, minimize the breathlessness, as respiratory system has to inhale sufficient amount of air to compensate for fatigue, in this way it starts working properly. On the other side it also causes an individual’s appetite to normalize (Nodari, Metra, Cas, & Cas, 2003). At the same time, formalized group discussion panel containing professional doctors, was unable to develop a more effective and efficient way for the treatment breathlessness and appetite disorder, in comparison with existing ones (Kasje, Denig, Stewart, Graeff, & Haaijer-Ruskamp, 2012). A revolutionary finding is being highlighted by Mangiavacchi & et al, (2008), which points out towards the increased death rate, due to heart failure, in those diabetics who were suffering from respiratory issues, and were treated by insulin, thus concluding in the favor of non-usage of insulin on diabetic heart patients. At the same time, Metformin is recommended for the treatment of diabetes in heart patients with breathlessness (Eurich & etal, 2009). Breathlessness is caused by a malfunctioning part of a respiratory system, starting from nose to lungs (Bennett, 2003). On the other hand, this situation can be caused by blockage of air passages of nose, thus limiting the airflow to the lungs A problem in human’s circulatory system can also cause an individual to feel breathless, because with the sufficient amount of oxygen reaching to the cells of the body. The nerves system, therefore attempts to compensate for oxygen deficiency (Bennett, 2003). By pushing respiratory rate to a higher level, as a consequence patient feels breathless. It is believed that an early detection of breathlessness and appetite loss in elder people could be helpful in treating the disease (Boonman-de Winter & etal, 2009). In the case study Mr. Herbert has been diagnosed, with breathlessness earlier, so it will be relatively simple to devise a healthcare plan for him. Along with this, his caring attitude regarding his health is commendable. Metaformin treatment is suggested for Herbert, because it does not endanger the life of a cardiac patient with breathing disorder, unlike insulin (Andersson & etal, 2010). Along with the medication, proper, light and routine exercise is also prescribed for the patient under study. However, relax home environment is critical for the health of the patient. According to the findings of a preliminary study, breathlessness could cause a heart attack, as a malfunctioning respiratory system, leads to de-oxygenation of blood (Anderrson & etal, 2010). This observation leads the medical scientists towards a strong linkage between the two diseases. It is rather safe to forego the insulin treatment in the case of Herbert, because it will result in aggravation of breathlessness and appetite loss. Herbert is suffering from breathlessness. This problem could lead him towards severe heart attack or angina, while in bed (Jilek & etal, 2011). Therefore, use of inhaler is also firmly recommended, to prevent him from the inevitable. Metformin is also reported to better the respiratory system (Wang, Zhang, Li.L, Zhao, Tao, & Zhang, 2011). The use of metformin is again supported by this finding to treat Herbert. Deployment of electronic devices to maintain a steady and normal heart rate is becoming a norm in the developed nations, where the ratio of people suffering from vascular and respiratory diseases is on the rise (Uriel & etal, 2011). These devices maintain the rhythm of heart beat through constantly monitoring it. They also produce an electric shock to regulate the heart and respiration rate when needed. This paper is in favor of planting a pace maker in the chest of Herbert, because the probability of heart attack in his case is higher than the normal, due to his breathlessness issue. In another study, focused on similar topic, an unhealthy life style of anorexia patients is being reported to lead them towards a painful ramification (Edelmann & Etal, 2011). Herbert should be given a detailed briefing about his condition to minimize the possibility of carelessness from him with reference to his medical condition. At the same instance, there is sufficient evidence presented supporting the presence of divergence in treating a same disease by various physicians (Gaughey, Roughead, Shakib, Vitry, & Gilber, 2011), due to this trend many patients died in past decade, thus it is logical for Herbert to consult to only one specialist doctor, to somewhat minimize this risk. Beta Blocker is an