Left heart failure

  • Category:
    Nursing
  • Document type:
    Assignment
  • Level:
    Undergraduate
  • Page:
    2
  • Words:
    1192

7Left Heart Failure

Left Heart Failure

Mrs. Brown, 78 years old

oncept map

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LEFT HEART FAILURE

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Question 1

Pathogenesis

Mrs. Brown is a 78 year old woman was admitted to the emergency department after waking up with severe breathlessness. She had a history of heart failure and this is one of the most probable causes of the condition. Heart attacks usually results to poor left side heart function (Drummond, et al, 2011). High blood pressure is also a major cause of the problem when it is not well managed. Mrs. Brown had a blood pressure of 170/95 mmHg which is an indication that she was suffering from high blood pressure. The high blood pressure is usually in response to the lack of oxygenated blood on the other parts of the body (Hu, & Xu, 2011). This action strains and stresses the heart leading to an increase in the blood pressure. Other probable cause of the condition includes high alcohol consumption as well as heart muscle infection. It is however important to note that there is no record of alcohol consumption by Mrs. Brown.

The left side of the heart usually receives blood that is rich in oxygen from the lungs. It then pumps it to the remaining side of the body. A decrease in the ability to pump blood from the left side of the heart due to the different causes results to the failure to supply oxygenated blood to the other parts of the body (Singh, et al, 2013). Fatigues set in and the pressure in the veins of the lungs increases and it may cause fluid accumulation in the lungs. This finally results to shortness of breath and pulmonary edema which was experience by Mrs. Brown before being taken to the emergency department. An abnormal heart motion can also be felt through touching the chest wall (Daviglus, et al, 2012). Listening to the heart may also reveal murmurs or cracking sound. In the case of Mrs. Brown, crackles were revealed in the lungs through the physical examination. The physical examinations also reveal an increase in the breathing rate as well as the blood pressure.

Left heart attack is usually manifested through various symptoms on the patient. This includes waking up due to shortness of breath which was experienced by Mrs. Brown. The patients also portray the symptoms of fatigue and general body weakness. The pulse may also be rapid or irregular in some cases. Mrs. Brown had an irregular pulse rate which was 110 beat per minute. Other symptoms include coughing frothy or blood-tinged mucus. The chances that the heart will fully recover are quite minimal. The condition of the patient can however remain stable for many years if the condition is controlled well by medication (Tonetti & Dyke, 2013). This condition affects millions of people every year. The prevention mainly involves the modification of the lifestyle. The dietary guidelines have to be strictly adhered to. Eliminating smoking and alcoholic consumption are the main prevention strategies. The individuals should also ensure that they carry out regular exercises.

Question 2

Mrs. Brown requires immediate nursing strategy in order to ensure that her condition is improved. The management is mainly for the purposes of relieving the stress on the heart and reducing the risk of worsening heart failure. Medication can be used for the purposes of management. Different types of medication can be administered to the patient immediately in order to ensure that her condition stabilizes. The medicines include beta-blockers, digitalis, diuretics, spironolactine, digoxin and ARBs (Bullock, & Manias, 2014). Each of the medicines has a different function and it is aimed at improving on the condition of Mrs. Brown. Left heart failure is one of the most common types of heart failures. It is a serious condition that has the ability of resulting to early death. The ability to recover from the condition is dependent on various factors including age, cause and ability to tolerate exercise. In case the condition of Mrs. Brown worsens, cardiac catheterization can be carried out to unblock the heart arteries. The patients will also be advised to carry out moderate exercise, eat less salt and avoid the consumption of alcohol after being discharged from the hospital (Mendis, et al, 2011). The lifestyle change is an important aspect that can be used to manage the condition after the discharge from the hospital.

Question 3

Furosemide is a type of diuretics that is commonly used in case of the left heart failure. This drug is useful in terms of getting rid of the extra fluids in the body. This is achieved through reducing the intravascular volumes. This leads to the decrease in central venous pressure. It increases the venous capacitance which leads to fluids returning to circulation (Bullock, & Manias, 2014). Glyceryl trinitrate is mainly used for the treatment of angina. It has the ability of reversing angina once it has started and hence reducing the pain and the heart attack. This is achieved by supplementing blood concentrations of nitric oxide. This drug is only efficient when used for a short time as the body usually develops resistance.

The use of the drugs has some adverse effects that may further complete the health of the patient and hence the need for monitoring. The adverse effects of that will be monitored for Furosemide includes hypokalemia which results from increased sodium delivery. The other adverse effects include hypomagnesaemia and hyponatremia. When administering glyceryl trinitrate includes severe headache, severe hypotension, bradycardia and necessitating analgesic (Bullock, & Manias, 2014). The long term adverse effect includes nitrate tolerance. The adverse effects have to be well monitored as it may result to long hospital stay or fatalities.

The therapeutic effects of the drugs will mainly be monitored based on the improvements in the symptoms of left heart failure. An improvement in the symptoms within the first 24 hours will be an indication that the drugs are working well. However, in the event that the symptoms continue to remain the same or worsen after the administration of the drug, urgent steps have to be taken. The failure of the symptoms to improve is an indication that the patient is not responding well to the drug (Bullock, & Manias, 2014).

References

Drummond, G.R., et al., (2011). Combating oxidative stress in vascular disease: NADPH oxidases as therapeutic targets. Nat Rev Drug Discov
10, 453–471.

Hu, Y., & Xu, Q. (2011). Adventitial biology: differentiation and function. Arterioscler Thromb Vasc Biol
31, 1523–1529.

Singh, G. M. et al. (2013). The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PloS one, 8(7), e65174.

Daviglus, M. et al. (2012). Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. Jama, 308(17), 1775-1784.

Tonetti, M. S., & Dyke, T. E. (2013). Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of clinical periodontology, 40(s14), S24-S29.

(7th ed.). Frenchs Forest, NSW: Pearson Australia. Fundamentals of pharmacology Bullock, S., & Manias, E. (2014).

Mendis, S. et al. (2011). Global atlas on cardiovascular disease prevention and control. World Health Organization.