Heart Failure: Complication into a Person Heart - Essay Example

HEART FAILURE: A CRITICAL ANALYSIS Contents Introduction 3 Heart Failure and Social Implications 3 Medical Dynamics of Heart Failure 4 Heart Failure – Standard Medical Practice 5 Diagnosis 6 Counselling & Therapy 6 Emergency Treatment 6 Disease Management 7 Practical Case Analysis: Heart Failure in Writer’s Clinic 7 Diagnosis 7 Emergency Treatment Process 8 Role of Nurses in Interprofessional Practice 8 Administrative Unit 8 Advanced Practice Nurses 8 Doctors 9 Challenges in Heart Failure Patients and Treatments 9 Conclusion 9 Bibliography 10 Introduction Heart failure is a critical and often fatal situation in which a person gets a complication in his or her heart which when there is no kind of intervention, might lead to death or a serious situation or consequence. Due to the extreme impact of heart failure, it is an important and fundamental aspect of healthcare and training. And there are different roles of different players and stakeholders in the healthcare industry who ensure that persons with heart diseases are given the appropriate care and attention. The aim of this paper is to analyse and evaluate care for patients with heart failure by examining evidence and how they apply to practice. In order to attain this end, the following objectives will be examined: 1. A review of the medical dynamics of heart failure and how it occurs; 2. An analysis of standard practice for diagnosing, treating and monitoring heart failure patients; 3. An evaluation of heart failure treatment processes in the writer’s medical facility; 4. An identification of challenges in heart failure patients and how they are dealt with; 5. An analysis of Nurses and interprofessional practice for treating heart failure. Heart Failure and Social Implications “Heart failure (HF) is common and is associated with a high morbidity and mortality. Forty per cent of patients with symptomatic left ventricular systolic dysfunction (LVSD) die within a year of diagnosis and 10% per annum thereafter, giving a five-year mortality rate of up to 70%.” (Patel, et al., 2008, p. 35). Heart failure is therefore a major cause of death in nations like Britain. And this is often diagnosed through the identification of symptoms like left ventricular systolic dysfunction. This provides the identification of the main issues and the main signs that a patient might have a heart disease and heart complication. However, this is very chronic and fatal because many of the people diagnosed of this sickness will die within a year. Precisely, two out of five will die within a year and each year, one out of ten will die after the first year of diagnosis. This shows that heart failure (HF) is a major problem and a major issue within a given society. Heart failure is an issue that affects 0.4% to 2% of the population in Europe and half of this suffer from left ventricular systolic dysfunction (Patel, et al., 2008). This is representative of 2% of national health expenditure due to its danger and high risk (Patel, et al., 2008). Generally, early diagnosis for heart failure is poor because most patients get to know about their condition after they have suffered an attack (Mehta, et al., 2008). Clinical studies show that chronic heart failure patients die abruptly without any diagnosis because when they get their attacks, they do not survive it (Mehta, et al., 2008). However, the population of persons with mild heart failures who die during attacks is somewhat lower than those with chronic instances of the case and issue. Studies show that older patients form the large percentage of the population with risks of heart failure (Bruera, Bliggingson, & Von Guten, 2011). Due to the nature of heart failure as a major cause of morbidity and mortality, the incidence and diagnosis of heart failure causes so many social challenges to persons who are ever diagnosed of heart diseases (Chapa, 2011). This is because the fear of getting a fatal attack causes people and their families to live in fear and panic and this leads to the induction of depression amongst persons diagnosed of heart failure as well as people connected to such persons. The social impact of heart failure has laid the impetus for presenting various innovations in the healthcare systems to include homecare and other forms of medical practices which makes it easy for persons with heart related issues to get quick and immediate care (Kaladjurdjevic, 2013). Scientific evidence also identifies that where a patient gets proper care and proper social support, that patient can relax and live longer than those who do not get a high degree of social support (OConnor, Stough, Gheorgiade, & Adams, 2013). Medical Dynamics of Heart Failure Heart failure is often related to cardiovascular disorders which cause the heart of a person to stop functioning as it needs to, in order to pump blood into different parts of the body to ensure sustenance (Moser & Riegel, 2011). Studies show that coronary heart diseases are the most common causes of heart failure and most of this is hereditary in nature as there is a strong relationship between people and their children who suffer from coronary heart diseases (Moser & Riegel, 2011). Normally, the heart accepts blood from low filling pressure during diastole and propels it forward in systole (Lilly, 2010). “Heart failure is present when the heart is unable to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure), or is unable to do so only if the cardiac filling pressures are abnormally high (backward failure) or both (Lilly, 2010, p. 216). Other factors like tissue rapture that could lead to high levels of haemorrhage can cause a person to lose so much blood that blood circulation might be affected. Heart disease reduces cardiac output and increases venous pressures, which progressively causes a reduction in the functioning of the heart muscle (Katz, 2009). Heart failures can be induced by other diseases like cancer which involves various complications like: 1. Ischemic Heart Disease 2. Hypertension 3. Sepsis 4. Cardiotoxicology 5. Nutritional Disorders (Lenihan, 2007) These