Analysis Of Heart Failure Case Study

Introduction: Analysis Of Heart Failure

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In the meaning of heart failure, it happens when the heart cannot pump properly to get the oxygen-rich blood to reach the human body's needs. It does not mean that the heart has to stop or it is about to end. On the other hand, without sufficient blood flow the organs might not work properly and that can bring serious problems. In this study, the disease is about the victim Lynda Wicks. This study reports that she had an unplanned medication disease which is related within 72 hours to the hospital readmission of discharge after the surgical repair of the fractured Left femur. Here a list has been mentioned of the medication that she had following in the morning. After the discharge of her surgery, she felt unwell so she called her daughter. She had a breathing problem so in this case study there are points that have been mentioned about how she could survive this situation After the surgery she felt unsafe as she was not capable of standing properly she had to take some support.

However, her condition and which disease she had all details has been mentioned here. In that case, through those diseases, the study is about the patient's healthcare and how she could get the treatment properly and have better health easily and quickly. Moreover, after taking her to the hospital again she has been prescribed the new medicines which she has to follow thoroughly.

Heart Failure with Reduced Ejection Fraction (HFREF)

In this case study, Lynda has faced heart failure with reduced ejection fraction. When the left ventricular ejection fraction is near about 40% or less then the HFrEF happens and it is conducted by the continuing adverse cardiac remodelling and left ventricular dilatation. The assessment of heart failure has started with securing the physical examination and medical history (Sindone et al. 2022). As per the given case study Lynda was having a fractured left femur after 72 hours of her discharge from the first surgery. She is an 82-year-old woman of 82 years old and she was following the open reduction and internal fixation for the left hip fracture which happened at home after she had fallen. 12 months ago she faced heart failure with the HrrEF. After this experience, a silent anterior myocardial has been infected. From the medical history, she has the disease of hypercholesterolemia and hypertension so she has suffered that heart failure.

Her age is so important to get extra care about her health at this age is highly conserving for getting every disease according to the heart which is the most important for living. When she was admitted to the hospital for the first time she had her own independence and managed her own activities of her daily lifestyle when the medications were included (Lam et al. 2020). Currently, she is assembling the frame and needs pain relief regularly after the operation. Any analgesia has been included as she discharged the medications that were dispensed in the blister pack. She was advised by everyone to visit the pharmacy for the reason of over-the-counter, medications, and for taking Ibuprofen 400mg TDS (Ilyas et al. 2021). She was following medications like Enalapril 20 mg daily, Spironolactone 25mg daily, Atorvastatin 40 mg daily, Furosemide 40 mg daily, and Bisoprolol 10 mg daily which was contained by her blister pack.

After two days of discharge, she felt breathless and unwell, and she was having difficulties in the walking frame due to the ankles which were swollen so much that she phoned her daughter. As per further questioning from her daughter, she denied the pain she felt and said that she had managed this so well with the help of the new painkillers that the hospital had prescribed on discharge for her (Danielson et al. 2022). She admitted to feeling the breathing problem which has increased over the weekend and she needs to sleep properly at night in the recliner chair. On the scale, she had not felt safe standing so she had not considered herself on doing it. She had an appointment for Wednesday with her general practitioner the following week and then an outpatient has taken an appointment in the other two weeks with an orthopedic surgeon. On Sunday her daughter had decided to take her mother Lynda to the emergency department for a general review (Sindone et al. 2021). At that time on arrival at the hospital, Lynda was having BP 190/110, RR 28, HR 120, AE: diverse crackles auscultated bilateral lung fields, pitting edema bilateral legs, and SpO2 96% with 6L Oxygen through Hudson mask.

Medication Management for Heart Failure with Reduced Ejection Fraction (HFREF)

For heart failure medication management has to be more efficient as with the heart all things are dependent for living. Human beings are alive and breathing and breathing is related to the heart so human beings should take more care of their heart. In this case, study Lynda is a good woman who has faced heart failure She has gone through surgery and after the surgery, she felt many problems too as her age is also a huge number so that in that age surviving properly is more difficult (Butt et al. 2022). According to the case study, a peripheral intravenous cannula has been inserted and the blood has been taken too. In that case, she has been prescribed intravenous Furosemide 80 mg which has been managed with good effects. For the investigation, she has been admitted to heart failure with exacerbation. To avoid heart failure people should live a healthy lifestyle where they have to follow regular exercise, proper diet, and proper lifestyle.

