Acute Care Nursing: CHF Risk Factors, Symptoms, Interventions

Acute Care Nursing
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Q.1.
Congestive heart failure (CHF) is a cardiovascular condition which is associated with
inability of heart to pump adequate amount of blood. Heart pump inadequate amount of blood
mainly due to narrowing of arteries and hypertension. Risk factors of CHF include old age,
high cholesterol level, diabetes, hypertension and smoking. Age of Mckenzie is 77 years;
hence, her age could be the risk factor for CHF in her. 2 and 5 % people of age between 41 -
60 and 61 – 70 respectively are at higher risk of CHF. Alcohol intake, family history,
inadequate physical activity and obesity are also responsible for CHF. Hypertension is one of
the significant risk factors for CHF. Likewise, Mckenzie is also detected with hypertension.
In comparison to the normal females, hypertensive females are 4 times are at higher risk of
CHF. Moreover, females (60 %) are at higher risk of CHF in comparison to males (40 %)
(Mahmood and Wang, 2013). High levels of low-density lipoproteins and low levels of high-
density lipoproteins are risk factors of CHF. Intake of high amount of saturated fat is mainly
responsible for CHF. β-type natriuretic peptides at the higher side are also responsible for
CHF (Mirkin, Enomoto, Caputo, and Hollenbeak, 2017). 36 and 20 % people associated with
active smoking and obesity respectively are susceptible to CHF (Australian Institute of
Health and Welfare (2014).
Cardiovascular disease conditions like coronary artery disease (CAD), myocardial infraction
(MI), arrhythmias, cardiomyopathy, defective heart valves and myocarditis are responsible
for the occurrence of CHF. MI in case of Mckenzie, might increase chances of CHF.
Consumption of medicines like antidiabetic medicines (rosiglitazone and pioglitazone),
nonsteroidal anti-inflammatory drugs (NSAIDs) (rofecoxib and celecoxib), anaesthetic and
anticancer might produce CHF (Castillo, Edriss, Selvan, and Nugent, 2017). It has been
reported that people with CHF might not survive more than 5 years after its diagnosis. In
comparison to the normal people, death rate might be 10 % more in people with CHF
(Australian Institute of Health and Welfare, 2014).
Mckenzie is associated with cardiovascular and respiratory dysfunction. Hence, she
might not be able to carry out her daily activities. It is necessary for her to take support from
family members. In addition to support her in activities, family members should observe her
daily activities. It might extend emotional and psychological strength to her. Family members
might experience financial burden and psychological stress due to her diseased condition.
Speedy recovery of Mckenzie could be effectively achieved through monitoring her
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medications, diet and risk factors by family members and care staff. Positive communication
is one of the important factors for the recovery of older people; hence, family members and
staff members need to develop positive communication with her (Raman, 2016).
Q2. :
Symptom Pathophysiology
Dyspnoea CHF is associated with decreased cardiac output. As a result, there would
be less blood supply to different parts of the body including skeletal
muscle. Less supply of blood to skeletal muscle results in the improper
functioning of the skeletal muscles. It has been established that improper
functioning of the skeletal muscles leads to increased left ventricular
pressure to improve cardiac output. Consequently, sequence of events
occur like pulmonary diffusion and interstitial oedema and breathlessness.
Increased diastolic pressure lead to more expenditure and requirement of
energy. It lead to myocardial ischemia and augmented myocardial oxygen
requirement (Pang, Collins, Gheorghiade, and Butler, 2018). Hence,
Mckenzie is suffering through shortness of breath due to increased oxygen
requirement.
Swollen
ankle
Swollen ankle occurs due to swelling in the ankle or leg. Accumulation of
fluid is mainly responsible for the swelling in any organ. Swelling is the
consequence of increased cardiac output. Increased levels of natriuretic
peptide and β-type natriuretic peptide are mainly responsible for the
vasodilation and decreased ventricular filling pressure. Vasodilation and
decreased ventricular pressure results in the decreased both cardiac preload
and afterload. Consequently, it results in the decreased blood back flow to
the heart through the veins. Valve narrowing is mainly responsible for the
reduced blood back flow which results in the inadequate blood pumping by
the heart (Moe, 2016). This cardiovascular dysfunction like reduced cardiac
output is mainly responsible for the swollen ankle in McKenzie.
Dizziness CHF mainly occur due to recued amount of blood to various organs as well
brain. Reduced supply of blood to the brain results in the dizziness in the
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