Congestive heart failure (CHF) is a situation where the heart is not able to pump adequate blood to the other organs of the body. Causes of CHF are coronary artery disease, past myocardial infarction, hypertension, heart valve disease, cardiomyopathy, congenital heart defects, endocarditis and myocarditis (American heart association, 2013) . In the case scenario of Mr. P 76 year old man comes with the history of cardiomyopathy and CHF and in the past repeatedly admitted for the management of CHF symptoms. This essay discusses about approach to care, treatment plan, patient and family education and teaching plan that is given to Mr.
P. Approach of Care In this given case scenario, Mr. P not only has medical problem he also has some psychological and social problems as well. The client present with difficulty in breathing, pulmonary crackles and pitting edema, depression, hopelessness and in addition non-complaisance with treatment and face some financial problems. To manage Mr. P’s condition well, comprehensive approach of care is very important which includes medical, psychological, social and financial support. Mr. P needs must be transferred to an acute care setting where his clinical symptoms will be taken care of.
Detailed education about the patient’s prognosis and treatment plan, emotional support and dietary counseling will help the patient to stick to health treatment and life style recommendations. In addition social worker referral to be made to aide with financial issues for Mr. P. Moreover considering Mr. P to cardiac rehabilitation program reference is very important for emotional support and psychological well being. Arranging for home visiting nurse would be highly recommended for Mr. P which could facilitate him to be complaint to his medications management and an issue of polyphamacy (Paul, 2008).
Treatment plan The main goal of the treatment plan is to remove the accumulation of excessive body fluids which causes myocardial contraction due to its intensifying force. (Monhan et al. , 2007). This done by providing adequate rest and administering proper medications. The first and foremost administration of concentrated oxygen is very important to relieve dyspnea and hypoxemia, continuous pulse ox monitoring and heart monitoring,12-lead EKG,Xray chest ,blood test and intravenous access for intravenous medications.
The medications used to treat CHF include loop diuretics to remove excess fluids Beta blockers used to reduce the myocardial workload . The isotropic agents given to increase the contacting force of the heart muscles. Morphine is given to relieve pain and anxiety. In addition anti depressants should be administered as per patient’s condition and psychologist’s order. Diet with restricted sodium and fluids to be advised (Monahan et al. , 2007). In addition patient evaluation done by continuous vital signs and cardiac monitoring.
Patient and Family Education Since Mr. P is 72 years old with diagnosis of CHF and history of multiple admissions to the hospital, patient and family education is very vital to prevent further frequent episodes of readmissions. Mr. P and his wife need to be educated through multidisciplinary team approach which emphasis on medication compliance, daily weight monitoring, fluids and sodium restrictions, daily activity as tolerated, understanding of signs and symptoms of the disease worsening and seek medical aid when needed(Paul, 2008).
Teaching plan: Verbalization of understanding of teaching by patient and family is very important, so that we can be sure that teaching technique is effective. Teaching can be done with large print material, video shows and pictures . Other useful techniques such as keeping list of medications in medication box or cabinate, printed information about signs and symptoms of worsening disease along with provider’s contact numbers could be placed at any visible place.
Supplicate with list foods which need to be avoided with pictures and information’s so that it helps the patient to avoid eating and shopping those food items. Provide information if necessary help the patient to join social support groups and cardiac rehabilitation for further management of the disease (paul,2008). Frequent phone calls are made to the patient as a reminder for follow up medical check ups. Conclusion HF is progressively more general situation that results in substantial morbidity, mortality, and use of medical resources, particularly amongst elder Americans (American heart association, 2010).
Education plays a key role in preventing frequent readmissions to the hospital. More over adequate knowledge about the disease and social support will improve the living status. It is extremely vital for clients to comprehend and distinguish the alterations in their capacity to uphold standard performance and acquire health care support with any deterioration symptoms. Being submissive with treatment plan and diet are the main features of successful management of CHF.