effective tool to diagnose, the breathing disorder within potential patients (Wai & etal, 2012). This research effort strongly approve the use of this technique to accurately identify the current stage of the disease concerning Herbert, however this method will also help in opting for an effective treatment for the patient’s condition. In the guidance of profound research findings, this paper is recommending Herbert’s hospitalization, until his situation gets better, because the environment and technology at hospital could assist him significantly in gaining his health back (Breuer & Meier, 2012). Another suggestion that is worth mentioning is the need of a professional nurse at Herbert’s home, who could take care of him on day to day basis, because medicine alone cannot heal a person, but care could, that professional should also be able to demonstrate compassion towards her patient (within professional boundaries). This will make Herbert feel important and in this way his will to recover will grow manifold. Herbert is also suffering from anorexia; this problem is a mild one, because it can be treated by increased physical activity. Mild exercise and walk would be able to resolve this condition. The use of medication for this purpose is not recommended, because in this way, Herbert’s hunger will become artificial in nature, therefore he will rely on them for rest of his life. Now this paper will provide some nursing interventions to treat a breathless patient, in this case Herbert. The first intervention proposed is concerning the general description of a person, if he is attentive, energetic and responding to the examination positively. These symptoms mean that he is not feeling breathless. The next phase is to examine the physical condition of a patient. It starts with noting the color of his nails, if their color is turning towards grey or blue. This means oxygen level is dropping. It is also the duty of nurse to observe erection of patient’s posture while interacting, because if the patient cannot maintain his posture when talking, along with this if he gets interrupted by unevenness of breath. These are sure signs of breathlessness. Nurse should also study the medical history of the patient thoroughly, to search for any complications in his record (Bennett, 2003). However, the nurse assigned to Herbert must examine his respiratory and heart rate after every hour. It is also wise to take these readings after every meal, so that his condition can be monitored continuously (Bennett, 2003). Nurse should be checking the condition of Herbert’s inhaler. Conclusion This paper examines the medical condition of a person named Herbert. He is suffering from appetite loss along with severe breathlessness. In this situation he needs medical attention at all time. This research effort recommends plantation of pace maker for Herbert, so that it could regulate his heart and respiration system. On the other hand, it is suggested that, doctors should not administrate insulin, because of its aggravating effect on patient’s respiration. But instead, metaformin is a much more safe option, because its side effects are negligible and it also causes respiration to better. This plan also suggests a regular, but mild exercise for Herbert, because, it will keep him active and will improve his respiration, while increasing his appetite as well. At the same time, healthy food ingredients are essential for him, because they will keep his blood pressure in check. However, Herbert seems to be very conscious about his health. This attribute of his personality will definitely help in his recovery. Inhaler is prescribed to treat Herbert’s breathing disorder, to solve, because this disorder can trigger a severe heart attack at any time. Herbert is also struggling in financial terms; therefore, it is the responsibility of government to assist him in gaining his good health back, through economical health insurance. On the other hand regular visits to a doctor are also highly recommended for rest of Herbert’s life, because it is very important to keep an eye on his health, because of weakened immune system due to aging. Herbert is also in need of a professional nurse at his home that could take care of him on daily basis, because Herbert is betrayed by his age now, therefore, is in no position to take care of him. This individual should keep a close eye on his condition, while recording his food intake. She will also be responsible for conducting his routine