Heart Failure and Its Management - Desklib

This article discusses heart failure, its symptoms, risk factors, pathophysiology, and nursing interventions for its management. It also highlights the importance of cardiac rehabilitation and medication for the treatment of heart failure.

Running head: HEART FAILURE AND ITS MANAGEMENT
HEART FAILURE AND ITS MANAGEMENT
Name of the student:
Name of the university:
Author note:

1
HEART FAILURE AND ITS MANAGEMENT
Introduction:
Heart failure can be described as the situation where the heart fails to keep up with the
workload. As a result, the body fails to get the oxygen that it requires to perform different
functions of the body. Heart failure can therefore be described as the serious condition and
researchers are therefore of the opinion that there is no proper care that can reverse the
conditions (Morton et al., 2017). Cardiovascular disorders have become one of the significant
forms of diseases burden in the nation of New Zealand accounting for about $ 501 million that
had made the National Health Policy to flag this disorder as a priority disease area for 2013 to
2014. The prevalence of the disease like that is Ischemic Heart diseases was found to be 5.5% in
the nation with adults aged over 15 years in 2011 to 201 that accounts for about 193000
individuals with more men than women. Moreover about 30% of the adults aged over 75 were
diagnosed with the disorder and seen to live poor quality lives..However, many patients with
heart failure can thereby lead a full as well as an enjoyable life when they are able to manage the
conditions effectively. They can manage them with proper heart failure medications and proper
healthy lifestyle changes. With the proper support of family as well as friends, it is possible for
the patients to live longer days. Therefore, nursing professionals of the healthcare centers have
the duty to have good amount of knowledge about heart failure and develop evidence-based
knowledge so that they can provide high quality care to the patient (Feltner et al., 2014). With
effective patient education and proper interventions, the nation of New Zealand can effectively
handle the increasing prevalence of heart disorders successfully. This assignment is therefore
based on the explanation of the disorder, signs and symptoms, risk factors, pathophysiology and
effective diagnosis. It will also discuss about the nursing interventions that healthcare
professionals should take in order to care for their patients and gift them healthy lives.

2
HEART FAILURE AND ITS MANAGEMENT
Discussion and pathophysiology of heart failures:
Heart failure can be described as the chronic as well as progressive condition in which the
muscles of the heart becomes unable to pump enough blood that would meet up the needs of
oxygen of the different parts of the body. The failure of the heart to keep up with the workload
mainly results in such a situation (Fihn et al., 2014). Researchers are of the opinion that heart
failure usually develops after other conditions had already weakened the heart. In heart failure,
the main pumping chambers of the heart may become too stiff and fail to fill properly in between
the beats. In some of the other cases of heart failure, it is seen that heart muscles may become
damaged and weakened and therefore the ventricles are seen to reach to a point where the heart
cannot pump blood efficiently throughout the body. However, in the initial phase of the
disorder, it is seen that the heart tries its best to make up for the situation by undertaking a
number of actions. The first one is called enlarging. The heart is seen to stretch so that it can
contract more strongly and thereby keep up with the demand of pumping more blood. In course
of time, it is seen that the heart gradually becomes enlarged. The second way that the heart
adopts is the development of more muscle mass (Black et al., 2014). Researchers are of the
opinion that increase in the muscle mass occurs mainly because the contracting cells of the heart
gradually becomes larger. Therefore, initially, the heart is seen to pump more strongly. The third
way by which the heart compensates is by pumping in a faster motion and this helps to increase
the output of the heart. The body is also seen to compensate in many other ways. The blood
vessels are seen to gradually get narrow in order to keep up with the blood pressure. The body
mainly does this so that it can make up for the loss of power of the heart. Researchers have also
found that the boy responds to this situation by diverting the blood away from the less important
organs and tissues and more towards the heart as well as the brain (Park, 2014). All these actions