situations and circumstances induces the condition in which there is an issue relating to the heart’s ability to pump blood in a person’s body or system (Shils & Shike, 2012). The patient goes through various forms of challenges that are symptomatic of the heart issue and this include shortness of breath and fatigue (Shils & Shike, 2012). The Oxford Textbook of Heart Failure identifies the “classical triad of symptoms” as breathlessness, fatigue and fluid retention (McDonagh, Gardner, Clark, & Dargie, 2010). Therefore, it can be identified that heart failure is fundamentally a result of a situation where the heart is not able to pump sufficiently to ensure consistent blood flow to meet the needs of the body. Hence, it leads to a situation where the human body fails to meet its needs and hence, there is a heart attack or other forms of diseases. Heart failure is different from cardiac arrests where the blood flow of the human heart ceases immediately without any kinds of signals (Katz, 2009). There are three main classes of heart failure and this includes the following: 1. Left-Sided Failure; 2. Right-Sided Failure 3. Biventricular Failure. Left-sided heart failure is associated with the pulmonary edema which includes increased bronchovesicular sounds, crackles, coughs, and tachypnea which leads to respiratory disorders as well as discharges from the nose (Robinson & Sprayberry, 2010). This reflects in the left ventricular end-diastolic pressure that leads to elevated pulmonary artery pressure (Holmes, 2002). This usually results from ineffective left ventricular contraction which leads to pulmonary congestion and decreased cardiac outputs (Holmes, Visual Nursing: A Guide to Diseases, Skills and Treatment, 2008). Left-sided heart failure occurs as a result of ineffective left ventricular contractive function (Eckman, 2011). This implies that there is a general failure of the left ventricular system to pump out blood and perform its fundamental and basic function. As a result of that, the heart is not put in a position where it can provide blood to the rest of the body and there is a general dysfunction that causes a fatal and serious condition in patients. Right-sided heart failure comes about as a result of increased contraction strengths which causes the flow of blood out of the heart to be stopped or limited significantly (Porth, 2012). Through this situation, the right ventricular fails to eject total diastolic filling volumes into the pulmonary artery (Timby & Smith, 2010). This involves a situation where the right volume of blood is not pumped out of the body. Hence, there is a general trend whereby the person’s body loses its right proportions of blood and there is a situation where the body functions begin to fail as a result of the lack of blood in the system of the person. Right-sided heart failure is about the congestion of the peripheral tissues and the dependent edema and ascities fail to get their right flow and share of blood supply (Porth, 2012). This often leads to liver congestions and there is a tendency towards GI tract congestion as well as anorexia (Porth, 2012). The patient often loses weight and the effect is felt gradually, rather than instantly. This is something that happens over a longer period of time rather than in an instant as the case may be with left-sided heart failure which causes more instantaneous results and impacts. Biventricular heart failure is about the dullness of the various arteries and blood-transporting tissues which leads to pleural effusion that culminates in fluid collection between the lung and chest wall (Abraham & Maliga, 2007). This involves as situation where both sides of the heart fails to function and it culminates in a case where the heart becomes static and fails to perform any of its functions and processes. The symptom of biventricular heart failure includes loss of breath, dry coughing and the like. This is primarily because the heart is congested from two different sides and there is a general problem and a challenge in the operation and proper functioning of the heart in order to meet its ends. Also, there is limited circulation and this leads to various symptoms that occur that shows that the patient is unwell. However, in most cases, this is rather gradual and can lend itself to treatment if it is detected early enough for the patient to get the right attention and guidance. However, the left-sided heart failure often occurs suddenly and could prove to be fatal to a patient if no right emergency intervention is carried out on the patient. Heart Failure – Standard Medical Practice Due to the fact that heart failure is crucial and it can affect numerous people and also have fatal consequences, various forms of practice have evolved to deal with the problem and treat it. This has culminated in the presentation of a generally accepted code and system of practice that most medical facilities and medical practitioners have put in place to ensure that there is a good and an appropriate system and process for carrying out their activities and processes. This has evolved over the years and various practitioners and various persons have come up with the more convenient and more acceptable means and methods for treating patients with heart failure. The most common and widely accepted means and system for treating patients with heart failure include: 1. Diagnosis 2. Therapy 3. Disease Management in Collaborative Care 4. Emergency Treatments (Berger, Schuster, & Van Roenn, 2010). Diagnosis refers to the systems and processes through which a heart failure condition can be detected by examining and assessing a patient. This includes the use of various techniques and processes to examine the patient and find out what the fundamental problem with the patient might appear to be. This is often the case in cases that are symptomatic of other conditions that the patient might have. In other words, the diagnostic phase has to do with the identification of various red flags or conditions that might suggest that there are heart issues that are inherent in the patient. Hence, there will be the presentation