Congestive Heart Failure Case Study

Defective heart valves affect the movement of blood within the hearts chambers causing an increased workload and an elevation of the blood volume to be processed by the heart in each cardiac cycle. This increase in blood volume leads to the pooling of blood. Other causative factors of congestive heart failure include thyroid disorders, myocarditis and diabetes. The risk factors for congestive cardiac failure include health conditions such as; poorly managed hypertension, obesity, high cholesterol levels viral infections of the heart and thyroid disorders (Del Gobbo et al. Medication side effects from medications such as nonsteroidal anti-inflammatory drugs, cytotoxic medications among others. This consequently elevates the capillary hydrostatic pressure hence increased capillary fluid extra filtration into the peripheral tissues leading to edema which is characterized by the edema noted in the legs, feet and the ankles.

Peripheral Edema can also be evidenced by characteristic widening of the abdominal girth due to ascites. Fatigue and weakness Reduced cardiac output consequently there is reduced tissue perfusion to muscles which leads to depletion of oxygen in muscles causing fatigue and weakness (Pellicori, Kaur & Clark, 2015). Activity intolerance Exertional dyspnea occurs in congestive cardiac failure due to the increased demand for oxygen by the muscles involved in exercises, the reduced tissue oxygenation due to reduced gaseous exchange following pulmonary edema and a reduction in cardiac output hence reduced tissue perfusion (Kupper, Bonhof, Westerhuis, Widdershoven & Denollet, 2016). As activity consume much energy and oxygen, congestive cardiac failure patients have difficulties maintaining exercises leading to activity intolerance observed in the condition (Santos et al. The action of the venous dilators hence provides a relieve from the systemic and pulmonary edema that is common in patients with cardiac failure.

Diuretics are medications that induced increased excretion of water from the body through increased urine output in the kidneys. Diuresis is achieved through inhibit reabsorption of sodium hence increasing water excretion (Qavi, Kamal & Schrier, 2015). The diuretics function to inhibit sodium reabsorption at different segments of the nephron. The common classes of diuretics action directly on sodium reabsorption are the loop diuretics such as hydralazine and thiazide diuretics such as hydrochlorothiazide (Qavi, Kamal & Schrier, 2015). To ease breathing I will position the patient in a cardiac bed raised at 450 which will also enhance the drainage of secretions that may be in the airway. Another key strategy will be to ensure concurrent hemodynamic and heart rhythm (via 12-lead ECG) monitoring of the patient. Hemodynamic monitoring is essential as it informs on the management of the symptoms of the congestive failure and informs on the patient’s progress (Amakali, 2015).

Administration of the medications as per the physician orders will be critical to relieve the symptoms of the congestive cardiac failure. I will insert a catheter to the patient to facilitate hourly monitoring of the patient’s urine output. Clinical Care for the Patient with Heart Failure: A Nursing Care Perspective.  Cardiovascular Pharmacology: Open Access, 04(02). doi: 10. 1000142 Del Gobbo, L. , Kalantarian, S. 009 Dubé, B. , Agostoni, P. , & Laveneziana, P. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors.  European Respiratory Review, 25(141), 317-332. 1186/s12875-016-0537-5 Kupper, N. , Bonhof, C. , Westerhuis, B. , Widdershoven, J. , & Denollet, J. v5. i2. 85 Pellicori, P. , Kaur, K. , & Clark, A. 123 Qavi, A. , Kamal, R. , & Schrier, R. Clinical Use of Diuretics in Heart Failure, Cirrhosis, and Nephrotic Syndrome.