3
HEART FAILURE AND ITS MANAGEMENT
taken by the body of the patient in the initial sessions are helpful in temporarily masking the
problems of the heart failure but they are not enough to solve the problems of the heart failure
entirely. The conditions of the heart failures are seen to worsen until the substitute procedures no
longer work. In course of time, the heart and the body fail to keep up with the condition and
symptoms of heart failures are seen to occur. The patient seems to suffer from fatigue, breathing
problems as well as other symptoms that compel the patient to visit healthcare centers for
recovery.
A number of occurrences within the heart may contribute to the situations where the
patients may suffer from heart failure. Researchers are mainly of the opinion that coronary artery
diseases and heart attack may contribute to such a condition of the heart. This mainly results in
building up of the fatty deposits called plaques in the arteries. This is seen to reduce flow of
blood and can thereby lead to heart attack. High blood pressure is also seen to be another
contributor to that of heart failure (Ong et al., 2016). When the pressure of the blood is quite
high, the heart needs to work harder that it should under normal conditions. This is mainly for
circulating the blood throughout the body. In course of time, the extra insertion can result in
making the heart muscle either too stiff or too weak in order to pump the blood effectively.
Faulty heart valve can also result in contributing to heart failures. The normal function of the
valves is to keep the blood flowing in the proper direction throughout the different chambers of
the heart and thereby prevents their back flow. Researchers are of the opinion that a damaged
valve mainly due to the result of the heart defect, coronary artery as well as due to a heart
infection may result in forcing the heart to work harder. This can result in weakening of the heart
over time (Clark et al., 2015). Another contributor to the disorder is the damaging of the heart
muscles, which is also called the cardiomyopathy. Damaging of the heart muscles can have many

4
HEART FAILURE AND ITS MANAGEMENT
of the causes that include several disorders. Alcohol abuse, infections, toxic habits of th drugs
like that of cocaine and as well as chemotherapy treatments can cause damage to the muscles of
the heart. Researchers also state that genetic factors may also lad to the occurrence of the disease.
Myocarditis is also another form of inflammation of the heart muscles that are mainly seen to be
cause by a virus and can thereby left-to-left-sided heart failures. Heart arrhythmias are other
important contributors. Abnormal heart rhythms may also result in making the heartbeat too fast
and these results in creating of extra pressure for the heart. Again slow heart beat also results in
the occurrence of the disorders (Bekelman et al., 2015).
Risks for heart failures:
A number of risk factors increase the chances of occurrence of heart failure situations in lives of
different individuals. It is extremely important for the healthcare professionals to identify the
different risk factors that make people vulnerable to heart failures so that they can take measures
before hand and also educate the effectively to save their lives from any form of threats. Having
any sort of heart problems before and possessing raised blood pressures can act as risk factors for
the development of conditions of heart failures. Increased cholesterol levels, smoking disorder
and diabetes also expose individuals to the risks of facing heart failures in their lives (Mahramus
et al., 2014). Lack of physical activities and advancement of old age also make human beings
more vulnerable to the development of the disorders. Gender is also seen to be one of the most
important factors that decide advancement of heart disorders in the individuals. Men are seen to
be at a higher risk for heart failures than the females and therefore the male patients are more
vulnerable to life threatening situations due to heart failures (Stamp et al., 2014). Moreover,
family history of heart disorders also makes individuals more prone to undergo such threatening
situations in their lives. Therefore, the nursing professionals should first try to identify the risk

5
HEART FAILURE AND ITS MANAGEMENT
factors and thereby educate patients in ways by which they can help the patients to lead healthy
lives without any heart ailments (Reigel et al., 2016).
Signs and symptoms of the heart failures:
Healthcare professionals are expected to develop high amount of knowledge about the
signs and symptoms of heart failures so that when patients arrive to the healthcare centers, their
ailments are quickly diagnosed and treatment starts earlier. This helps to reduce the chances of
threatening issues that might be faced by the patients. The patients may suffer from shortness of
breath when they exert themselves or when they are seen to lie down. This is called dyspnoea.
Fatigue and weakness are also some other symptoms which are also found in patients with the
disorders. Swelling or edema in the legs, ankles as well as feet is also observed in the patients
(Ross et al., 2015) Rapid as well as irregular heartbeat and reduced ability of the individuals to
exercise also exhibits the chances of the individuals to have developed heart ailments. Many
researchers are of the opinion that persistent cough as well as wheezing with white or pink blood
tinged phlegm is also the other symptoms that help in development of the disorders. Moreover,
such patients who have increased risk of heart failures are also seen to develop an increased need
for urination at night (Kitsiou et al., 2015). Swelling of the abdomen also called ascites as well as
very rapid weight gain from fluid retention, lack of appetite and nausea are also some of the
symptoms that might indicate the nursing professionals that the patients have increased risk for
heart failures. Difficulty on the action of concentrating as well as decreased alertness may also
show in occurrences of the disorders. Sudden severe shortness of breath as well as coughing up

