...Heart failure (HF) is one of the most common manifestations of heart disease. In the US, the lifetime risk of developing HF at age 40 is one in five for both men and women, and continues at this level through the age of 80, despite the reduction in life expectancy.{Roger, 2012 #1789} Chronic HF in particular has increased in prevalence, even as control of other common cardiovascular syndromes, such as myocardial infarction (MI), has improved in recent years.{McCullough, 2002 #1851;Roger, 2012 #1789} HF is a disease of the elderly, affecting 10% of men and 8% of women above the age of 60 years, and its prevalence rises with age.{Roger, 2012 #1789} Given the expected aging of the population, if the incidence of new HF cases continues to increase...
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...Heart failure occurs when cardiac output is insufficient to effectively perfuse the tissues, despite normal filling of the heart. Usually causes include hypertension, cardiomyopathy, and coronary heart disease. In heart failure, the increase in the resistance against which the heart pumps (afterload) further depresses cardiac output. A reduced renal blood flow induces renin secretion and increased plasma aldosterone and angiotensin concentrations. Water and sodium retention increases blood volume causing central venous pressure to increase. These changes overall first help to maintain cardiac output however in the long term they eventually cause morbidity and mortality (BOOK). Treatment of heart failure begins with angiotensin converting enzyme (ACE) inhibitor and as severity increases a diuretic is added which supports the excretion of sodium and water (book). In very severe heart failure, the addition of β-blocker further decreases mortality in patients on ACE inhibitors and diuretics. Valsartan/ Sacubitril is a combination drug approved for use in heart failure. It has a brand name of Entresto and is also previously known as LCZ696....
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...Introduction Heart failure is a condition in which the heart cannot pump enough blood through the body. When this happens, parts of the body do not get the blood and oxygen needed for them to function properly. This can cause symptoms such as shortness of breath, fatigue, and confusion. There is no cure for heart failure. However, following your health care provider's instructions about a healthy lifestyle and being treated with medicines can help you stay active and live longer. The types of medicine you are prescribed will depend on your symptoms and what is causing the heart failure. In some cases, you may need to take more than one medicine. It is important to talk to your health care provider about all the medicines you are taking, how...
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...Introduction Heart failure is a condition in which the heart does not fill or pump enough blood and oxygen to support your body and its functions. Heart failure is a long-term (chronic) condition. Living with heart failure can be challenging. However, following your health care provider's instructions about a healthy lifestyle may help improve your symptoms. This includes choosing the right exercise plan. Doing daily physical activity is important after a diagnosis of heart failure. You may have some activity restrictions, so talk to your health care provider before doing any exercises. What are the benefits of exercise? Exercise may: Make your heart muscles stronger. Lower your blood pressure. Lower your cholesterol. Help you lose weight....
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...Robert great summarization post of congestive heart failure, my grandfather had congestive heart failure so I know first hand the effects it has on a person’s life. I thought it was very interesting that you pointed out one the first symptoms being not able to exercise without experiencing discomfort because not many individuals think of that as being a symptom they go to the go to symptoms like shortness of breath, coughing, and fatigue. In the beginning, before my grandfather was diagnosed with congestive heart failure he experienced difficulties lying down flat. Lying down flat causes parts of the lung to be in a more ¬¬¬dependent position. Another symptom to keep in mind for an individual with congestive heart failure is waking up with severe shortness of breath, and immediately needing to sit up to get their breath, and this is known as “paroxysmal nocturnal dyspnea”. The reason why there is a fluid build is when the heart’s output decreases; the body tries to compensate for it by releasing hormones that make the heart beat faster and stronger. This reflex though is only a short-term gain, and in the long run it really damages the heart’s function. The kidneys also sense the heart’s decrease in blood output, and they release hormones into the body, which cause sodium and...
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...Educating Congestive Heart Failure Patients Cynthia Jones The University of Texas at Arlington School of Nursing In partial fulfillment of the requirements of N3645 Cynthia Jones, RN October 1, 2012 Online RN-BSN Educating Congestive Heart Patients In comparison to the general population, the quality of life for patients with congestive heart failure is greatly impaired until patients are educated on the signs, symptoms and treatment of congestive heart failure. How can nurses use non-physical aspects of nursing to assist congestive heart failure patients improve their quality of life and decrease hospital visits? Patients with congestive heart failure receive physical aspects for treating the disease with the use of medications and surgery, but if patients were educated on the signs and symptoms at the onset of heart failure, outcomes should improve. When researching articles for information regarding congestive heart patients, I searched for articles in The Journal of American College of Cardiology, The Journal of Family Social Work, and the International Journal of Nursing Technologies and Classifications. I decided on these articles because they were published in reputable journals and provide correlations to the research question. In the first article seventy-six caregivers of patients with congestive heart failure used The McMaster Model of Family functioning (problem solving, communication, roles, affective responsiveness and affective...