They have to maintain their regular check-ups and follow the recommendations from their general physician. People have to do blood tests which could help them diagnose diseases that can infect the heart. From the blood test, people could also find out the specific protein that has been made by the blood vessels and heart. When the level of this protein has gone up heart failure has been caused. To not getting the disease about the heart people should do a chest x-ray which could help them to know the condition of the heart and lungs (Cistulli et al. 2023). Besides the x-ray, humans should check the electrocardiogram which is a painless and quick test method and it documents the electrical signals of the heart. It showed how the heart is beating fast or slow. On the other hand, they should do the echocardiogram as from this people could find out the sound waves which would create the images of the beating heart. From this test record people could find out the structure and size of the heart, blood flow, and heart valves that have been passed through the heart. However, ejection fraction is a quantification of the percentage of blood that leaves the heart each time it squeezes. This quantification has been taken during the echo diagram.

The test reports help to classify the heart failure and guide the further treatment. 50% ejection fraction or higher has been evaluated as ideal. But after all of these people still have the possibility of heart failure if the number has been taken ideal. The tests have involved riding a stationary bike or walking on a treadmill and at that time the heart has been observed. These exercise tests can give reports of how the heart acknowledges this physical activity (Prasad, Holland & Atherton, 2023). People should do the exercises rather than take the medicines. Moreover, this heart failure disease depends on daily exercise and diet people should follow these strategies in their lifestyles so that they can avoid heart failure.

Person-centred nursing care

The concept within the context of the study refers to Person-centred nursing Care, the term refers to the person-centred approach where each individual involved in the care is respectfully treated, and not just required to be treated. It is professional work to deliver health and social care to the patients. However, the study of Person-centred nursing Care deals with certain principles such as:

• It provides people the affordable dignity, respect and compassionate
• It helps offer treatment, which involves coordination between the people in care and support.
• It also offers the individual with personalized treatment, support and care.
• Person-centred nursing Care is one of the techniques of the nurses or the social care mentors in bringing back the strength and belief in their abilities to perform their daily activities independently and fulfil their needs of life all alone.

The seven core values that are provided to the patients are independence, rights, respect, dignity, partnership, privacy, individuality and choice. These factors rae given significance in Person-centred nursing Care, which helps the nurses to focus on the care that the individual requires. The importance of care has been highlighted within this context of the study as it helps in the rapid improvement of the patients by bringing back their independent lives (van Belle et al. 2020). This helps in reducing the burden of having someone’s care in fulfilling the needs of life. This also encourages the patients to make their own decisions which gradually increases their confidence to live their lives independently. The role of Person-centred nursing Care involves the empowerment of the patients to become self-independent.

The overview of Picker’s Eight principles of patient-centred care refers to the wide range of care facilities that are involved in the caring of patients. However, with these eight principles, the most significant role of care is to provide education to the patient about the treatment. The patients had the right to know all the health-related issues, the status related to the clinical process, and the progress and prognosis accompanied with this. The patient must be thoroughly informed about the process that would take place in the treatment of the patient (Solell & Smith, 2019). The study here gives significance to the nurse's role in the planning of the discharge of a patient. It is known that treatment within the hospital is given under the surveillance of the doctors and more than two care providers. But in case the patient is ready to go back home it is often required that the patient needs care. The planning of the discharge made by the nurse is crucial for the patient. However, being important it is also a critical part of the preparation of the discharge for a patient. The proper planning of the discharge involves certain factors and processes such as:

Referrals

The initial treatment that takes place in the hospital after the patient further requires care in the improvement of the health. However, following the initial treatment, the nurse is responsible for making the discharge plan according to the condition of the patient (McCormack & McCance, 2021). The planning involves the referrals of the patient and deciding the treatments such as primary care, home care and physical therapy.

Understanding of the procedures

Many times it has been observed that discharge planning nurses are not involved in the treatment procedures during their stay in the hospital. Therefore in that case the nurse must go through a detailed discussion about the planning with the doctors and nurses involved in the treatment of the patients. The plan must also be discussed with the patient’s family as in the procedure of healing the family plays a significant role.

