Understanding Congestive Cardiac Failure: Causes, Incidence, and Impact on Patients and Families

In this document we will discuss about Understanding Congestive Cardiac Failure and below are the summary points of this document:- Congestive cardiac failure (CCF) is a heart disorder caused by factors such as hypertension, diabetes, and coronary artery disease. CCF leads to the accumulation of fluids in the lungs and body, causing symptoms like swelling, shortness of breath, and weakness. The incidence of cardiac diseases, including CCF, is significant, with a high mortality rate and a major impact on patients' lives and their families' well-being.

CONGESTIVE CARDIAC FAILURE
CONGESTIVE CARDIAC FAILURE
Name of the Student:
Name of the University:
Author note:

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Q1) Outline the disease, causes, incidence and risk factors. Discuss the impact of the selected
disease on the patient and their family
 CAUSES:
Congestive cardiac failure (CCF) is not considered as a disease but is related to a type of
heart disorder, when the tolerant has a continued antiquity of hypertension, diabetes and
coronary artery disease (Mohamed et al., 2019). Congestive cardiac failure develops due to
the incapability of the heart to pump blood in order to encounter the body’s need that leads to
accumulation of the fluids in different portions of lungs and body. This takes place in two
ways, firstly, when the ventricles fail to pump sufficient blood with adequate force known as
systolic heart failure (Kojmane, Hmami & Atmani, 2019). Secondly, when there is no
sufficient blood present in the ventricles even after pumping known as diastolic heart failure.
In both conditions, excess fluid accumulate in the lungs leading to heart congestion (Yadav et
al., 2019). This causes excess fluids to outflow from blood vessels resulting in symptoms
such as swelling, out of breath, and weakness. Likewise, patients suffering with left ventricle
failure (LVF) will experience symptoms such as tiredness, weakness, exercise intolerance
and trouble in concentrating (Mohamed et al., 2019). Similarly, patients suffering from right
ventricle failure (RVF) will exhibit symptoms such as swollen legs, ankles with swollen GI
tract with excess fluid. This condition is communal in patients suffering with lung sicknesses
such as chronic disruptive respiratory disease, pulmonic hypertension, and immense lung
embolus (Yadav et al., 2019).
 INCIDENCES:
In 2013, Australia reportedly encountered 43,600 deaths due to cardiac diseases.
Ischemic or Coronary heart disease reported 19,760 death, which was the leading reason of
death. National heart Foundation of Australia published a report stating 400,000 people
suffers from heart attack once in their lifetime, and annually 54000 people actually suffers

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from major heart attack. Myocardial infraction and cardiac comorbidities is directly
associated with congestive heart failure resulting in 8,443 deaths in Australia with an average
of 23 death per day (Patel & Cornell, 2019).
 RISK FACTORS:
Adults including women and men above 65 old are at a higher threat of congestive
heart failure. The causes of congestive cardiac failure (CCF) are as follows (Morris & Chen,
2019):
 Growing age accompanied with unhealthy routine.
 Accumulation of plaque in the walls or lining of blood vessel.
 High BP or hypertension.
 Alcohol consumption and
 Smoking cigarettes.
 IMPACT OF THE DIEASES ON PATIENT AND FAMILY:
The patient’s life quality was severely compromised as she was suffering from
depression, weakness, sleep withdrawal, dyspnoea and fatigue. The patient’s everyday ability
to cope up with the body physical demand was lowered (Crisan, Tint & Petrescu, 2019).
Incapability to involve in social activities left her feeling isolated and alone. The patient’s
condition affected her husband and family, as they could not see her suffering and not being
able to do anything, which made the patient happy. The inability of the family to help the
patient recover made them sad too. This effected the patient and family members personally
and socially (Ghosh et al., 2019).
Q2) discuss the common signs and symptoms of the selected disease and explain the
underlying pathophysiology of each.
The common signs and symptoms of Congestive Cardiac Failure (CCF) are as follows
(Bhurane et al., 2019):

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 Dyspnoea- This symptom occur due to incapability of the heart to pump blood in the
body, which damages the heart muscle causing left ventricle failure. This condition
leads to shortness of breath in the patient due to fluid accumulation in alveoli. No gas
exchange takes place making the patient difficult to breathe (Newman, 2018).
 Edema- This symptom occur due to fluid accumulation resulting in swollen legs and
ankles. Right side heart fails to push the fluids proficiently to the body, which leads to
pressure in the left side ventricle (Cattapan, 2018). This accumulation of fluid
hampers the kidney of the patient, hence restricting the kidney to function efficiently
with excretion leading to fluid maintenance and swelling.
 Tachycardia- Tachycardia is considered as the crucial symptom of CCF. It is the
condition where patient’s heart rate exceeds the normal heart beat rate, which leads to
distressing symptoms. This condition take place due to abridged cardiac output,
sensitive rise in nervous stimulation and speed or intensity of blood flow (Bhurane et
al., 2019).
 Skin alterations- Change in skin integrity is one of the main and common symptom in
patients suffering with CCF. This symptom occurs due to increased extraction of
oxygen in capillary tissue resulting in alteration of skin texture. This condition also
takes place when enough quantity of oxygen content in the body (Cattapan, 2018).
 Weight fluctuations- Due to CCF various weight fluctuation takes place, which
include weight gain due to fluid accumulation, and sudden weight loss making the
patient sick and weak (Newman, 2018).
Q3) Discuss the pharmacodynamics & pharmacokinetics of one (1) common class of drug
relevant to the chosen patient.
 Pharmacokinetics of calcium channel blockers:

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Verapamil, diltiazem and nifedipine are some of the calcium channel blockers with
similar pharmacokinetic property. These class of drugs through oral administration are
completely absorbed in the body but due to hepatic absorption, the bioavailability of the drug
is reduced. Action of drugs belonging to this class initiates in 0.5-2 hours, which is
comparatively fast. In case of nifedipine, the quick inception of drug in instant-release
invention leads to increase reflex in sympathetic activities with an intensification of anginal
symptoms (Kasper, 2018). Slow-release invention can also be used to delay the onset time of
the drug in the body. The oral bioavailability of nifedipine drug through GITS formulation is
55-65% and under steady state, it is 75-85%. The half-life elimination of the drug is in
between 2-7 hour. Vascular selectivity of this drug is small and limited for patients suffering
from left ventricle dysfunction (Prajapati, Karen & Vaghela, 2019).
 Pharmacodynamics of calcium channel blocker:
Calcium channel blockers are used for the treatment of vascular spasm, hypertension and
angina. The pharmacodynamics of the drug will state the process of how a class of drug
performances in the human body or how the body reacts to the drug (Prasad et al., 2018).
Calcium channel blockers work by inhibiting the cascade of calcium ions through the
myocardial membrane and the arteries of heart muscle cells by decreasing the electrical
movement of heart muscle. Hence, blocking the contraction of heart muscle cells due to the
alternation in the action potential of the heart muscle (Kasper, 2018). This effect of drug will
reduce myocardial contraction, relaxed heart impulse in conductive soft tissue, and results in
relaxation and dilation of blood vessels, which leads to reduced blood pressure and making it
stress-free for the heart to pump blood.
Q4) In order of priority, develop a nursing care plan for your chosen patient who has just
arrived on the ward from ED. Nursing care plan goals, interventions and rationales must
relate to the first 8 hours post ward admission.

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The nursing care approaches developed for the patient mainly includes improving the
tissue perfusion and breathing condition of the patient.
 Patient should take complete rest and the head of patient’s bed should be positioned at
an angle of 30 degree, which will allow the patient with better breathing pattern
(Peterson, 2018).
 Pain management should be done appropriately by observing the symptoms such as
restlessness, facial changes, and difficulty in communication. Analgesic like morphine
can be used to help the reduce pain. Pain management is done by measuring the
patient anxiety, which is important for pain management. Some of the important steps
required for pain management include constructing patient affinity, operative
communication with patients, asking question to patients such as why they get anxiety
attack and what situation makes the patient to sense anxiety, has this situation ever
occurred before and what measures did they took to get relieved and did the treatment
worked for them. Also uplifting and proposing health support, which includes
different breathing help and distraction (Cruz, Macrae & Webb, 2019).
 Noticing the patient’s respiratory rate and breathing pattern for oxygen saturation and
dyspnoea and after analysis providing and commencing oxygen therapy to the patient
in order to relive him from hypoxia and shortness of breath. Oxygen therapy is also
required to develop tissue perfusion and blood oxygen level of the patient.
Observation of respiratory rate of patient also includes observing the diastolic and
systolic blood pressure of the patient, involving assessment of body temperature,
cardiac output, urine output, psychological status of the patient and assessment of
capillary refill, which should be less than 2. The patient’s heart rhythm and pulse rate
is monitored by using ECG i.e. 12-lead echocardiogram. The patients suffering with
CCF usually have a high or elevated pulse rate because of reduced cardiac output,

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moreover when currently working on angiotensin, a process that convert enzyme
inhibitors (EI) in order to reduce the level of pulse rate. Hence, by evaluating all the
vital signs mentioned above of the patient, will result in improvement of the patient
with enhanced care provision (Rotter, 2019).
 Development of communication with the patient- An effective and motivating
communication of the patient with their close relatives, family members, friends and
multi- disciplinary team (MDT) is an important nursing strategy for patient
improvement (Dotinga, 2018). The effective communication by nurses and MDT will
help them to collect all the required information and data of the patient, initiate
interventions, assess the result of interventions, confirming and sharing of
information, and finally executing the required changes for effective patient care in
order to avoid any unsafe practice (Peterson, 2018). The effective communication
strategy will improve the trust of the patient and builds understanding with patient.
This approach enhances to open up the communication relationship between the nurse
and the patient, hence allowing the nurse to move headlong with the patient and build
trust between them. Hence, effective communication strategy is a significant
constituent to harmless patient centred care.

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da Cruz, E., Macrae, D. J., & Webb, G. D. (2019). Intensive Care of the Adult with
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