Role of the Acute Care Nursing
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Added on 2021-04-17
Role of the Acute Care Nursing
Added on 2021-04-17
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Running head: ACUTE CARE NURSINGAcute care nursingName of the student:Name of the University:Author’s note
1ACUTE CARE NURSINGQ 1. Causes, incidence and risk factors of identified condition and its impact on the patientand family Mrs. Sharon McKenzie is a 77 year female patient, who came to the emergencydepartment with symptom of shortness of breath, swollen ankles, mild nausea and dizziness.Based on his vital sign observation and presenting symptoms, congestive cardiac failure (CCF) isthe identified condition in Mrs. Sharon. CCF is a progressive and chronic clinical condition thataffects the hearts ability to pump blood at normal rate. This results in symptoms of tachycardia,fatigue, weakness, wheezing and rapid pulse (Teerlink et al., 2013). Many abnormalities likepressure and volume overload affects the myocardial contractility and the ability to maintainarterial pressure of vital organs. In case of heart failure, the adaptive mechanism involved inmaintaining the contractility of heart becomes maladaptive. This results in poor cardiac outputand activation of three major compensatory mechanisms such as adrenergic system, rennin-angiotensin-aldosterone system and ventricular hypertrophy. The adrenergic mechanismenhances sympathetic activity and increases level of cathecholamines contributing peripheralvasoconstriction. Hence, the compensatory mechanism increases the venous return and lead toalterations in heart rate, preload, afterload and contractility (Kemp & Conte, 2012).. CCF is a global pandemic affecting about 26 million people worldwide and its incidenceis increasing data by day due to poor lifestyle and behavioral risk factors. It is a significant publichealth problem as CCF is associated with significant mortality, morbidity and health careexpenditure (Roger, 2013). The review of heart disease statistics of Australia reveals that it is asignificant health issue in Australia too as heart disease affects around 1.2 million Australiansand it is the single leading cause of death in the country (The Heart Foundation, 2018). Hence,
2ACUTE CARE NURSINGmajor preventive care activities needs to focus on addressing the behavioral risk factor of thedisease. There are many common cause of CCF such as coronary heart disease, hypertension andalcohol consumption. Apart from this, poorly controlled diabetes, smoking, high cholesterol andfamily history of heart diseases are common risk factors that lead to CCF. Evidence has shownthat diabetes amplifies the risk of CCF and many other comorbid conditions like obesity,hypertension and coronary heart disease contributes to high rate of CCF. Insulin resistance andhyperglycemia is directly linked to cardiac dysfunction due to its effect on cardiac metabolismand the rennin-angiotensin system (Nasir & Aguilar, 2012). The diagnosis of CCF is associatedwith great physical and psychological impact on patient and their family member. They struggleto cope with the comorbidities of the condition and many psychosocial issues like depression andlack of social support further increases hospital admission rates in patient. In case of familymembers, emotional distress and care giving burden increases. Negative situations arising fromcare worsens their quality life, increases level of stress and increase care giving burden forfamily members (Lacerda et al. 2017). Hence, certain interventions should be implemented forfamily members to help them cope with psychological burden of the disease. Q2. List five common signs of the selected diseases and for each provide the link to theunderlying pathophysiology In case of Mrs. Sharon McKenzie, she was identified to be suffering from CCF due topresence of symptoms like shortness of breath, mild nausea, dizziness and swollen ankles andhigh respiratory rate. All the four symptoms along with palpitations are are common signs ofCCF and they are linked to the pathophysiology of the disease. Edema is seen in patients with
3ACUTE CARE NURSINGCCF due to the activation of humoral and neurohumoral mechanism that promotes reabsorptionof sodium and water by the kidneys. Apart from this, CCF leads to abnormal Starling forces thusincreasing venous capillary pressure and fluid extravasation. Such mechanism increases thelikelihood of edema in patients with CCF (Arrigo et al. 2016).Shortness of breath is the most common symptom seen in CCF patient due to pulmonaryedema. Pulmonary edema may be caused by narrow of the arteries, kidney failure of effect ofmedications. During CCF, the heart’s ability to pump blood at a normal rate is affected and thisleads to accumulation of blood in the veins that take blood through the lungs. The increase inpressure in the blood vessels pushes fluid into the alveoli and disrupts normal oxygen exchangethrough the lungs. All these factors together causes shortness of breath in patient (Dubé,Agostoni & Laveneziana, 2016).Many patients with CCF experience symptoms of dizziness. Irregular heart beat alsoresults in decreases blood pressure which leads to dizziness in patient. Dizziness is caused by theeffect of medications too. In addition, the symptom of nausea is seen due to the build-up of fluidaround liver and guts. The complex interaction between central nervous system, autonomicnervous system and endocrine nervous system results in nausea. Histamines and dopamines actas stimuli that give rise to nausea (Singh, Yoon & Kuo 2016). The fifth symptom of CCF is palpitation and it is associated with very rapid or irregularheart beat in patient. This symptom in seen during CCF due to the effect of the disease on hearsmuscle contractility. Patients like McKenzie may feel that their heart is racing or pounding at arapid rate. This may be caused by the onset of compensatory mechanism. Cardiac arrhythmiasalso results in high heart rate and it the condition affects the normal heart rhythm. The
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