Teaching

The responsibility of the nurse in planning the discharge is to teach the patient’s family the activities that they are required to perform in healing the patient. The simple procedure must be taught to the family by the nurse to help the patient cure.

Post-treatment preparation

The responsibility of the nurse is the planning of the discharge but be aware of the initial treatment of the patient. The preparation of the post-treatment refers to the devices and necessary devices required in the treatment.

The factors that may have contributed to the exacerbation of heart failure are:

• Excessive intake of salt due to insufficient knowledge
• Failure in the process of compilation
• Use of inappropriate medications

In the case of the patient that had been studied within this context of the paper is Lynda Wicks, who is about an 82-year-old woman who was admitted to the hospital due to her fracture of the left femur and was discharged after 72 hours of surgical observation. However, as she returned home she developed the problem of heart failure with reduced ejection fraction which had occurred 12 months ago. However, in her daily life, she faces pain and the report of her history about her health provides evidence that she had hypertension and hypercholesterolemia. After her discharge from the hospital within twio days she felt breathless for which she called her daughter and was again admitted to the hospital and found to the heart failure. The clinical guidance which had been observed in case of Heart Failure:

• Patients with heart failure should be assessed in the guidance with each encounter to help in the proper management (Carvajal et al. 2019). This also includes the medications that are required in the treatment and proper adjustment of Diuretics.
• The person who is facing the symptoms or is dealing with proper heart failure must have the proper screening of the physical and historical examination of heart failure.

According to Pirhonen et al. (2020), in this study, the concept of person-centred care along with heart failure cases is thoroughly studied. The benefit of the care by the burse is mostly cost-effective which helps in the maximum reduction in the costs of the healthcare visits and treatment. However, the study was performed in the primary way to get the data regarding the raised issue of the topic (Kim et al. 2022). The study concentrated on heart failure patients who are suffering from chronic diseases and for them the care by the nurse after the post-discharge of the patient is highly required.

Conclusion

The overall study of the context concludes with the importance of the nursing care of patients who are suffering from chronic heart failure diseases. Here, in the study, the overall discussion is based on the case study of a patient Lynda Wicks who had been suffering from a fracture of her left femur which resulted in heart failure as she returned home (McCormack & McCance, 2021). The case study reflected the improper planning of the discharge by the nurses who were engaged with her as she was discharged 72 hours later with no proper post-discharge requirements (Jaarsma et al. 2021). The study here discusses the detailed information and description of Heart Failure with reduced ejection fraction with the proper management of the medication that is required in Heart failure. As per the study the discussion was made on the Person-centred care of the nurse in treating the patients (Pirhonen et al. 2020). However, the study had described the scenario of the case study along with which the description of the care procedures had been thoroughly discussed within the context of the study. The education and the proper guidelines were provided within the study (Ali et al. 2020). However, the overall study helps in the proper understanding of the gaps that were observed in the treatment of Lynda Wicks, and the study fulfilled the gap with the proper explanation of the disease and its required treatment. This will be the proper guidance for future references.

