Case Study on Congestive Heart Failure

Running head: CONGESTIVE HEART FAILURE
Case Study on Congestive Heart Failure
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CONGESTIVE HEART FAILURE 2
Introduction
Congestive Heart Failure (CHF) happens when one’s heart muscle fails to pump blood as
proper as it should (Grady, 2017). Particular illnesses such as high blood pressure or constricted
arteries in an individual's heart (coronary heart condition), progressively leave one's heart very
weak or hard to fill and pump properly. Not every condition that results in CHF could be
retreated; however, treatments may enhance the symptoms and signs of CHF to assist an
individual in living longer. Lifestyle alterations such as lowering one's sodium intake, cutting
weight, exercising, and coping with stress could enhance an individual's quality of life. One
technique of inhibiting CHF is to hinder and regulate illnesses that lead to heart failures, such as
obesity, hypertension, diabetes or coronary heart condition. CHF could be fatal; therefore if an
individual is suspected of having it, speedy medical treatment should be sought.
According to Centrella and Nigro (2016), CHF is a universal epidemic affecting at best
27 million persons globally, and it is escalating in prevalence. Approximately 5.9 million
individuals in the U.S. alone have been diagnosed with CHF. An epidemic may reveal escalated
incidence, escalated survival resulting in an increased rate or both aspects combined. It is an
overwhelming medical and public health concern, linked to considerable deaths, illness, and
healthcare expenses, specifically amongst older individuals aged 65 and above. There is an
increasing rate of cases presenting with conserved discharge for which there is no definite
treatment. In spite of the advancement in lowering deaths related to CHF, hospitalisations for
CHF stand very common and proportions of readmissions are still rising.

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Case Study
The presented case study is of an old female aged 74 who had a coronary artery bypass
graft (CABG) surgery six weeks before admission to the facility. Her chief complaint includes
abdominal pain, breath shortness, general sickness for three or four days, blurry vision, fevers,
and recent inception of headaches. Her history of present disease comprises abdominal pain and
oliguria, breath shortness, inability to carry out recommended therapy activities, and general
malaise for three or four days. The patient is currently on medications which include Enalapril
20mg BD, Tramadol 100mg BD, Metoprolol 50mg BD, Jurnista 16mg daily, Lasix 40mg daily,
Endone 5mg prn, Span K 600mg daily, Lipitor 20mg daily, Metformin 500mg daily, Rantidine
150mg BD, Novorapid 20 units TDS, Coloxyl with senna 2 tablets daily, Lantus 30 units BD,
Movicol 1 sachet PRN, and Panadol Osteo ii TDS. She has no identified allergies.
The patient’s past medical history asserts that she is obese weighing 115kg, she has had
hypertension for 25 years, hyperlipidemia and type 2 diabetes for ten years, protracted back pain
for 12 years, gastric ulcer for five years, osteoarthritis of limbs/spine, CABG (× 4 grafts) six
weeks ago. Additionally, she drinks a litre of cask wine daily, has anxiety but does not take
suppositories, persistent obstructive pulmonary disorder with slight exercise easiness, petulant
bowel pattern with regular constipation, fresh inception protracted renal failure and non-
compliant with fluid 1.5 litre fluid retention and renal dialysis, peritoneal dialysis 4 times in a
week but takes on once in a week.
There is no account of her mother; however, her father died of bowel cancer at 68. Two
of her siblings were diagnosed with heart disorders; one of them has undergone a heart surgical
procedure. The patient is a widow with two sons and two daughters, all of whom are married. All

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her children have requested her to stay with them due to her poor urine release, blurred vision,
loss of memory, and current headaches but she has refused because she does not want to be an
encumbrance.
Comprehensive Patient Assessment
Medical treatment for CHF comprises several non-pharmacologic, pharmacologic, and
intrusive strategies to regulate and reverse its appearances (Journal of Continuing Education in
Nursing, 2018). Basing on the seriousness of the disease, non-pharmacologic treatments consist
of dietetic fluid and sodium restraints, somatic action as suitable, and mindfulness to weight
addition. Pharmacologic treatments comprise the use of vasodilators, diuretics, beta-blockers,
digoxin, anticoagulants, and inotropic agents. Intrusive procedures for CHF consist of electro-
physiologic intrusion like pacemakers, implantable cardioverter-defibrillators (ICDs), and
cardiac resynchronisation therapy (CRT); valve replacement or repair; ventricular restoration;
and revascularisation procedures like percutaneous coronary intervention (PCI) and coronary
artery bypass grafting (CABG). However, the PCI and CABG are not routine procedures. PCI
may be used to intervene and stop a heart attack when a patient is actively having a heart attack
by opening up the blocked or narrow artery. On the other hand CABG is used as a treatment
option in severe CHF if heart failure is caused by coronary artery condition. In this procedure,
the physician uses veins or arteries taken from other body (referred to as grafts), and redirects the
flow of blood around one or more obstructed heart arteries.
Various aspects should be regarded in CHF elderly patients going through
pharmacological therapy. First, such patients suffer from numerous chronic illnesses, which
escalates the possibility of adverse medication reactions (electrolytic disturbances kidney