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...head: EDUCATION AND CONGESTIV HEART FAILURE How does patient education affect compliance with Congestive Heart Failure? How does patient education affect compliance with Congestive Heart Failure? How does education affect compliance with congestive heart failure? I have chosen this topic because congestive heart failure is a disease process that continues to grow throughout our communities. These patients tend to be readmitted into the hospital frequently due to noncompliance. Problem Identification Education of congestive heart failure is one of society’s largest challenges. The need to focus on compliance of treatment plan, self management, and patient education of this disease process is essential for favorable outcomes. The articles chosen for the information retrieval paper were located on line at the University of Texas at Arlington library in the CINHL database. These articles were written between the years of 2006 and 2009. All three articles were peer reviewed. While searching the data base for articles, information regarding education, compliance, and outcomes was a key focus. The articles were chosen for their content related to the education process of the patient with congestive heart failure and how compliance would affect outcomes. The knowledge of congestive heart failure of the medical professional was also explored. Summary of Articles First article Congestive heart failure is a debilitating and chronic...
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...Nursing Theory Plan of Care Nur/513 May 16, 2011 Introduction Nursing theories describe and explain the phenomena of interest to nursing in a systematic way in order to provide understanding for use in nursing practice and research. Nursing theories provide a framework for nurses to systematize their nursing actions: what to ask, what to observe, what to focus on and what to think about. They provide a framework to develop new and validate current knowledge. Researchers use nursing theories to define commonalities of the variables in a stated field of inquiry, guide nursing research and actions, predict practice outcomes, and predict client response. Analysis of the Congruence and Theoretical Statements Henderson define nursing as helping people, sick or well, in the performance of those activities contributing to health and its recovery that they would perform unaided if they had the necessary strength, will or knowledge (Fitzpatrick & Whall, 2005). It is the function of nurses to help people become independent as rapidly as possible. She saw how nursing could focus on the patient and on developing a good nurse-patient relationship. She believed that the patient-focused nursing was the most beneficial kind of nursing. Henderson emphasized the use of nursing care plan. To develop effective care plan, collection of necessary information is important. She developed the 14 Basic Needs in her Theory (Fitzpatrick & Whall, 2005) as basis of individualized nursing...
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...Prevention of Hospital Readmissions Related to Symptoms of Congestive Heart Failure NRS 441V Professional Capstone March 1, 2014 Abstract Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the evidence. Provide at least 1 evidence based literature; for at least 1 evidence based solution. Keywords: congestive heart failure, therapy, education, patient outcomes Description of the Problem Prevention of Hospital Readmissions Related to Symptoms of Congestive Heart Failure Health care providers must ensure skills, knowledge and teaching is effective when providing care to their patients and families about symptoms of CHF. The length of stay for an average hospital visit can be two days however, for more chronic issues warrant an even longer stay. To avoid readmission of the disease processes of CHF warrants additional care and resources during and after discharge. . Some patients cannot follow up with their primary care physician because...
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...time these patients have left is not spent at a hospital. Elderly readmission rate is unusually high, especially when it comes to the readmission rate of elderly patients with congestive heart failure, thus there must be ways to counteract the high volume of readmission rates amongst the elderly and lower it. The research study by Rich and Beckham used a multidisciplinary approach to treat the elderly patients, who are recovering from congestive heart failures, which might be able to significantly reduce the rate of readmission for elderly patients at high risk (Rich and Beckham 1995). Rich and Beckham conducted the study by first gathering the elderly patients who are at high risk for readmission post congestive heart failure which ending up being 1306 patients. The patients were then randomly assigned to whether they will receive the special treatment or the ordinary treatment by use of a computer random selective system. Detailed data were collected at the time of enrollment, 90 days after they were discharged, and whenever a patient was rehospitalized during the 90 time period (Rich and Beckham 1995). The results of this study show that with an effective multidisciplinary approach readmission rates for elderly patients with congestive heart failures will significantly drop. The research conducted by Rich and Beckham can be used in hospitals, and everyday nursing practice. The study indicates that a multidisciplinary approach will drop readmission rate significantly if used...
