The Concept of Congestive Heart Failure - Essay Example

RUNNING HEAD: Congestive Heart Failure Congestive Heart Failure Table of Contents Introduction 3 Discussion 4 Chestinfections 4 Medical monitoring 4 Electrolyte and fluid monitoring 5 Psychosocial effects of medication to the patient and family 5 Discharge plan 6 Conclusion 7 Introduction Congestive heart failure (CHF) is a state of the body where the heart fails to reach the optimum rate for metabolic purposes. This means that the body gets less nutrients and oxygen than required making it fatigued even after performing very light duties (Clark & McMurray, 2001). It is a chronic condition that causes accumulation of fluid in the legs and lungs that causes breathing shortness. This condition is caused by; disease of the coronary artery, long term abuse of alcohol, hypertension, heart valve disorders, and other unknown causes (Fang, Mensah, Kroft, & Keenan, 2008). The symptoms vary from one person to another depending with the underlying cause and they include; fatigue, edema, fluid accumulation, nausea, loss of appetite and weight, abdominal pain, etc. There are several other conditions that are associated with congestive heart failure (Jeffrey & Barry, 2007). Congestive heart failure is diagnosed clinically based on the patients’ medical history. This is important because it could disclose the existence of some of the symptoms or even associated diseases. A physical examination on breath sounds, swelling of the legs or neck is done to determine the presence of excessive body fluid, pulse rate and heart size are also recommended physical exams (Sosin, Bhatia, Lip, & Davies, 2006). Diagnostic tests such as areechocardiogramam (used to show the heart image), and chest X-rays electrocardiogram aare done so as to detect any previous attacks, arrhythmia to show fluid accumulation and heart enlargement (Plantz & Adler, 2002). This condition can be treated through the use of analgesics, inotropic, nitrates, and diuretics. These medications are used to alleviate the symptoms associated with the disease. The ultimate treatment could be a heart transplant which is very risky or a surgery depending on the underlying cause. (Yancy & Firth, 1988) Discussion Chest infections This is a viral or bacterial airway infection that affects the lungs. Its main symptoms include a hefty cough that comes with, difficulty in breathing, pain in the chest, and thick mucus. Mr. B has all these symptoms and his chest has to be monitored because it could lead to a heart attack. The shortness of breath is brought about by fluid accumulation in the lungs and its surroundings. Chest infections can be life threatening or mild, it is worse when one has a congestive heart failure disease (Choi, Ryter, & Levine, 2013). Medical monitoring Mr. B is suffering from sleep apnoea-hypopnoea (snore) as indicated by the breath sounds. It is a disorder mostly associated with cardiovascular diseases. It is monitored using the continuous positive airway pressure (CPAP). On the other hand a central venous catheter (CVC) has been put. This is a catheter put inside a large neck vein probably the jugular vein or in the auxiliary chest vein or the femoral vein in the groin. It is used in obtaining blood tests to determine the oxygen saturation in the veins, administering fluids and medication, and obtaining measurements like the pressure of the central veins. Central venous catheters are of two types; tunneled and non-tunneled. The tunneled catheters pass below the skin to an exit site separate from the insertion point. All its attachments emerge from here. Non-tunneled ones are placed at the insertion site where they are visible. (Edward, 2002) An art line or arterial catheter is put into an artery. It is very thin in size and is used in intensive care to check the blood pressure, and retrieve blood to assist in gas measurements. An art line is usually inserted into the radial artery of the wrist or any end-artery. (Russel, Michael, & Gregory, 2007) For insertion to take place, anesthetic must be used to reduce the pain. An indwelling catheter is inserted into the bladder and is left inside. Electrolyte and fluid monitoring Water is very important in the body because it regulates the body temperature, dilutes cell solids, and transports messages to the body organs. It is regulated through renal regulation. An imbalance of fluid and electrolytes is monitored through the cardiovascular system. Components like blood pressure, heart rate, mucus membrane color, and capillary refill time are monitored (Nicholson, 2008). If there are changes in the electrocardiogram then there is a possibility of various imbalances. Examinations of the respiratory system include; respiratory rate increase or decrease, respiratory effort, and auscultation. This shows an increase in fluid volume. Renal examinations including; urine output and gravity assessment, weight of the patient, and hourly intake and output assessment give information on fluid volume (Cleland, 2008). Body weight changes are used to estimate the severity