References

• Ali, L., Wallström, S., Barenfeld, E., Fors, A., Fredholm, E., Gyllensten, H., ... & Ekman, I. (2020). Person-centred care by a combined digital platform and structured telephone support for people with chronic obstructive pulmonary disease and/or chronic heart failure: Study protocol for the PROTECT randomised controlled trial. BMJ open, 10(7), e036356. doi:10.1136/ bmjopen-2019-036356
• Butt, J. H., Dewan, P., Merkely, B., Belohlávek, J., Dro?d?, J., Kitakaze, M., ... & McMurray, J. J. (2022). Efficacy and safety of dapagliflozin according to frailty in heart failure with reduced ejection fraction: a post hoc analysis of the DAPA-HF trial. Annals of internal medicine, 175(6), 820-830. https://doi.org/10.7326/M21-4776
• Byrne, A. L., Baldwin, A., & Harvey, C. (2020). Whose centre is it anyway? Defining person-centred care in nursing: An integrative review. PLoS One, 15(3), e0229923. https://doi.org/10.1371/journal.pone.0229923
• Carvajal, A., Haraldsdottir, E., Kroll, T., McCormack, B., Larkin, P., & Errasti-Ibarrondo, M. B. (2019). Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review. https://doi.org/10.19043/ipdj.92.008
• Cistulli, P. A., Malhotra, A., Cole, K. V., Malik, A. S., Pépin, J. L., Sert Kuniyoshi, F. H., ... & Somers, V. K. (2023). Positive airway pressure therapy adherence and health care resource use in patients with obstructive sleep apnea and heart failure with preserved ejection fraction. Journal of the American Heart Association, 12(14), e028733. https://doi.org/10.1161/JAHA.122.028733
• Danielson, C., Lileikyte, G., Ouwerkerk, W., SP Lam, C., Erlinge, D., & Teng, T. H. K. (2022). Sex differences in efficacy of pharmacological therapies in heart failure with reduced ejection fraction: a meta?analysis. ESC Heart Failure, 9(4), 2753-2761. https://doi.org/10.1002/ehf2.13974
• Ilyas, F., Jones, L., Tee, S. L., Horsfall, M., Swan, A., Wollaston, F., ... & De Pasquale, C. G. (2021). Acute pleiotropic effects of dapagliflozin in type 2 diabetic patients with heart failure with reduced ejection fraction: a crossover trial. ESC Heart Failure, 8(5), 4346-4352. https://doi.org/10.1002/ehf2.13553
• Jaarsma, T., Hill, L., Bayes?Genis, A., La Rocca, H. P. B., Castiello, T., ?elutkien?, J., ... & Strömberg, A. (2021). Self?care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. European journal of heart failure, 23(1), 157-174. doi:10.1002/ejhf.2008
• Kim, J. M., Kim, N. G., & Lee, E. N. (2022). Emergency Room Nurses’ Experiences in Person-Centred Care. Nursing Reports, 12(3), 472-481. . https:// doi.org/10.3390/nursrep12030045
• Lam, C. S., Voors, A. A., Piotr, P., McMurray, J. J., & Solomon, S. D. (2020). Time to re the middle child of heart failure: heart failure with mildly reduced ejection fraction. European Heart Journal, 41(25), 2353-2355. https://doi.org/10.1093/eurheartj/ehaa158
• McCormack, B., & McCance, T. (2021). The person-centred nursing framework. In Person-centred nursing research: Methodology, methods and outcomes (pp. 13-27). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-27868-7_2#DOI
• Pirhonen, L., Gyllensten, H., Olofsson, E. H., Fors, A., Ali, L., Ekman, I., & Bolin, K. (2020). The cost-effectiveness of person-centred care provided to patients with chronic heart failure and/or chronic obstructive pulmonary disease. Health Policy OPEN, 1, 100005. http://dx.doi.org/10.1016/j.hpopen.2020.100005
• Prasad, S. B., Holland, D. J., & Atherton, J. J. (2023). Controversies and dilemmas in the diagnosis of heart failure with preserved ejection fraction. Medical Journal of Australia. https://doi. org/10.1136/heartjnl-2022-321609
• Sindone, A. P., De Pasquale, C., Amerena, J., Burdeniuk, C., Chan, A., Coats, A., ... & Atherton, J. J. (2022). Consensus statement on the current pharmacological prevention and management of heart failure. Medical Journal of Australia, 217(4), 212-217. https://doi.org/10.5694/mja2.51656
• Sindone, A. P., Haikerwal, D., Audehm, R. G., Neville, A. M., Lim, K., Parsons, R. W., ... & Liew, D. (2021). Clinical characteristics of people with heart failure in Australian general practice: results from a retrospective cohort study. ESC heart failure, 8(6), 4497-4505. https://doi.org/10.1002/ehf2.13661
• Solell, P., & Smith, K. (2019). If we truly cared': understanding barriers to person-centred nursing in correctional facilities. International Practice Development Journal, 9(2). https://doi.org/10.19043/ipdj.92.007
• van Belle, E., Giesen, J., Conroy, T., van Mierlo, M., Vermeulen, H., Huisman?de Waal, G., & Heinen, M. (2020). Exploring person?centred fundamental nursing care in hospital wards: A multi?site ethnography. Journal of clinical nursing, 29(11-12), 1933-1944. DOI: 10.1111/jocn.15024