Case Study Analysis: Managing Heart Failure and High Blood Pressure

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
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CASE STUDY ANALYSIS
The assignment is based on a case study of an indigenous man named Reggie who is 42
years old and lives with his wife and 3 children near Blackall in central Queensland. However,
he is now shifted and admitted to a healthcare organizational for management of cause
decomposition of the heart failure. The respiration rate and oxygen saturation value had been
found to be 28 rates per minute and 92% respectively. He is suffering from respiratory issues
and feels fatigued. He complained about a pin on inspiration and is also seen to be suffering from
pitting edema and visible ascites as well. He had gained for about 10 to 15 kg in the last few
months. Moreover, he is also seen to have high blood pressure of about 184/75 and had also
suffered a wound at his workplace which was not recovering and is now found to be infected as
well. This assignment would mainly be utilizing the clinical reasoning cycle to identify the
nursing priorities successfully and this should then be followed by developing nursing
interventions. These would help in helping the patient to live better quality live by overcoming
his sufferings.
The respiration rate of the patient named Reggie is found to be quite high for about 28 in
one minute when the rate of normal respiration should be between 12 to 20 breaths per minute.
This shows that Reggie is having breathing difficulty. This breathing difficulty resulting in
shortness of breath can be attributed to the conditions of the pulmonary edema that might occur
in patients who are suffering from heart failures (Ong et al., 2016). Congestive heart failures can
result in backing up of fluids in the lungs and might interfere with oxygen getting in the blood
making the patient suffer from dyspnea. This condition mainly means that extra fluid is
accumulated in the lungs that make it hard for the patients to breathe. Studies are of the opinion
that when the heart is weak or become damaged, it fail in pumping of enough blood that it gets
from the lungs. When such situations take place, pressure is seen to get built in the heart which

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CASE STUDY ANALYSIS
eventually pushes fluid into the air sacs of the lungs. This, in course of time interferes with the
breathing ability of the lungs making the patients suffer from shortness of breath. Studies have
found out that when the left side of the heart begins failing, fluid gets eventually collected inside
the lungs (Hassan et al., 2018). This extra fluid that gets accumulated in the lungs makes it more
critical for the airway passages to get expanded as the person inhales. Breathing is therefore seen
to become more difficult and this might has been the reason that makes it painful for Reggie
during inspiration. Moreover, pitting edema is another symptom that shows retention of fluid
taking place in the body of the patient. It has been found that when the right side of the heart
starts failing, the fluid is seen to get collected in the feet as well as the lower legs. This mainly
occurs because the failure of the ability of heart to collect blood from all part of the body back to
it because of its loss of pumping ability (Mebazza et al., 2015). Puffy leg edema is a sign that
right heart failure had taken place in the patients. As the right heart failure gradually worsens
over time, the upper legs are seen to be swelled and eventually the abdomen collects fluid as well
as giving rise to situation called the ascites. Weight gain is also seen to accompany the fluid
retention and is thereby a reliable measure of how much the fluid is being retained (Dunlay et al.,
2017). Reggie is seen to gain weight over time and is seen to suffer from pitting edema and
ascites. Hence, m the nursing priority that should be set for Reggie would be management of
excessive fluid volume in his body and helping him to overcome shortness of breath and help
him overcome his sufferings.
In order to help the patient named Reggie overcome edema, the nursing professionals
should be administering intravenous diuretics as the first line of the medication. This medication
mainly helps the kidneys in removing excess of the fluid from the body. Diuretics can be
categorized into three important categories, which are the thiazide-like that get help the body to

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CASE STUDY ANALYSIS
get rid of a moderate amount of water and can be used for a for long time (Guder et al., 2015).
Another category is the loop category which are the more powerful group and are found to be
extremely important in emergencies. Another group is the potassium-sparing category, which
mainly keeps the potassium while getting rid of the water and the salt. This medication can be
provided with any one of the medication belonging to the other two groups. Studies are of the
opinion that bumex medications like that of bumetanide has proved to be successful in reduction
of the extra fluids in the body like in edema that had been caused by conditions such as the heart
failures, liver disorders as well as the kidney disorders (Carthon et al., 2015). These medications
are also seen to be helpful in lessening the symptoms of the shortness of breath as well as
swelling in arms, legs, and abdomen. This medicine is also called water pill, which causes the
kidney to make more urine helping the body to release he extra fluid. This medication can be
given to Reggie by the nurse to be taken orally about once or twice daily. The nurse should also
monitor if the patient is not occurring any side effects like that of dizziness, lightheadedness,
dehydration, muscle cramps, unusual tiredness, vomiting, confusion, fainting, drowsiness,
irregular heartbeat, and many others. The dosage should be 0.5 mg to 2 mg and should be given
in a single dose (Sethares et al., 2016). Another intervention that can be applied for the patient
named Reggie is the oxygen therapy. Oxygen therapy includes providing oxygen to the patient
with the help of a facemask or nasal canula, which is a flexible plastic tube that has two
openings, and help in delivering oxygen to each of the nostrils. This helps in easing out the
symptoms of the respiratory distress. Increase in the blood oxygen would help in temporarily
restoring normal level of the blood gases and this helps in developing tissue function thereby
promoting healing. This would help Reggie feeling stable and overcome the pain and suffering
he is going through with his symptoms of shortness of breath.