of fluid volume alterations. The mucous membrane and skin are also examined to check for elasticity and moisture. If the patient has low volumes of fluid the membrane is dry. The skin is also dry and warm. (Cogan, 1991). Electrolyte imbalance is checked through the use of an electrolyte panel. It is done to monitor the treatment effects of a particular imbalance. Electrolytes include potassium, sodium, bicarbonate and their levels are affected by diet intake, body fluid, and the amount excreted. Psychosocial effects of medication to the patient and family Most patients undergoing highly technical medication due to a chronic disease suffer from stress. This is because of the lack of comfort and the ability to adhere to treatment. (Francis, 2011) The patients are concerned about family issues, accessibility to supportive care and the quality of life. Psychosocial care (provision of social, spiritual and psychological care) is therefore essential to both the patient and the persons taking care of the patient. It has a great impact on the quality of life as it encourages the patients not to lose hope. Hope includes development of new goals and finding the meaning of life, reflection and re-evaluation. This allows people have more flexible and realistic goals that are attainable. Emotional imbalance can occur at any time due to changes in thinking and feelings towards the treatment (George, Matters, McGruder, Valderama, & Xie, 2008). There are also physical problems like pain, sleeplessness and tiredness. Most patients tend not to adhere to their medication due to this (MayoClinic, Diseases and Conditions, 2011). They feel that they are just headed for death and they are a burden to their family. The family members on the other hand feel obligated and blame themselves for any misfortunes that may happen like the lack of funds for the treatment. Good communication skills are an essential part of caring for these patients (Peeters, Mamun, & Willikens, 2002). This helps in conveying support and empathy to both the patients and affected party by providing understandable medical information. It creates a healthy relationship between the patients and the care providers that is based on honesty, openness, understanding, trust, respect, and mutual goals. This relationship is an important boost to the patient which in turn gives the family a reason to move on. Discharge plan This is a plan that is mostly taken when the heart failure condition worsens and it becomes impossible for a heart transplant to take place. This allows friends and family to take care of the sick with the help of trained volunteers or nurses in their homes. For Mr. B due to his excess fluid in the body, he will need to sleep with his legs elevated in order to ease up breathing and reduce the risk of swollen feet. (MayoClinic, Heart Failure home care, 2012) His indwelling catheter should be taken care of to avoid other infections. His diet should have a little or no salt (low sodium), and low levels of solid fats. Salt may cause excessive fluid build up while fats may cause unhealthy cholesterol levels increasing the risk of heart attack. Foods rich in omega-3 fats are encouraged. Weight should be measured on a daily basis to keep track of any fluid increment, and avoidance of exposure to smoke (Stephen, Schueler, John, Beckett & Gettings, 2011) Conclusion Congestive heart failure is a disease that needs long time management. It is called a silent epidemic in America because very many people have it and are not aware. It is evident when the heart is not strong enough to pump sufficient blood to the body system. (Theresa, Roy, Andrew, & Henry, 2011)With the use of medications symptoms are bound to improve and the heart could become stronger. Treatment helps the patient to live for a longer time and reduces the occurrence of sudden deaths. Heart failure sometimes can be corrected by medicating its causal factor. For example, through surgery of a heart valve or regulating a fast heart beat may reverse the condition. (Silver, 2013). For many patients though, treatment involves the right medications, which may include devices that aid the heart in proper contraction. Proper and healthy diet is also advised to reduce the risk factor of a heart attack, a lot of fruits and vegetables are essential because they are a source of potassium References Choi, A. M., Ryter, S. W., & Levine, B. (2013). Mechanisms of disease; Autophogy in Human Health and Disease. New England journal of medicine , 651-662. Clark, A. L., & McMurray, J. J. (2001). Heart Failure Diagnosis. London: Martin Dunitz. Cleland, J. (2008). Understanding Heart Failure. Poole: Family doctor books. Cogan, M. (1991). Fluids and electrolytes: physiology and pathophysiology. Norwalk: Apple and Lange. Edward, J. (2002). Central venous catheters. intensive care medicne , 1-17. Fang, J., Mensah, G. A., Kroft, J. B., & Keenan, N. L. (2008). Heart Failure Related Hospitalization. American College of Cardiology jornal , 428-434. Francis, G. S. (2011). 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