Congestive heart failure nursing care plan Assignment

Assignment Task

Purpose

The purpose of this assignment is to enable students to work through one selected case study to identify problems and issues in a scenario, to demonstrate their developing knowledge of theories and professional policies, and to make decisions and recommendations based on these to either prevent or solve some of the issues in that scenario focusing on examining the links between various course concepts and the client/family experiencing a chronic health challenge.

Assignment Details

You will be responsible for selecting and completing one of the attached case studies focusing on examining the links between various course concepts and the client/family experiencing a chronic health challenge. The case studies will depict a real-life clinical situation that you will need to collectively work through, responding to questions that reflect appraisal of knowledge and its application to nursing practice. Each response should be written in a scholarly fashion and supported by relevant course readings and other literature. As outlined below, you are expected to submit a professionally completed assignment with the required sections.

Question

1. What risk factors may have contributed to the development of this client's chronic condition? What is the rationale for each of the diagnostic tests? What is the relationship between the diagnostic tests and the underlying pathophysiology? How would you explain these tests to the client/family member?
2. Chronic health conditions impact individuals, partners, and family members. Explain the potential impact on the clients and their families. Support your answer with the literature.
3. Identify and describe three (3) relevant social determinants of health that can impact the client's illness experience. Support your selections with the literature.
4. 4. Develop a care plan to help the client manage their chronic illness. Include any health teaching. Provide support for this plan of care with the rationale for your plan. Include relevant assessment data, goals, interventions, and evaluation of your care plan.

Case study

Scenario 1

Congested Heart failure H.J. presented to the ER late one evening complaining of a “racing heartbeat.” She is an overweight, 69-year-old white female, who has been experiencing increasing shortness of breath during the past two months and marked swelling of the ankles and feet during the past three weeks. She feels very weak and tired most of the time and has recently been waking up in the middle of the night with severe breathing problems. She has been sleeping with several pillows to keep herself propped up. Five years ago, she suffered a transmural (i.e., through the entire thickness of the ventricular wall), anterior wall (i.e., left ventricle) myocardial infarction. She received two-vessel coronary artery bypass surgery 41 ⁄2 years ago for obstructions in the left anterior descending and left circumflex coronary arteries. Her family history is positive for atherosclerosis as her father died from a heart attack and her mother had several CVAs. She had been a three pack per day smoker for 30 years but quit smoking after her heart attack. She uses alcohol infrequently. She has a nine-year history of hypercholesterolemia. She is allergic to nuts, shellfish, strawberries, and hydralazine. Her medical history also includes diagnoses of osteoarthritis and gout. Her current medications include celecoxib, allopurinol, atorvastatin, and daily aspirin and clopidogrel. The patient is admitted to the hospital for a thorough examination Laboratory Blood Test Results Diagnostic Testing Chest X-Ray: Prominent cardiomegaly, Perihilar shadows consistent with pulmonary edema ECG : Sinus tachycardia with waveform abnormalities consistent with LVH, Pronounced Q waves consistent with previous myocardial infarction ECHO Cardiomegaly with poor left ventricular wall movement Care & Discharge After administration of low doses of the diuretics hydrochlorothiazide and triamterene, H.J. voided 4,500 mL clear, yellow urine during the first 24 hours and another 3,500 mL during the second day post-admission. Bibasilar “crackles” and dependent edema also subsided. The patient lost three pounds in total body weight. Vital signs were as follows: BP 115/80. P 88 and regular; RR 16 and unlabored; PaO2 (room air) 90; H.J. was discharged on day 4 with prescription medicines and orders to pursue a follow-up with a cardiologist as soon as possible

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