of a diagnostic plan and option to ensure that the main issues and problems with the patient are identified and appropriate remedial action is taken. Diagnosis Diagnosis is often in two phases. In the first phase, the patient accidentally shows conditions that might be similar to what people with heart failures often exhibit. Hence, the patient is referred to some specialist checks and processes like lab checks in order to find the causes of the problem and also define the best ways and means of dealing with the issues relating to the problem. Diagnosis involves various laboratory examinations and checks that culminate in the identification of major problems and issues relating to the patient. From there, an appropriate treatment plan and system can be put together to help the patient in question. Counselling & Therapy After a person is identified to be suffering from some kind of heart failure or heart condition, the patient must be counselled and given care that will let him realise the kind of condition that he is living in and from there, the patient can make changes and adjustments to his life. The counselling about changes in lifestyle will include the adoption of better lifestyles like reducing excessive smoking, exercising and other things (Arnot, 2010). These healthy lifestyles enable a patient to get a better life and an improved chance of surviving longer with the heart failure and in some cases even eliminating the heart failure’s risk totally. However, the therapy must also include advising people close to the patient in order to ensure that the patient’s lifestyle is improved and enhanced and also, the patient gets the right support and guidance from someone close to him or her. This enables the threat of heart failure to be reduced significantly. Emergency Treatment In cases where there is a major issue or a life threatening situation that demands immediate attention, there is the need for the medical facility to admit the patient and provide quick medication that will relieve the patient. Where congestion fails to improve, there is the need to introduce recompensate diuretic therapy which could involve sodium and fluid resetters that will enable the patient to get some degree of relieve (Mebazaa, Gheorghiade, Tannade, & Farrillo, 2012). Where the condition remains poor, the dosage of the medication could be improved under medical advice. This will help to relieve the congestion and enhance the processes and the circumstances relating to the patient’s heart. In specific cases, there is the need for specific forms of medications to be introduced in order to ensure that the patient can get the right chemical composition that will enable him to attain some kind of recovery. Disease Management In order to provide appropriate treatment, there is the need for the patient’s medical history to be taken and from there, there could be a plan for the management of the patient’s condition and situation (OConnor, Stough, Gheorghiade, & Adams, 2012). Disease management involve a proactive and conscious effort by the medical practitioners of the patient to monitor the patient and his or her situation and conditions for remedial action to be taken where necessary. The most popular processes include checking the patient’s weight regularly, adjusting the dietary status of the patient and defining an appropriate lifestyle that the patient must adhere to (Salzman, Colins, & Hajjar, 2010). This will also include the adherence to a plan for the attainment of the plans and objectives of the proposed actions recommended for the patient. This includes exercising and other activities that will be meant to keep the heart of the patient active throughout his life. Through this, the patient can get a higher and improved quality of life that will enable him or her to become more active and less prone to attacks that might worsen the patient’s conditions and put him or her under a fatal situation (Salzman, Colins, & Hajjar, 2010). Practical Case Analysis: Heart Failure in Writer’s Clinic This section will include the narration of the fundamental approaches and methods used by the writer’s clinic to deal with heart failure patients and heart failure processes. Basically, the hospital has two main routes through which a person with heart failure conditions will be diagnosed and treated: 1. Diagnosis 2. Emergency circumstances Diagnosis There are numerous situations in which a patient might be subjected to various diagnostic processes aimed at detecting whether s/he has conditions like heart failure and the like. This includes various processes like comprehensive checks and other narrations of patients that show traces and suspicions of heart disease. Through this, there will be various kinds of tests and processes that will be conducted and it could be deduced that the patient has a heart condition. The diagnostic process is mainly an inter-professional situation in which a broad range of cases are checked and tested. Where the signs show that the patient has numerous traces and elements of symptoms of heart failure, a more thorough evaluation is done. From there, the proper and appropriate case management approach is prescribed by the medical practitioner in question. Thus, there are issues and problems that show traces of possible heart failure. However, there are further checks that are carried out in order to find the issues and causes of medical conditions. This might point out to heart diseases and situations that might prove to need attention. The appropriate disease management plan often comes with an education and treatment plan which focuses on how the patient must adjust his or her life to meet the changes that have been induced by the symptoms of heart failure found. Emergency Treatment Process In cases where a patient suffers from a heart failure, that individual is rushed to the facility by an ambulance which rushes the patient to the hospital. The ambulances affiliated to the hospital provide basic training in heart failure conditions for the ambulance attendances. So in the case of a heart failure, the ambulance staff provide basic resuscitation processes