6
HEART FAILURE AND ITS MANAGEMENT
pink foamy mucus as well as chest pain in case of heart attacks are also signs which show that
the patient’s life is in threatening positions. Researchers are of the opinion that when patients are
having chest pain, fainting as well as severe weakness should immediately consult doctors.
Rapid, irregular heartbeat along with shortness of breath, chest pain or fainting, coughing with
pink, foamy mucus and others need immediate attention from the healthcare professionals (Yu et
al., 2015).
Nursing interventions:
Pharmacological interventions are one of the most important forms of interventions that
the nursing professionals need to develop to save the patients who have suffered heart failures.
The medications should be taken regularly and if the medications are seen to create any side
effects, the patients should immediately inform the healthcare professionals. Diuretics or water
pills are one of the main medications that allow the kidneys in removing excess of the fluids and
salt from the body. This is mainly done by increasing the amount of urine that is produced.
Angiotensin converting enzymes or the ACE inhibitors can also be used. This type of
medications mainly helps in relaxation of the blood vessels and makes it easier for the heart to
pump blood to different tissues of the body (Vedel & Khanassouv, 2015). It would also help the
patients to perform more without the patients becoming breathless or even tired. Angiotensin-II
receptor antagonists are some of the medications that can be used by individuals who face
difficulty in tolerating the different ACE inhibitors. The nursing professionals can also
recommend digoxin to the patients as the medication helps the patients by making the heartbeat
strongly as well as regularly. It mainly belongs to the class of medications called the cardiac
glycosides and is mainly seen to work by affecting the certain minerals inside the heart cells.
This mainly helps in reducing the strain on the heart muscles and thereby helps in the

7
HEART FAILURE AND ITS MANAGEMENT
maintenance of the normal steady and strong heartbeat (Cajitta, gleason & han, 2016). Beta-
blockers are some of the medications that the professionals can provide to the patients for
developing the pumping action of the heart. Spironolactone is also another medication that are
also called aldosterone antagonist. This has a diuretic effect and may help in cases of severe
heart failure. Other medications that can be also used are the calcium channel blockers. These
medications are sometimes used in the slowing down of the heart rate if it cannot be controlled
with the help of the beta-blockers. Warfarin is also seen to help in stopping the clots of blood
from forming.
Non-pharmacological interventions:
Cardiac rehabilitation is one of the interventions that nursing professionals should advise
patients who have already been affected by heart failures. This is mainly a medically supervised
program that are seen to help heart patients to recover from their ailments and thereby improve
overall, physical, mental as well as social functions. The main goal of this form of intervention is
the stabilization, slowing as well as reversal of the progression of the heart failure symptoms,
signs and conditions. This form of intervention can help in the reduction of the chances of the
risk of heart diseases as well as another cardiac event or death (Piette et al., 2015). The nursing
professionals and the experts taking part in the cardiac rehabilitation programs usually provide a
number of interventions. They conduct medical evaluation for figuring out the needs as well as
limitations and then develop a physical activity program that would be tailored in ways by which
the needs of the patients can be met. The nursing professionals should counsel and educate the
patients to help them understand the different conditions of the patients and thereby help them to
manage them with proper interventions. The nursing professionals also support and train the
patients with the disorder to help them return to work on their normal activities. Moreover

