Case study on Adult Assignment
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Added on 2021-01-03
Case study on Adult Assignment
Added on 2021-01-03
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Adult Case study
Table of ContentsINTRODUCTION...........................................................................................................................3MAIN BODY...................................................................................................................................3Problem 1: An Acute Decompensated Heart Failure.......................................................................3Pathophysiology.....................................................................................................................3Nursing interventions.............................................................................................................5Problem 2: Bilateral Pitting Oedema...............................................................................................6Pathophysiology.....................................................................................................................6Nursing interventions.............................................................................................................7CONCLUSION................................................................................................................................9REFERENCES..............................................................................................................................10
INTRODUCTIONAdult care refers to a set of clinical practices and methods which can be used to providecare and medical facilities in adult patients in order to make the disease free. It consist thecriteria of focussing on more appropriate methods and procedures which is require to be carriedout in terms of solving health problems of patients (Abrams and et. al., 2018). The present reportis based on case study about patient named Reggie with age of 42 years old and he is anindigenous Australian. He has been diagnosed in his childhood with rheumatic heart since he hada degree of compensated heart failure. However, Reggie has been transferred to Brisbane formanagement of an acute decompensation of his heart failure. In addition to this, he complainsabout pain on inspiration, and appears fatigued along with having visible ascites. He also statesthat he has gain around 10 to 15 kg weights in last two months. This assignment will focus ontwo health problem of selected patient such as an acute decompensated heart failure and bilateralpitting oedema. MAIN BODYProblem 1: An Acute Decompensated Heart FailureThe acute decompensated heart failure can be described as common and potentially fatalcause of acute respiratory distress. This clinical syndrome is characterised by the development ofdyspnoea which is usually connected with rapid accumulation of fluid within alveolar spaces andlung's interstitial as well. However, it will facilitate to acutely elevated cardiac filling pressures
which can be considered as cardiogenic pulmonary oedema. There are some of common signs &symptoms which are observed in patients such as peripheral oedema, dyspnea, orthopnea,paroxysmal nocturnal dyspnea (PND), nausea or vomiting, elevated jugular venous pressure,weight gain or loss, pulmonary rales, hepatomegaly, cardiac gallops and pleural effusions(Godaert and et. al., 2017). PathophysiologyThe pathophysiology of an acute compensated heart failure consist number of diagnosingactivities and procedures which are required to be conducted in order to recognise the actualproblem and issue of patients. In context of given case study, it is essential to determine actualreason behind the selected problem as it will facilitate to make correct decision to provideaccurate medication in respect of making him well-being. Firstly, ECG is an effective diagnosingmethod in which electrocardiograms may consist q waves that suggest about prior myocardialinfarction & persistent scar. It also shows left ventricular hypertrophy (as a manifestation ofcardiomegaly), heart block or trachyarrhythmias. Secondly, the method of chest X- ray can beconducted as it facilitate to reveal pulmonary oedema or may provide evidence regarding analternative cause of dyspnea and another findings of radiography indicates about heart failure.Thirdly, this heart failure consist pleural effusions, prominent pulmonary arteries, Kerley B linesand pulmonary vascular redistribution. However, procedure of evaluating serum electrolyteswhich facilitate to observed specifically with advanced acute heart failure along with certainaspects such as elevated serum BUN and/or creatinine, low serum bicarbonate and hyponatremia.Meanwhile, the analysis of elevated function of liver test facilitate to determine passive hepaticcongestion which is very common to be observed in patient with decompensated right heartfailure (Abrams and Brodie, 2017). Moreover, brain natriuretic peptide (BNP) or pro- BNPlevels are analysed to be often elevated because of increase in cardiac pressure or volume andincreased myocardial wall stress. These laboratory values are highly sensitive along withextremely negative predictive value for acute decompensated heart failure. Furthermore, anothertechnique consist that trans thoracic echocardiogram can evaluate contractile function whichfacilitate to identify presence of concomitant valvular disease and provides clues to cardiac aswell as central venous pressures. Basically, the process of cardiac catheterization may beperformed to evaluate the existence or absence of obstructive coronary artery disease. The right
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