Question

ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care ACTIVE LEARNING TEMPLATES THERAPEUTIC PROCEDURE A11
ONE TEMPLATE ON CONGESTIVE HEART FAILURE AND ONE ON DIABETES

Answer 1

A. Congestive heart failure

Alteration in health(Diagnosis)-Congestive heart failure

Pathophysiology related to clients problem-Congestive heart failure is a syndrome that can be caused by abnormalities such as pressure ,volume overload,primary muscle diseases, peripheral demands.In heart failure heart muscles has reduced contractility.This produces a reduction in cardiac output which becomes inadequate to meet the peripheral demands of the body.The determinants of left ventricular performance are altered as follows,

• Decrease in the muscle contractility
• preload or left atrial filling pressure is increased resulting in pulmonary congestion and dyspnea
• increased systemic vascular resistance which can further reduce cardiac output.
• heart rate is increased as a part of compensatory mechanism associated with an increase in sympathetic tone and circulating catecholamines.

An increase in heart size may be particularly deleterious by increasing wall tension because of increase in myocardial oxygen consumption.

Health promotion and disease prevention in congestive cardiac failure is by

• Early detection and treatment of high blood pressure,high cholestrol
• Avoid cigarette smoking
• Prompt management of Diabetes
• Follow healthy diet and physical activity
• Prompt management of over weight and obesity

ASSESSMENT

Risk factors of congestive heart failure include

1. Hypertension
2. Myocardial inraction
3. Abnormal heart valves
4. Enlargement of heart
5. Family history of heart disease
6. Diebetes

Diagnostic procedures

• Review of medical history
• Electrocardiogram
• Chest X ray
• Exercise test
• Cardiac catheterization

Expected findings

• Shortness of breath
• swelling of the feet and legs
• lack of energy
• Difficulty in sleeping at night
• cough with frothy mucus
• increased urine output at night
• confusion
• impaired memory

Laboratory tests

• Natriuretic peptides-low concentration rule out heart failure.
• renal function tests to evaluate kidney disease
• Trop I or Trop T-to rule out ischemia or myocyte damage
• Lipid profile elevated
• Iron studies-suspected iron overload

PATIENT CENTERED CARE

Medications-

• ACE inhibitors
• beta blockers
• Anticoagulants
• Diuretics

Therapeutic procedures

1. Cardiac resynchronisation therapy-devices sends tiny electrical pulses to the lower chambers of heart to help them to beat more synchronised fashion
2. Heart surgery-To repair or replace the valve

Nursing mangement

• Monitoring health status of the patient including haemodynamic status
• Prompt self management
• Improve quality of life
• Provide education to the patient anf family
• Observation of the respiratory status and propped up position in breathing difficulty
• Cvp monitoring
• Temperature and daily weight monitoring
• A strict fluid balance
• Nutritional assessment and pressure ulcer assessment

Client education

• regular and prompt use of medications
• Nutrition,and healthy diet to be followed
• Regular exercise programme
• Information about physical aspects of heart failure
• Provide information about the understanding of heart failure

complications

1. Pulmonary complications-pneumonia,pulmonary embolism,
2. Stroke
3. Organ failure
4. Sudden death
5. Cardiac arrythmias