8
HEART FAILURE AND ITS MANAGEMENT
counseling on the modifying risk factors with the effective suggestions through diet and nutrition
as well as with the proper utilization of the prescribed medications help the patients to come out
of vulnerabilities and live a safe and steady life. Surgery is also considered to be one of another
intervention that the healthcare professionals may suggest (Vedel & Khanassouv, 2015).
Coronary bypass surgery is mainly helpful for those patients who have coronary arterial
disorders s a cause of the heart failures. Other treatments such as caring after pacemakers as well
as implantable cardioverter defibrillators or ICDS are also helpful in effective management of
the heart failures in such people. Although the professionals do not take part in surgery but they
contribute to post operative and preoperative management of the patients (Ross et al., 2015).
Another very important aspect is providing patient education to the patients either for
preventing patents who have risks of heart disorders or for caring for patients who have already
gone through conditions of heart failure to prevent them from further such threats and accidents.
Some of the important areas that the nursing professionals should educate the patients to
maintain healthy lives and to reduce the chances of heart disorders are to avoid salt. Salt can
result in retaining of the fluids and this can lead to breathlessness and swollen ankles. Another
important aspect is healthy eating by the patients (Yu et al., 2015). When patients would chose
healthier foods, smaller portions, wholegrain, healthy fats and less processed foods, the chance
of heat failures will reduce. Limiting fluids, stopping excessive smoking and limiting alcohols
will prevent further damaging of the heart and will reduce the chances of heart attacks. Limiting
stress, proper sleep in the night, remaining active, losing weight and proper vaccination are some
of the points that the nurse should provide in the education plan for the patients (Cajitta, Gleason
& Han, 2016).

9
HEART FAILURE AND ITS MANAGEMENT
While working as a nursing professional in the rehabilitation ward i the healthcare center,
I have realized that effective team working is very much important in the multidisciplinary
teams. Different types of experts need to attend the patients to help the patients meet their needs
and requirements. Most of the time a single patient is seen to be attended by more than one
expert helping them with their health issues after heart failures. The nursing professionals need
to communicate with each of them effectively and documents the conditions of the progression
of the health of the patient. This information is very important for effective communication
among the members, to reduce any medication errors or other forms of errors that may affect the
patient health. I have realized that pharmacological interventions are very important and thereby
learning proper medication administration to the patients with the 5R of medication is important.
Moreover, non-pharmacological interventions are also important to develop the quality of life of
the patients. Most of the patients remain very scared and helping them to develop health literacy
and be confident about their lifestyle interventions are very important. Hence, I believe that
educating them properly is also an important responsibility of the nurse.
From the above discussion, it becomes quite clear that heart failures result in different
signs and symptoms that cause very poor quality life of the patients. They tend to be highly
vulnerable to life threats and therefore they need proper treatments from professionals. Heart
failures mainly affect the pumping of the heart of individuals affecting the distribution of oxygen
to different part of the organs that create life risks. Different types of medications are available
that the professionals can provide to the patients. They can also arrange for cardiac rehabilitation,
surgery if needed and proper patient education. Such interventions would help in helping the
patients overcome the risks and live high quality lives.

10
HEART FAILURE AND ITS MANAGEMENT
References:
Bekelman, D. B., Plomondon, M. E., Carey, E. P., Sullivan, M. D., Nelson, K. M., Hattler, B., ...
& Rumsfeld, J. S. (2015). Primary results of the patient-centered disease management

11
HEART FAILURE AND ITS MANAGEMENT
(PCDM) for heart failure study: a randomized clinical trial. JAMA internal
medicine, 175(5), 725-732.
Black, J. T., Romano, P. S., Sadeghi, B., Auerbach, A. D., Ganiats, T. G., Greenfield, S., ... &
Ong, M. K. (2014). A remote monitoring and telephone nurse coaching intervention to
reduce readmissions among patients with heart failure: study protocol for the Better
Effectiveness After Transition-Heart Failure (BEAT-HF) randomized controlled
trial. Trials, 15(1), 124.
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2018). Nursing
Interventions classification (NIC)-E-Book. Elsevier Health Sciences.
Cajita, M. I., Gleason, K. T., & Han, H. R. (2016). A systematic review of mHealth-based heart
failure interventions. The Journal of cardiovascular nursing, 31(3), E10.
Clark, A. M., Wiens, K. S., Banner, D., Kryworuchko, J., Thirsk, L., McLean, L., & Currie, K.
(2016). A systematic review of the main mechanisms of heart failure disease
management interventions. Heart, 102(9), 707-711.
Clark, A. P., McDougall, G., Riegel, B., Joiner-Rogers, G., Innerarity, S., Meraviglia, M., ... &
Davila, A. (2015). Health status and self-care outcomes following an education-support
intervention for people with chronic heart failure. The Journal of cardiovascular
nursing, 30(4 0 1), S3.
Feltner, C., Jones, C. D., Cené, C. W., Zheng, Z. J., Sueta, C. A., Coker-Schwimmer, E. J., ... &
Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons

