Case Study 2
Max Points: 50
In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.
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Case Study 2\r\n\r\nCase Study 2\r\nMr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.\r\n\r\nQuestion\r\nConsidering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:\r\n• Describe your approach to care.\r\n• Recommend a treatment plan.\r\n• Describe a method for providing both the patient and family with education and explain your rationale.\r\n• Provide a teaching plan (avoid using terminology that the patient and family may not understand).
Congestive Heart Failure
Congestive heart failure is a condition whereby the heart inadequately pumps blood to other body parts. Main causes of this condition include coronary artery diseases, heart valve disease, congenital heart defects, past myocardial infarction, hypertension and endocarditis. This case scenario involves Mr. P, whose medical history reflects cardiomyopathy and CHF, following repeated admissions at the healthcare unit for managing his condition of CHF symptoms. My essay will focus on approaches to care, treatment plan, patient and family education and teaching plan that should be given to Mr. P for controlling his condition.
Approach to Care
Mr. P has both medical, psychological and social problems. The client was presented with depression and hopelessness, pulmonary crackles, breathing difficulties, pitting edema and failure to comply with treatment patterns ad financial issues (Aurigemma, 2015). Proper management of this condition will entail a comprehensive approach to care through provision of financial, psychological, social and medical support. The patient is also supposed to be transferred to an acute care setting, where his clinical related symptoms can be well managed. Provision of emotional support, detailed information concerning the patient’s diagnosis, treatment plan and dietary counselling is crucial in enabling the patient comply to his treatment and life style recommendations. Making of social worker referrals is important for eliminating his financial issues, alongside other cardiac rehabilitation programs for boosting psychological and emotional well-being of Mr. P. Organizing home visiting nursing schedules is equally recommended to ensure Mr. P adjusts to his medical management strategies.
A Treatment Plan
The treatment plan aims at facilitating removal of excessive body fluids to prevent their accumulation, which forms a major causative factor of myocardial contraction due to forces of intensification. This can be achieved through provision of adequate rest and proper administration of medications (Fisher et al., 2014). Administering concentrated oxygen will be key in relieving dyspnea and hypoxemia, continuous monitoring of pulse ox monitoring heart condition, blood test, X ray chest and access to intravenous medications.
The medications used for treating CHF comprise of Beta blockers for reducing myocardial workload and loop diuretics for removing excess body fluids. Increasing the contacting force of heart muscles can be achieved through provision of isotropic agents. Morphine is also administered for relieving pain and unnecessary anxieties. Moreover, anti-depressants are also crucial to monitor patient’s condition in a psychologist’s order (Norhammar et al., 2017). Consumption of diets with limited amount of fluid and sodium is equally important and finally, patient evaluation should be done basing on vital signs for cardiac monitoring.
Patient and family education
Considering Mr. P is 72 years old with CHF diagnosis, with his medical history displaying multiple admissions to the healthcare, provision of patient and family education is very relevant for preventing frequent readmission episodes. Use of multidisciplinary team approach in educating Mr. P and his wife will bring about emphasis on need for medical compliance (Norhammar et al., 2017), need for monitoring body weight, restrictions on fluids and sodium, need for daily exercises and proper understanding of disease signs and symptoms so that in case it worsens, one can readily seek medical attention.
Use of verbal means during teaching is important for clear understanding of concepts by patient and family, and make the entire teaching technique very effective. Teaching programs can be enhanced through use of large print materials, video showing and elaboration on pictures displayed. Medication lists, data on disease signs and symptoms alongside a provider’s personal information must be kept in an accessible place (Puckett et al., 2013). Moreover, supplicating lists of food stuffs that should be avoided with clear pictures and easily interpretable information will help patients avoid access to such type of resources. Rationalizing on importance of joining support groups on cardiac rehabilitation is a key strategy for better management of the condition.
Aurigemma, G. P. (2015). 4 ECHOCARDIOGRAPHIC ASSESSMENT OF THE PATIENT WITH KNOWN OR SUSPECTED CONGESTIVE HEART FAILURE. Color Atlas and Synopsis of Echocardiography, 95.
Fisher, S. A., Brunskill, S. J., Doree, C., Mathur, A., Taggart, D. P., & Martin-Rendon, E. (2014). Stem cell therapy for chronic ischaemic heart disease and congestive heart failure. Cochrane Database Syst Rev, 4(4).
Norhammar, A., Johansson, I., Thrainsdottir, I. S., & Rydén, L. (2017). Congestive Heart Failure. Textbook of Diabetes, 659-672.
Puckett, C., Shapiro, M., & Goodlin, S. J. (2013). Congestive heart failure. In Geriatric Imaging (pp. 235-257). Springer Berlin Heidelberg.