Running head: CASE STUDY 2 1 3 CASE STUDY 2 Congestive Heart Failure Case Study 2 This case study is about Mr. P, a 76 year old male, hospitalized usually to treat cardiomyopathy and congestive heart failure (CHF). The author describes the approach to care, treatment plan, method to provide education and a teaching plan about the CHF. Congestive heart failure is defined as “the state in which the heart is unable to pump blood at a rate adequate for satisfying the requirements of the tissues with function parameters remaining within normal limits usually accompanied by effort intolerance, fluid retention, and reduced longevity” (Denolin, 1983, p. 445). Approach to care · Assessment of patient: Physical examination of the patient (at each visit), with particular attention to assessment of their vital signs, cardiovascular system (including volume status), signs of deterioration and co-morbid conditions. · Assessment and management of the patient’s cardiovascular risk factors (e.g. hypertension, dyslipidaemia, diabetes, smoking and obesity). · Assessment of the patient’s nutritional status. · Assessment of the patient’s potential for adverse effects of medicines · Regular reassessment of the patient’s biochemistry (including urea and creatinine) and haematology (including haemoglobin) parameters. · Assessment of the patient’s daily fluid and salt intake from food and drink. · Ongoing monitoring of the patient’s electrolytes (particularly serum sodium and potassium levels) and renal function. · Monitor intake and output strictly and take daily weight. Treatment Plan CHF is a complex clinical syndrome; therefore, treatment plan includes the focus on the fundamental causes. Appropriate combination of medicines, control over lifestyle with careful monitoring is the basic treatment for CHF. · An Angiotensin-Converting Enzyme (ACE) inhibitor (captopril, enalapril etc) or an Angiotensin II receptor blocker (ARB) helps to relax the blood vessels and enhance the blood flow. · Beta-blockers (bisoprolol, carvedilol etc) reduce the blood pressure and stabilize the heart beat rate. · Diuretics (lasix, bumex etc) remove more sodium and water from the body, which helps in lowering blood pressure. Also, spironolactone and eplerenone called as potassium-sparing diuretics help to retain potassium. · Other drugs include anticoagulant, statin and digoxin as per doctor’s recommendation. Besides medication and diet alteration, devices and surgical procedures are available for the treatment of heart failure. An implantable cardiac defibrillator (ICD), coronary artery repair and valve repair or replacement (as appropriate) can be done (Heart.org, 2016). Education method Heart failure patients and their family members should acquire the education, problem solving abilities and motivation regarding the treatment plan, medications and effective participation in self-care. “Patient education and post discharge management have demonstrated be ...