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...Introduction Heart failure is a difficult disease to manage; and every patient’s family experiences the disease uniquely. Caring for a sick family member is never an easy task. For years, families have relied on hospitals to care for sick loved ones; however some families need to care for their loved more than what just a hospital can facilitate. In the article “Family Caregivers’ Experiences of Caring for Patients with Heart Failure” by (Etemadifar et al., 2015, p.153-160) the level of evidence in this research article is a level IV. This type of level includes consensus panels and opinion of respected authorities. Research Problem and Hypothesis The research problem is the poor heath condition of the caregivers and patients with heart...
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...Preventing Heart Failure Readmissions Henry D. Santos Purdue University Calumet I. Introduction High morbidity, mortality, and healthcare spending have been connected with heart failure management. As per Gheorghiade et al., every year, there are almost a million cases of hospitalization for heart failure, responsible for 6.5 million hospital days, and estimated expenditures of $37.2 billion here in the United States alone (2013). The incident of heart failure readmissions has increased over the last decades, distinctly related to the aging population and surpassed recovery after a myocardial infarction. Based on the Centers for Medicare and Medicaid Services (CMS) 2005 data, heart failure is the most frequent diagnosis among Medicare beneficiaries and the third highest reimbursement for hospitals (AHRQ, 2013). In 2009, CMS started the public reporting of readmission rates after being discharge for heart failure, and, the year after, the Patient Protection and Affordable Act inaugurated financial penalties for healthcare establishments with most rates of readmission within the 30 days after discharge. The elevated concern relating the want to decrease readmissions has been the biggest focused of national researchers and hospitals with the efforts of identifying and predicting which patients with heart failure are likely to be readmitted. Formulated designs and preventive strategies have been established, in order to avoid unnecessary readmissions. Heart failures risk factors...
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...Nurse Driven Education for A Patient Diagnosed With Chronic Systolic Heart Failure Refusing Diagnostic and Interventional Procedures Heather Horsley Wilkes University School of Nursing Abstract Heart failure (HF) is a chronic progressive disease, arising from structural or functional disorders of the heart, in which incidence increases with age. This review attempts to describe the types and causes of HF while focusing on variable aspects of patient education that have a positive effect on patient outcome and quality of life. Specifically, the potential benefits of this education for a 55 year old male patient diagnosed by transthoracic echocardiogram with chronic systolic heart failure, who has refused physician deemed necessary diagnostic testing and treatment. Keywords: heart failure, nurse driven education, heart failure, self-care Nurse Driven Education for Patient Diagnosed With Chronic Systolic Heart Failure Refusing Diagnostic and Interventional Procedures Heart failure (HF) is a major health care concern affecting over 5.7 million people in the United States. It is responsible for 1 in 9 deaths and costs the nation over 32 billion in health care expenses each year (Center for Disease Control, 2013). HF is the most common reason for hospitalization of people older than age 65 (Hinkle and Cheever, 2014). According to Hinkle and Cheever, HF is a “clinical syndrome resulting from structural or functional cardiac disorders that impair the ability of the ventricles...
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...Annotated Bibliographies Lisa Stevens Kaplan University Annotated Bibliographies Au, A., McAlister, F., Bakal, J., Ezekowitz, J., Kaul, P., & vanWalraven, C. (2012). Predicting the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization. American Heart Journal, 164(3). 365-372. Retrieved from: http://www.medscape.com/viewarticle/771215_print This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many that looked at prediction ability. The LACE+ index is a model that looks at length of stay, acuity, the Charlson comorbidity score and age, to predict readmissions. They found that no one model was appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were...
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...approximately six days after blooming and typically bloom from the end of June to the middle of July (Withering). The plant grows between 2 to 6 feet in height and 18 inches in width. Foxglove grows best in partly shaded areas where the soil is rich and slightly acidic (www.gardenguides). It prefers an average amount of moisture and is often found in crevices of granite walls, dry hilly pastures, roadsides and rocky places (www.gardenguides). It has a short life span; living for only 2 years. The first year the growth remains in a basal rosette of leaves. The second year the flowering stems are produced (Munro). Foxglove digitalis is native to Europe and the Pacific Northwest United States but today it is grown commercially and used to produce the heart drugs Digoxin and Digitoxin (Munro). The name Foxglove digitalis has its roots in Latin where the word digitalis means finger. This was used to describe the blossoms of the plant that fit the human finger perfectly. Foxglove digitalis has several other names including the name foxes glofa. This name was given to the plant by the Anglo-Saxons because the flowers of the plant resemble fingers of a glove (Munro). A common folk lore suggests that folk’s glove was another name used for this plant. “Folks” referred to woodland fairies or little people and as the story goes the woodland fairies gave the blossoms to the fox to put on his toes so that he might...
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