12
HEART FAILURE AND ITS MANAGEMENT
with heart failure: a systematic review and meta-analysis. Annals of internal
medicine, 160(11), 774-784.
Fihn, S. D., Blankenship, J. C., Alexander, K. P., Bittl, J. A., Byrne, J. G., Fletcher, B. J., ... &
Naidu, S. S. (2014). 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the
guideline for the diagnosis and management of patients with stable ischemic heart
disease: a report of the American College of Cardiology/American Heart Association
Task Force on Practice Guidelines, and the American Association for Thoracic Surgery,
Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography
and Interventions, and Society of Thoracic Surgeons. Journal of the American College of
Cardiology, 64(18), 1929-1949.
Jonkman, N. H., Westland, H., Groenwold, R. H., Ågren, S., Atienza, F., Blue, L., ... & Kempen,
G. I. (2016). Do Self-Management Interventions Work in Patients With Heart Failure?
CLINICAL PERSPECTIVE: An Individual Patient Data Meta-
Analysis. Circulation, 133(12), 1189-1198.
Kitsiou, S., Paré, G., & Jaana, M. (2015). Effects of home telemonitoring interventions on
patients with chronic heart failure: an overview of systematic reviews. Journal of medical
Internet research, 17(3).
Mahramus, T., Penoyer, D. A., Frewin, S., Chamberlain, L., Wilson, D., & Sole, M. L. (2014).
Assessment of an educational intervention on nurses' knowledge and retention of heart
failure self-care principles and the Teach Back method. Heart & Lung: The Journal of
Acute and Critical Care, 43(3), 204-212.

13
HEART FAILURE AND ITS MANAGEMENT
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a
holistic approach (p. 1056). Lippincott Williams & Wilkins.
Ong, M. K., Romano, P. S., Edgington, S., Aronow, H. U., Auerbach, A. D., Black, J. T., ... &
Ganiats, T. G. (2016). Effectiveness of remote patient monitoring after discharge of
hospitalized patients with heart failure: the better effectiveness after transition–heart
failure (BEAT-HF) randomized clinical trial. JAMA internal medicine, 176(3), 310-318.
Park, H. (2014). Identifying Core NANDA‐I Nursing Diagnoses, NIC Interventions, NOC
Outcomes, and NNN Linkages for Heart Failure. International journal of nursing
knowledge, 25(1), 30-38.
Piette, J. D., Striplin, D., Marinec, N., Chen, J., Trivedi, R. B., Aron, D. C., ... & Aikens, J. E.
(2015). A mobile health intervention supporting heart failure patients and their informal
caregivers: a randomized comparative effectiveness trial. Journal of medical Internet
research, 17(6).
Riegel, B., Dickson, V. V., & Faulkner, K. M. (2016). The situation-specific theory of heart
failure self-care: revised and updated. Journal of Cardiovascular Nursing, 31(3), 226-
235.
Ross, A., Ohlsson, U., Blomberg, K., & Gustafsson, M. (2015). Evaluation of an intervention to
individualise patient education at a nurse‐led heart failure clinic: a mixed‐method
study. Journal of clinical nursing, 24(11-12), 1594-1602.

14
HEART FAILURE AND ITS MANAGEMENT
Stamp, K. D., Machado, M. A., & Allen, N. A. (2014). Transitional care programs improve
outcomes for heart failure patients: an integrative review. Journal of Cardiovascular
Nursing, 29(2), 140-154.
Vedel, I., & Khanassov, V. (2015). Transitional care for patients with congestive heart failure: a
systematic review and meta-analysis. The Annals of Family Medicine, 13(6), 562-571.
Yu, D. S., Lee, D. T., Stewart, S., Thompson, D. R., Choi, K. C., & Yu, C. M. (2015). Effect of
Nurse‐Implemented Transitional Care for Chinese Individuals with Chronic Heart Failure
in Hong Kong: A Randomized Controlled Trial. Journal of the American Geriatrics
Society, 63(8), 1583-1593.