TEST BANK MATERNITY AND PEDIATRIC NURSING 3RD EDITION BY SUSAN RICCI, THERESA KYLE, AND SU, Exams of Nursing

Download TEST BANK MATERNITY AND PEDIATRIC NURSING 3RD EDITION BY SUSAN RICCI, THERESA KYLE, AND SU and more Exams Nursing in PDF only on Docsity! AH1 Congestive Heart Failure Case Study/2023.Qualified Virginia State University Objectives: At the end of this lecture the student will be able to: 1. Define congestive heart failure. Congestive heart failure also known as CHF is a chronic progressive condition that affects the pumping plow power of your heart muscle this also is known as heart failure. chronic heart failure could also be referred to as the stage in which fluid builds up within the heart and causes it to pump insufficiently. 2. Describe the signs and symptoms of congestive heart failure (CHF) Congestive heart failure is a coronary artery disease some of the symptoms of CHF would be high blood pressure also known as hypertension this could be due to longstanding alcohol abuse, you could also have diminished exercise capacity which is another word for feeling fatigued. due to individual feeling fatigue it's also possible that a person could have shortness of breath. if you have typically right sided heart failure you could also have swelling in edema in your lower extremities. 3. List nursing interventions for this patient Some nursing or physician interventions that we might be able to do as medical providers to diagnose congestive heart failure would be 1st hey careful a physician's examination how long with selected laboratory test. knowing the patient's history and background would also be imperative. If the patient tends to have swelling or adima in the lower extremities you could have the patient the rise their feet up that will alter the swelling you could also place compression socks on the patient's legs. If the patient is having shortness of breath, then it would be vital to AH1 CONGESTIVE HEART FAILURE CASE STUDY QUESTIONS AND ANSWERS RATD A+ DOWNLOAD TO SCORE A make sure the patient has an order of oxygen being supplied to the body this is due to the heart being a unable to pump the adequate amount of blood throughout the body which may cause the patient to not be able to breathe this is also another sign and symptom of left sided heart failure. Molly Sawyer is a 66 year old female that arrives in the Emergency Room per EMS. She complains of shortness of breath for 1 week which seems to have gotten worse today. Ms. Sawyer complains of persistent cough especially at night. Allergies: NKDA Medications: Clonidine Digoxin Insulin 70/30 and Regular History: DM (Diabetes Mellitus) HTN Heart problems Assessment: Nail beds dusky Sitting upright AH1 CONGESTIVE HEART FAILURE CASE STUDY QUESTIONS AND ANSWERS RATD A+ DOWNLOAD TO SCORE A With the information and asking about her medication she takes I would suspect the patient has congestive heart failure. 2. Describe the pathophysiology of CHF (congestive heart failure). With congestive heart failure there are several reasons that can cause one to have congestive heart failure this could include the pressure and volume overload on the heart it also could be due to the abundance of muscle or even the loss of muscle that could be presented in the heart. There also could be excessive peripheral demand such as high output failure. With left sided headed failure, you cannot effectively pump from out of the centrile into the aorta and the systemic circulation. When you have left sided heart failure you typically have signs of difficulty breathing. Within the case of our patient, she came into the hospital and had difficulty breathing as, the patient O2 sat was at 95% however the patient came in within shortness or breath and she had stated that her shortness of breath has gotten worst within the last week, which is one of the chief complaints why the patient came into the hospital. When you have left sided heart failure you will have difficulty breathing you have blood that is being backed up into the heart, which causes a backup in the lungs. This means the body is not getting the adequate amount of oxygen to the body. When you have right sided heart failure this is when you have swelling into the lower extremities, when it get worst enough you will also have jugular vein distention. “Systolic HF results in decreased blood ejected from the ventricle. The decreased blood flow is sensed by baroreceptors in the aortic and carotid bodies. The sympathetic nervous system is then stimulated to release epinephrine and norepinephrine” (Hinkle J., & Cheever K. H. 2017, Pg. 820,821) 3. What are the signs and symptoms of heart failure? AH1 CONGESTIVE HEART FAILURE CASE STUDY QUESTIONS AND ANSWERS RATD A+ DOWNLOAD TO SCORE A Some of the signs and symptoms of congestive heart failure is having difficulty breathing when your having left sided heart failure. Fluid is backed up into int other lungs and the patient will normally have shortness or breath. When you have shortness of breath your body becomes depleted of oxygen, this will usually cause fatigues and weakness. This will also cause a person to possible have sever and extreme anxiety because of the lack of oxygen that the person isn’t getting. Due to them not being able to breath a person could also be experiencing tachycardia which is an increase of a person heart rate due to the fact that they are unable to breath. If this was the cause with our patient I would also see if the patient was tri podding trying to catch their breath. You could also look at a person’s lips or fingertips to see and see if a person lips are presenting blue and or if the person is having any clubbing in their fingertips. When you have right sided heart failure you normally have fluid back up which will cause swelling. There could also be fluid that is leaks out into the intercellular space. Due to having heart failure, you also could have irregular heart beats and a persistent cough or wheezing, with the persistent cough you could have pink blood-tinged phlegm. (Hinkle J., & Cheever K. H. 2017, Pg. 822) 4. What pharmacologic agents are used to improve cardiac performance in patients with CHF? I believe there are several Asians that might help congestive heart failure improve their cardiac output. Some of these different agents on medications that assist with the congestive heart failure and the cardiac output, your diuretic medication will help with the preload of the heart. vasodilators will help with the after load not the heart as well as the reduction. Digoxin is something that the patient is also taking this can improve the cardiac output within the patient's heart. You have medications like in the tropic agents that will help to restore organ perfusion but this is based upon the organ itself. You also have medications that are anti coagulants to decrease AH1 CONGESTIVE HEART FAILURE CASE STUDY QUESTIONS AND ANSWERS RATD A+ DOWNLOAD TO SCORE A the risk of clots, running to the bloodstream this could be two different types of plots which could be an thrombosis clot or it could be a pulmonary embolism. Beta blockers are another medication that would help during congestive heart failure typically your beta blocker one will help with the heart while you're better blocker two will help with the lungs. Some of your after- load medications could be your angiotensin ace inhibitors calcium channel blockers receptor II block and your phosphodiesterase -3. These medications will help the heart pump a lot more easily. (Hinkle J., & Cheever K. H. 2017, Pg. 823,824,825) 5. What factors contribute to the patient’s heart failure? Congestive heart failure is a coronary artery disease some of the symptoms of CHF would be high blood pressure also known as hypertension this could be due to longstanding alcohol abuse, you could also have diminished exercise capacity which is another word for feeling fatigued. due to individual feeling fatigue it's also possible that a person could have shortness of breath. Patient is having shortness of breath throughout the day or night it's very well possible the patient will also have sleep apnea and not being able to get the proper sleep and rest throughout the day and or night. if you have typically right sided heart failure you could also have swelling in edema in your lower extremities. As you assess the patient and patient could be displaying jugular vein distention. Although a person might be having the signs and symptoms of congestive heart failure during this time, they could also have many heart attacks, which then they might be experiencing other manifestations. but this could further along the damage of the muscles of your heart. with everything that's going on within the body I would imagine you're more susceptible to getting sick because your body is trying to compensate for the heart but it's also weakening your immune system at the same time which is leaving you open to getting sick with bacteria or a viral infection. (Hinkle J., & Cheever K. H. 2017, Pg. 827,828) AH1 CONGESTIVE HEART FAILURE CASE STUDY QUESTIONS AND ANSWERS RATD A+ DOWNLOAD TO SCORE A