and help to ensure that emergency care is administered right in the ambulance. Once the patient gets to the hospital, the patient is rushed to the emergency room where important interventions and medications are offered to the patient immediately. This helps the patient to get some kind of expert treatment and expert handling to ease the pain and gain some kind of care. In the emergency room, the patient is given medication and treatment. After that, the patient will be kept in the hospital to recover and from there, the patient is given the appropriate disease management process which includes his or her family. The disease management plan for patients who survive a chronic and fatal attack includes full diagnosis which will include lab assessments and expert evidence. This includes taking submissions about the patient’s medical history amongst other things. This will help to provide a comprehensive set of information that the medical practitioner can apply in the case of the patient in order to define the best and most important treatment and systems that will be used to deal with the situation and/or condition. Quality life care will involve a change in the lifestyle of the patient as well as the management of other situations and conditions. Role of Nurses in Interprofessional Practice The treatment and handling of heart failure is one that requires inter-professional care and practice. This is because there are different components and elements of heart failure that demands different stakeholders in the medical industry to come together to attain optimum results and save lives and improve the quality of life of vulnerable populations. Administrative Unit The administrative unit of healthcare facilities have the obligation to ensure that they analyse the local population with heart failure in order to find important methods and approaches for dealing with heart failure. This will include amongst other things, the taking of data about the age, gender, economic status and types of heart failure that occurs among patients in the sub-community. Healthcare providers also need to ensure coordination of affairs between healthcare professionals and other entities and institutions relevant in ensuring the best care available to patients. Also, there must be proper care coordination that will involve the processing of various activities and their impacts. Advanced Practice Nurses APN will have to ensure that they play a role in coordination and ensuring that different stakeholders and different persons in the organisation carry out their activities in such a way and manner that the best interest of patients can be met. This involves playing the role of providing referral services and processes to enable the patients to get the right attention and the right services that will guide them and provide them with the proper care. Nurses also play the role of playing a key role in the implementation of treatment plans and systems. This includes various follow ups and the provision of quality of life services and processes to help the patients to recover. Doctors Doctors provide specialised care and controls including referrals and other things. This includes drawing up plans for the treatment and management of heart failure amongst patients and the obligation placed upon nurses is to help to implement this and also provide specialist care where necessary (Jaarsma, 2005). Challenges in Heart Failure Patients and Treatments The fundamental challenge in dealing with patients suffering with heart failure is the definition of leadership roles and communication within such networked environments (Weenick, Van Lieshout, Jung, & Wensing, 2011). There is the need for proper definition of roles and objectives. This is the best way to get all the stakeholders and all the key players in the heart failure treatment process and system to come up with the best ways and the best processes to link up and provide timely and appropriate care to various patients. Where the roles and obligations of stakeholders are not clearly defined, there is bound to be a number of issues with working together and achieving results amongst the practitioners. This implies that there must be a better and more enhanced method and process for organising workers and organising various stakeholders in order to ensure that the best processes are met. Also, the connection between facilities is important and vital because there are various stakeholders and various players who need to provide information about the things they know about the patient. In most cases, these things do not exist. Hence, there is a general problem and issue trying to figure out information. Sometimes, this leads to the duplication of information and it might cause some degree of inappropriate and inadequate care as required. This leads to major problems and major issues that might slow down the treatment process and activity. Conclusion It is identified from the study that heart failure is a major problem and issue that is caused by issues that relate to the flow of blood and the pumping of blood by the heart. This involves various challenges and issues like the lack of blood circulation which causes chronic conditions amongst patients. Heart failure is prevalent in society and a lot of people suffer from it. Effective treatment of heart failure involves diagnosis, treatment and a disease management plan. This includes various works from different healthcare professionals who play diverse roles in ensuring that patients get the proper care and attention they need. Nurses play the role of helping in emergency care processes as well as providing heart disease controls that can help the patients to come up with good and positive treatments that can enable them to attain the best and improved results. Bibliography Abraham, W. T., & Maliga, R. R. (2007). Cardiac Resynchronisation THerapy in Heart Failure. Amber, PA: Wolters Kluwer Publishing . Arnot, B. (2010). Seven Steps to Stop Heart Attacks. New York: Simon and Schuster. Berger, A. M., Schuster, J. L., & Van Roenn, J. H. (2010). 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