Describe four cardiovascular conditions that may lead to heart failure

Describe four cardiovascular conditions that may lead to heart failure

Obesity – Mrs. J is overweight (210.5 lb). Obesity can cause congestive heart failure. Left Ventricular hypertrophy is very common in patients with obesity.

High Blood Pressure – Mrs. J has a history of high blood pressure. The history of years of high blood pressure probably caused damage to the artery walls. The constant pushing on the walls of the arteries probably weakened her heart.

Atrial Fibrillation – Mrs. J is currently having atrial fibrillation. This means that the heart is not pumping enough blood to meet the needs of the body. This can lead to heart failure because the heart is beating so fast and working so hard that the heart doesn’t fill-up properly to pump blood to the body. The blood then can back up in the pulmonary veins which cause fluid buildup which Mrs. J is currently experiencing. Mrs. J is also has fatigue and dyspnea due to lack of rich oxygenated blood that is not being delivered to her body and brain (American Heart Association, 2015).

Coronary Artery Disease – Coronary artery disease is the most common form of heart disease and heart failure. It is the accumulation of fatty deposits buildup that causes reduction in blood flow, weakening the heart, and causing permanent damage to the heart.

And what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Obesity Intervention – Establish short and long term goals, encourage calorie intake appropriate for body type and lifestyle, encourage Mrs. J to keep a daily log of food and liquid consumption. Encourage Mrs. J to be more aware of nutritional habits that may contribute to weight gain. Encourage Mrs. J to exercise and encourage consultation of a dietician for further assessment and recommendations regarding a weight loss program. Educate Mrs. J of the importance of routine follow-up MD visits.

High Blood Pressure – Mrs. J has been smoking two packs of cigarettes daily for the last forty years. Smoking cause’s blood pressure to rise but the chemicals in the tobacco causes damage to the lining of the artery walls causing arteries to narrow, increasing the blood pressure. Educating the patient with the outcome of smoking is beneficial. Mrs. J needs to be educated on the importance of taking her blood pressure on daily and keeping a log of the blood pressure reading. Mrs. J should be placed on a low sodium cardiac diet. Educating Mrs. J on the importance of taking her medication on a daily basis as prescribed to prevent organ damage. Informing Mrs. J that lifestyle adjustment must be made to reduce the risk of cardiovascular morbidity. This is not a short term goal and it will take time for patients to get use to the lifestyle change and nursing follow is important for the patient to feel supported and follow the program.

Atrial Fibrillation – Atrial fibrillation is the loss of synchrony between the atria and ventricles. The goal is to maintain adequate cardiac output and tissue perfusion to make sure Mrs. J does not develop a thromboembolism. Monitoring the heart rate is very important and making sure that the systolic rate does not go below 90mmHg. Mrs. J should be educated on reporting any chest discomfort in which oxygen therapy would be beneficial. Continuous cardiac monitoring is imperative. Also making sure Mrs. J receives education on medications such as Amiodarone or Digoxin to control the atrial fibrillation. Educate Mrs. J how to obtain her own pulse and recognize symptoms of toxicity.

Coronary Artery Disease – is the accumulation of plaque buildup on the coronary arteries which leads to blockage. The heart is deprived of oxygen due to the blockage and is unable to pump efficiently. Very important to access patient level of consciousness, evaluate for chest pain, assess heart rate, blood pressure, peripheral pulses, and evaluate skin color and temperature. Provide oxygen in conjunction with medication therapy. Monitor fluid volume to prevent overloading the heart and lungs Reduce anxiety by providing Mrs. J to share her fears or concerns. Provide a quiet environment and uninterrupted sleep.

Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients.

Intervention: Interview Mrs. J to obtain a complete drug history that includes prescribed, OTC, home remedies, herbals, vitamins, and any drug allergies (Ackley & Ladwig, 2011).

Rationale: This will help the healthcare provider identify any potential side effects that might occur with the medications, OTC, home remedies, herbals, vitamins, or drug allergies (Ackley & Ladwig, 2011).

Intervention: Teach Mrs. J how to make a list of each medication, including the name, strength, appearance, purpose, and effects (Ackley & Ladwig, 2011).

Rationale: Educates the patient on the reason for taking the medication and what to look for(Ackley & Ladwig, 2011).

Intervention: Question Mrs. J on her self-medication practices. How does Mrs. J remember to take her medication? Does she forget to take her medication and what does she do when she remembers (Ackley & Ladwig, 2011).

Rationale: This allows the healthcare provider know if Mrs. J is over or under medicating herself (Ackley & Ladwig, 2011).

Intervention: Determine if Mrs. J is capable of administering medications (Ackley & Ladwig, 2011).

Rationale: There might be a physical impairment, memory loss, health, cultural beliefs, financial constraints, or social support lacking (Ackley & Ladwig, 2011).