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Essay - Decomposed Heart Failure

Added on - 05 Feb 2020

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CAREOFTHEPATIENTWITHCOMPLEXCARENEEDS1
TABLE OF CONTENTSKey issues....................................................................................................................................3Pathophysiology..........................................................................................................................3Assessment Framework..............................................................................................................4Pharmacology..............................................................................................................................6Source of evidence......................................................................................................................7Discussion...................................................................................................................................8References......................................................................................................................................112
Key issuesThe present research essay is discussing about Bob Evans who is a 68 year old man andwho was admitted in the hospital because of decomposed heart failure. It is after accessing thecase of Mr Evans, it is ascertained that there are two major health issues which are prevailingsuch as breathing problems and gross peripheral oedema (Skelly and et.al, 2016). As per theclinical history, Bob has ischaemic heart disease for around 20 years and along with that, he hascoronary artery bypass graft which is a compete heart block. It is also analysed that Mr Evans isvery much frightened especially during nights and as a result it becomes difficult for him to sleepproperly. He is also having bilateral pitting oedema with leaking fluid from both legs. It happensdue to the presence of gross peripheral oedema; thus it also brings pain in the legs. The amountof energy is also getting down as Mr Evans has no appetite; henceforth he eats very less.PathophysiologyIschemic heart disease also known as Coronary Artery Disease directly impacts upon thesupply of blood to the heart. Being a foremost issue of Bob, this situation leads to a blockedblood vessel that leads to a reduced supply of oxygen and nutrients to the heart muscle(Braunwald, 2016). Any defect in the heart affects the supply of oxygen to the vital organs likebrain, liver and kidneys. This also leads to the death of tissues and eventually it leads to death inmany cases.Shortness in breath usually occurs at the time of having cardiac symptoms and mostoften it also leads to development of cardiac pain.It also increases lung disease especially in the patients who have cardiac risk. In most ofthe retrospective study, it is mentioned that there are varied patients who have coronary diseaseusually experience shortness in breath Similarly, this also brings chest pain and as a result itencourages overall health complications (Preibsch and et.al, 2016).. Further, Mr Evans is alsohaving gross peripheral oedema which is an accumulation of interstitial fluid and has in turnresulted in the occurrence of bilateral pitting oedema. Apparently, the volume of fluid in theinterstitial space is 20% of the normal body weight; however leakage from capillaries andlymphatic drainage can aid in keeping the balance in the fluid.This usually occur due to enhance plasma volume, due to reduced plasma oncoticpressure and also because of lymphatic drainage. Oedema is also called pitting at when it ispressed on the affected skin. This is also regarded as a classic type of oedema that is caused3
because of fluid accumulation (Oellgaard and et.al, 2016). Therefore, in this context it is evidentthat non-pitting oedema occurs in conditions such as lymphoedema and myxoedema.Hence, itcan be said that because of this oedema, Mr Evans is having pain in the legs. Other symptoms arealso observed such as lack of appetite, no energy in the body and lack of sleep. It also increasescapillary hydrostatic pressure due to pulmonary hypertension.Apart from this, renal failure is also referred to be a possible occurrence in the given caseof Mr Evans where it is referred to a chronic failure of kidney which generally occurs due to aslow flow of blood to the kidney organs. Chronic renal failure is also linked with a higher risk ofgetting cardiovascular disease and chronic kidney failure where high blood pressure orhypertension is also an indicant for the same. However, hypertension cannot be stated to be acomplete reason for it is a common cause of many related diseases with most of the patientssuffering from an elevated blood pressure. On linking it to the presented case of Bob, someprime causes of renal failure in his body has been found and are associated with the signs ofheart failure where he is also known to suffer from urinary issues with inadequate flow of bloodto his kidneys.Assessment FrameworkActivities of life plays a crucial role in ascertaining how a person manages all the aspectsof life. This includes the way of promoting maximum independence through carrying outcomplete assessment of all the nursing intervention (Rizik and et.al, 2017). Further, according tothe health condition, diet chart can also be prepared subsequently in which Mr Evans will berecommended to have healthy diet. In activities of life, nurses should work on maintaining a safeenvironment so that while delivering palliative care services, safety and security aspects could bemaintained. In this respect, communication also holds much importance because it could directMr Evans to discuss all those issues which he is facing.Nurses should also work on managing breathing aspects as due to ischemic heart disease,the frequency of breathing gets changed. Roper’s model is applicable in this situation because itis a model of nursing care that helps the person to live healthy life. It is the most widely usednursing model in the UK and it is based upon the activities of daily life(Elsherif and Noble,2011). Thus, as per the model, there are several areas wherein Mr Evans has to bring changes sothat to proceed towards a healthy life. At the same time, the original purpose of the model is to4
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