...Definition Heart failure occurs when abnormal cardiac function causes failure of the heart to pump blood at a rate sufficient for metabolic requirements under normal filling pressure. It is characterised clinically by breathlessness, effort intolerance, fluid retention, and poor survival. Fluid retention and the congestion related to this can often be relieved with diuretic therapy. However, diuretic therapy should generally not be used alone and, if required, should be combined with the pharmacological therapies outlined in this review. Heart failure can be caused by systolic or diastolic dysfunction, and is associated with neurohormonal changes. [1] Left ventricular systolic dysfunction (LVSD) is defined as a left ventricular ejection fraction (LVEF) below 0.40. It may be symptomatic or asymptomatic. Defining and diagnosing diastolic heart failure can be difficult. Recently proposed criteria include: (1) clinical evidence of heart failure; (2) normal or mildly abnormal left ventricular systolic function; (3) evidence of abnormal left ventricular relaxation, filling, diastolic distensibility, or diastolic stiffness; and (4) evidence of elevated N-terminal-probrain natriuretic peptide. [2] However, assessment of some of these criteria is not standardised Top of Form Search the BMJ[pic][pic] Bottom of Form • BMJ • BMJ Journals • BMJ Careers • BMJ Learning • Evidence Centre • BMJ Group [pic] [pic] [pic] [pic] [pic] [pic] Home | Log in | Athens...
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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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...Heart Failure Christy Harding Western Governors University C155- Pathopharmacological Foundations for Advance Nursing Practice Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea, fatigue, dyspnea, cough with frothy sputum, peripheral edema, and decreased urinary output. Heart failure is caused by many conditions that damage the heart’s muscle. Any form of heart disease can lead to heart failure. A1. Pathophysiology Heart failure arises as a consequence of an abnormality in cardiac structure, conduction, rhythm, or function (Figueroa & Peters, 2006). Heart failure always begins with an index event. This event could be silent, as with the expression of a genetic mutation, or obvious, such as a myocardial infarction (Francis & Tang, 2003). Heart failure can be categorized into systolic ventricular dysfunction also known as systolic heart failure or diastolic ventricular dysfunction also known as diastolic heart failure...
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...case study on a current patient with heart failure being nursed in a community setting. Due to confidentiality and patient privacy, the patient discussed will be referred to as John¹. John is an 82 year old gentleman who lives alone in sheltered accommodation. John’s son and daughter live close and take it in turns to visit daily. John is an ex-smoker who gave up 20 years ago, has long standing hypertension and is overweight having a BMI of 30 kg/m. John was diagnosed with heart failure a year ago after being hospitalised three times in the space of four months. Stewart (2004) feels that a diagnoses of heart failure is problematic in older patients as their symptoms can often mimic other diseases. According to the National Institute for Clinical Excellence Guidelines (NICE) 2003, hospitalisation accounts² for 70% of the £716 million pounds spent on heart failure annually. In this assignment the physiology of the heart will be discussed and how heart failure affects its performance. John’s symptoms, medication and how his condition was diagnosed will be discussed³. John’s future care and how it will be managed along with who will be involved in his care4. NICE (2003) defines heart failure as a “complex syndrome” that results from any structural or functional cardiac disorder that impairs the ability of the heart to function as a pump to support a “physiological circulation”. Tendera5 (2005) states that heart failure is common in older adults and occurs...
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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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...Congestive Heart Failure Armi Gonzales Western Governors University Congestive Heart Failure A. Investigated Disease Process Congestive Heart Failure is a condition in which the heart is unable to pump a sufficient amount of blood for the body to function. If the heart’s ability to pump blood decreases, blood and fluids may start to pool into the lungs and accumulate in the legs, ankles, and feet causing an edema, shortness of breath, and fatigue. (Heart Failure, 2015, para. 2) The American Heart Association and American College of Cardiology defines heart failure as “a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricles to fill with or eject blood” (King, Kingery, & Casey, 2012, p. 1). Heart failure can be seen as a widespread disease, affecting around five million Americans. (Titler et al. n.d.) It is a chronic condition that is disabling and costly and common to our aging population. With the advancement in therapy and early diagnosis, survival increases from previously fatal acute cardiac events to patients feeling better and living longer. Millions of Americans living with heart failure are 65 years of age or older. (Roger et al, 2004) A1. Pathophysiology The Circulatory system focuses on the heart, a muscular organ that pumps blood through a complex network of blood vessels throughout the body. Blood that is pumped from the heart carries oxygen and nutrients that fuel...
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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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...Treatment of Congestive Heart Failure Nicole Martin North Island College Congestive Heart Failure Left heat failure, also known as congestive heart failure (CHF), is an imbalance in pump function in which the heart is failing and unable to do its work pumping enough blood to meet the needs of the body’s other organs. CHF is commonly thought of as a disease but in fact is a syndrome. A syndrome as defined by Mosby’s Dictionary, as “a complex of signs and symptoms resulting from a common cause or appearing in combination, to present a clinical picture of a disease or inherited abnormality” (Mosby, 2009). Heart failure usually develops slowly, often over years, as the heart gradually loses its pumping ability and works less efficiently. CHF affects individuals in different ways and to different degrees. It is usually a chronic disease and gradually becomes worse over time. Many people are not even aware of their condition until symptoms appear years after the heart began its decline. There are many causes, risk factors, and signs & symptoms that help determine if someone is at risk of developing CHF or already living with CHF. Nearly 500,000 Canadians are currently living with the condition, with 50,000 new cases diagnosed each year. With such high numbers of people diagnosed with CHF, I believe as a future nurse it will be beneficial to have a greater understanding as to how CHF develops, how it is treated, and how it is management. Etiology The etiology...
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...Ellen Diane Windham 11/8/15 Case Study: CHF Helen Montgomery * An 83-year-old female presents to ambulance crew after an episode of sudden weakness. A GP is on scene and has assessed the patient, deciding on hospital admission by ambulance as a matter of urgency. History Patient became very weak and was put to bed by NOK. Her breathing became very laboured and the NOK called for the local GP out-of-hours service to attend. The doctor was on scene within 15 minutes, and upon assessing the patient requested an ambulance transfer to the ED. Initial Clinical Findings * Airway – clear & patent * C Spine – not indicated (MOI/NOI: episode of weakness) * Breathing – tachypnoeic * Circulation – Pulse present, irregular, tachycardic; skin colour normal, cap refill normal * Disability – No LOC before ambulance arrival, patient responding to verbal stimuli Clinical Impression * ? Exacerbation of CHF * ? CVA * ? Post-seizure AMPLE History * A – Allergic to penicillin * M – Currently taking Warfarin, Furosemide * P – History of CVA x 1 year, CHF * L – Last oral intake 7pm the evening previous * E – Son stated patient became very weak before going to bed Observations * Pulse rate 110bpm * Pulse rhythm Irregular * ECG rate 116 * ECG rhythm A Fib * Resp rate 24 per...
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...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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...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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...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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...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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...Heart failure or Congestive Heart Failure (CHF) is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped or is about to stop working. It means that your heart is not able to pump blood the way it should. It can affect one or both sides of the heart ("Congestive Heart Failure | Heart Failure | CHF | MedlinePlus," 2017). Heart failure is a collection of signs and symptoms reflecting a physiologic change in the hearts ability to keep up with demand. Heart failure is considered a global pandemic and is a complex disease that oftentimes is progressive. Heart failure is often associated with underlying coronary atherosclerosis, and its associated risks, including...
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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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