Congestive Heart Failure: Risk Factors, Symptoms, Treatment, and Nursing Interventions

Nrsg 353 Acute Care
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Q.1.
Congestive heart failure (CHF) is a diseased status in which heart loses its ability to pump the
necessary amount of blood. Insufficient quantity of blood pumping by heart mainly occurs
due to cardiovascular conditions like high blood pressure and constricted arteries (Povsic,
2018). CHF is associated with risk factors like demographic factor like age, social factor
like smoking and inadequate physical activity and biological factors like high blood pressure,
obesity, diabetes and raised levels of cholesterol (Dhingra et al., 2014). In case of Mckenzie
(77 years), age is one of the risk factors for the occurrence of CHF. Probability of CHF
increases with increase in the age of the person. 2 and 5 % individuals upto age 60 and 70
years respectively are at risk of CHF. Moreover, Mckenzie is associated with hypertension.
Hence, it also can contribute to the occurrence of CHF in her. Females with hypertension are
four times at more risk with CHF relative to the normal female. Male and female are 40 and
60 % respectively at risk of CHF (Maahmood and Wang, 2013). High and low levels of low-
density lipoproteins and high-density lipoproteins respectively are responsible for the
occurrence of CHF. More saturated fat intake and β-type natriuretic peptides are also risk
factors of CHF (Díaz-Toro,Verdejo, and Castro, 2015). Obesity (36 %) and smoking (20 %),
also are risk factor for CHF (Australian Institute of Health and Welfare (2014).
Individuals with cardiovascular abnormalities and dysfunctioning like cardiomyopathy,
coronary artery disease (CAD), myocarditis, arrhythmias, defective heart valves and
myocardial infraction (MI) are at higher risk of CHF. Since, Mckenzie is associated with MI;
she is at higher risk of CHF. Medication consumption like antidiabetic drugs, nonsteroidal
anti-inflammatory drugs (NSAIDs), anaesthetic and anticancer might lead to development of
CHF (Chow and Senderovich, 2018). Individuals with CHF might survive maximum upto
five years after its diagnosis and these individuals are with 10 % higher death rate relative to
the normal individuals (Australian Institute of Health and Welfare, 2014).
Mckenzie might not be able complete routine activities due to cardio-pulmonary
diseased condition. Hence, family members need to extend support to her to carry out these
activities; and observe and monitor her activities. It would be helpful in extending
psychological and emotional support to her. Diseased condition of Mckenzie might impart
psychological stress and economical load on family members. Both family and staff members
need to regulate her medicines, diet and risk factors to achieve her speedy recovery. Positive
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communication of family and staff members with Mckenzie would be helpful in achieving
her speedy recovery (Cooper, DeVore, and Michael Felker, 2015).
Q2.:
Symptom Pathophysiology
Dyspnoea Dyspnoea is a condition in which individual experience breathlessness.
Patients with CHF are usually associated with dyspnoea due to decreased
cardiac output. Reduced cardiac output lead to lessened blood supply to
skeletal muscles which results in the skeletal muscle dysfunction. Skeletal
muscle dysfunction results in the rise in the left ventricular pressure which
is helpful in increasing cardiac output. It leads to cascade of events like
pulmonary diffusion followed by interstitial oedema and finally
breathlessness. Raised ventricular pressure require more amount of energy
due to extra expenditure of energy. It results in the development of
myocardial ischemia and raised requirement of oxygen. (Güde, Brenner,
Störk, Hoes, and Rutten, 2014). As a result, there is development of
dyspnoea in Mckenzie due augmented oxygen requirement.
Swollen
ankle
Swollen ankle is condition in which there is swelling in the ankle. Fluid
build-up is the prominent factor for swelling. Reduced ventricular filling
and raised levels of natriuretic peptide and β-type natriuretic peptide are
accountable for vasodilation. Reduced cardiac preload and afterload mainly
occur due to vasodilation and reduced ventricular pressure. Subsequently, it
produces diminished blood back flow to the heart through the veins.
Diminished blood back flow mainly occurs due to constriction of the valve.
It led to the insufficient blood pumping by the heart (Eisen, 2014). In
McKenzie, swollen ankle mainly occurs due to cardiovascular abnormality
like diminished cardiac output.
Dizziness CHF characterised by the diminished supply of blood to organs comprising
of brain. Individuals with diminished supply of blood to brain tend to
develop dizziness due to inadequate supply of oxygen. Irregularity in the
cardiovascular parameters like heart rate and rhythm are the prominent
factors responsible for the development of dizziness in the CHF patients.
Six primary neurotransmitters of three-neuron arc regulate functions of
vestibulo-ocular reflex (VOR). Acetylcholine acts as an excitatory
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