physical everyday and a detailed one in every week. She will have to inform the doctor about his condition on a daily basis. So that treatment can be modified according to the Herbert’s current condition. At the same time nurse will be responsible for administrating prescribed medication as well. On the other side an old man is in need of peaceful life, which should be away from tension. Herbert must consult with only one doctor, to avoid the possibility of divergence in his treatment, where the role of his wife becomes significant. Works Cited Anderrson, C., Norgaard, M., Henson, P., Fosbol, E., Schmiegelow, M., Weeke, P., Olesen, J., Raunso, J., Jorgenson, C., Vaag, A., Kober, L.,Torp-Pederson, C., Gislason, G. (2010). Heart failure severity, as determined by loop diuretic dosages, predicts the risk of developing diabetes after myocardial infarction: a nationwide cohort study. European Journal of Heart Failure, 12, 1333-1338. Andersson, C., Oleson, B., Hansen, P., Weeke, P., Norgaard, M., Jorgenson, C., Lange, T., Abildstrom,S., Schramm, T., Kober, A., Torp-Pederson,C., Gislason,G. (2010). Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia , 53 (12), 2546–2553. Bennett, C. (2003). Nursing the breathless Patient. Nursing Standard, 17: 45-51. Boonman-de Winter, L., Rutten, F., Cramer, M., Liem, A., Landman, M., Stel, H., Wit, G., Rutten, G., Hessen, P., Hoes, A. (2009). Early recognition of heart failure in patients with diabetes type 2 in primary care. A prospective diagnostic efficiency study. (UHFODM2) . BMC Public Health, 9, 479. Breuer, T., & Meier, J. (2012). Inpatient Treatment of Type 2 Diabetes. Deutsches Arzteblatt International , 109 (26), 466-474. Edelmann, Wachter, R., Dungen, h., Stork, S., Richter, A., Stahrenberg, R., Neumann, T., Luers, C., Angermann, C., Mehrhof, F., Gelbrich,G., Pieske, B. (2011). Heart failure therapy in diabetic patients comparison with the recent ESC/EASD guideline. Cardiovascular Diabetology, 10, 15. Eurich, D., Tsuyuki, R., Majumdar, S., McAlister, F., Lewanczuk, R., Shibata, M., Johnson, J. (2009). Metformin treatment in diabetes and heart failure: when academic equipoise meets clinical reality. Trials, 10, 12. Gaughey, G., Roughead, E., Shakib, S., Vitry, A., & Gilber, A. (2011). Co-Morbidity and Potential Treatment Conflicts in Elderly Heart Failure Patients A Retrospective, Cross-Sectional Study of Administrative Claims Data. Drugs Aging , 28 (7), 575-581. Jilek, C., Krenn, M., Sebah, D., Obermeier, R., Braune, A., Kehl, V., Schroll, S., Montalvan, S., Riegger, G., Pfeifer, M., Arzt, M. (2011). Prognostic impact of sleep disordered breathing and its treatment in heart failure: an observational study. European Journal of Heart Failure , 13 (1), 68–75. Kasje, W., Denig, P., Stewart, R., Graeff, P., & Haaijer-Ruskamp, F. (2012). An educational programme for peer review groups to improve treatment of chronic heart failure and diabetes mellitus type 2 in general practice. Journal of Evaluation in Clinical Practice , 12 (6), 613-621. Lavine, S., & Gellman, S. (2002). Treatment of Heart Failure in Patients with Diabetes Mellitus. Drugs, 62, 285-307. Mangiavacchi, M., Gasparani, M., Genovese, S., Pini, D., Klersy, C, Bragato, R., Andreuzzi, B., Municino, A., Regoli, F., Galimberti, P., Ceriotti, C., Gronda, E. (2008). Insulin-Treated Type 2 Diabetes Is Associated with a Decreased Survival in Heart Failure Patients after Cardiac Resynchronization Therapy. PACE , 31, 1425-1432. Nodari, S., Metra, M., Cas, A., & Cas, L. (2003). Efficacy and tolerability of the long-term administration of carvedilol in patients with chronic heart failure with and without concomitant diabetes mellitus. The European Journal of Heart Failure , 5, 803-809. Uriel, N., Naka, Y., Colombo, P., Farr, M., Pak, S., Cotarlan, V., Albu, J., Gallagher, D., Mancini, D., Ginsberg, H., Jorde, U. (2011). Improved diabetic control in advanced heart failure patients treated with left ventricular assist devices. European Journal of Heart Failure , 13 (2), 195-199. Wai, B., Kearney, L., Hare, D., Ord, M., Burrell, L., Srivastava, P. (2012). Beta blocker use in subjects with type 2 diabetes mellitus and systolic heart failure does not worsen glycaemic control. Cardiovascular Diabetology. 11:14. Wang, X., Zhang, J., Li.L, Zhao, X., Tao, H., & Zhang, L. (2011). Metformin improves cardiac function in rats via activation of AMP-activated protein kinase. Clinical and Experimental Pharmacology and Physiology , 38 (2), 94-101. Read More