Congestive Heart Failure for Left Hypertrophy -myassignmenthelp

Question: Discuss about theCongestive Heart Failure for Left Hypertrophy. Answer: Several causes can lead to the development of CHF. One of the important causes behind the development of the CHF is previous reported cases of myocardial infarction (Graham et al., 2010). According to the reports published by Graham et al. (2010), CHF is common among the 50% of the patients who have previously reported cases of myocardial infarction (MI). MI is also defined as heart attack or an irreversible death of the heart muscle arising out of the lack of adequate oxygen supply. Since the body was previously suffering from the lack of adequate oxygen within the body, there occurs immense stress over the heart muscles and vessels in pumping blood. These increases in the stress of the heart muscles create strain and thereby hampering their elasticity and all these cumulates towards the development of CHF (Graham et al., 2010). Mrs. McKenzie has developed MI at the age of 65 and that might be cited as a reason behind the development of CHF at 77 years of her age. One of the important risk factors behind the development of CHF poorly controlled high blood pressure (Cooper-DeHoff et al., 2010). According to Cooper-DeHoff et al. (2010), prolong report of high blood pressure results in the formation of left ventricular hypertrophy along with thickening of the heart muscles and this results in inadequate relaxation of heart muscles along with irregular heart beat and thereby leading to the generation of CHF. Moreover, prolong cases of high blood pressure makes it extremely difficult of the heart to meet the oxygen demand of all the organs of the body especially during exercise and as a result, the heart rate increases. These frequent cases of increase in heart rate along with deficiency of oxygen supply to all the organs of the body ultimately lead to the development of CHF (Cooper-DeHoff et al., 2010). Mrs. McKenzi has high blood pressure (170/100 mm Hg) and it was also reported that she suffers from shortness of breath and this increases when sh e does gardening and all these lead to the development of CHF. Age is another factor which has increased the risk factor of people like Mrs. McKenzi to develop CHF (Bui, Horwich Fonarow, 2011). Apart from damaging the physical health of the individual, CHF, also cast a significant impact on the mental health of the patients and this contribute to emotional burden. People with CHF, fails to perform their daily living activity due to their shortness of breath and thus they become dependent on other creating poor self-esteem. Moreover, CHF demands regular monitoring along with costly medication, which creates both mental and physical burden over the family members (Rutledge et al., 2013). Following the case study of Mrs. McKinzie, it can be stated that her shortness of breath, swelling of ankles, nausea and dizziness, cold feet and high blood pressure are main symptoms of CHF. Below mentioned is the pathophisiology of the each symptom. Symptoms Pathophysiology Shortness of breath CHF is defined as the difficulty of heart to supply adequate oxygen to the different organs of the body. This lack of adequate oxygen leads to the development of shortness of breath. In CHF the fluid backs up into the lungs and this interferes with the oxygen getting into the blood thereby causing dyspnea while at rest and orthopnea at night (Kemp Conte, 2012). Swelling of ankles Edema is common symptoms of CHF which leads to the development of swelling of ankles. Edema generally occurs due to the activation of humoral and non-humoral mechanism promoting re-absorption of the sodium and water from the kidneys and thereby increasing the body fluid concentration. As the right ventricular side of the heart begins to malfunction because of CHF, the fluid retention initiations and the extra fluid gets collected at the lower part of the body, feet (Kemp nd Conte, 2012). Nausea and Dizziness CHF leads to persistent tiredness along with difficulty in performing daily living activities because arising persistent tiredness. nausea and dizziness arise out of fatigue and can be regarded as the first symptom of CHF. The neurologic reason behind the development of nausea is related with the emetic centre of the brain, which occurs due to the lack of oxygen supply (Kemp Conte, 2012). According to Kemp and Conte (2012), the onset of nauseas may be attributed by the change in the level of vasopressin (common in CHF). Cold feet and finger tips According to Kemp and Conte (2012), feeling of cold in the extremities happens because the body is circulating the majority of available blood to the brain and other vital organs in order to compensate the reduced ability of heart to pump adequate blood to the different parts of the body. High blood pressure In CHF there occurs fluid build up within the body and increase in thickening of the heart muscle, this increases the labour of the heart to pump the blood to the different parts of the body leading to increase in blood pressure (Kemp Conte, 2012). Digitalis glycosides According to Ambrosy et al. (2014), digitalis glycosides is used for people who are suffering from heart failure which results out of left-ventricular systolic dysfunction. Digitalis glycosides is given along with standard CHF theray like angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and diuretics (Ambrosy et al., 2014). Digitalis glycosides works via inhibition of Na+/K+ ATPAse in the myocardium. Inhibition of Na+/K+ ATPase increases the intracellular level of sodium resulting in a decrease of sodium-calcium exchangers activity. Lack of activity of sodium-calcium exchanger increases the intracellular concentration of calcium ion and this lengthens phase 4 and phase 0 of cardiac action potential, which leads to the decrease in heart rate. Increase in intracellular Ca2+ ions increases the concentration of Ca2+ ion the sarcoplasmic reticulum. Ca2+ ion in the sarcoplasmic reticulum is released during the action potential and thereby increasing the contractility of the he art without increasing hearts energy expenditure (Ambrosy et al., 2014). ACE inhibitors ACE inhibitors reduce the formation of heart damaging hormones. ACR inhibitors have also been found to decrease the workload of the heart via decreasing blood pressure. The main action of ACE inhibitors is it blocks the formation of angiostenin II via blocking the conversion of angiostenin to angiostenin II. Angiostenin II is mainly responsible for the narrowing of the blood vessels and thereby increasing the blood pressure. Thus, decrease in the formation of angiostenin II prevents the narrowing of the blood pressure and this in turn prevents the vasoconstriction and thereby causing relaxation of the heart muscles and overall decrease in heart load and subsequent blood pressure (van Vark et al., 2012). ACE inhibitors also work via controlling rennin-anngiostenin-aldosterone system (RAAS) and this in turn controls the fluctuations of blood pressure and the fluid balance of the body. Proper control of the fluid balance of the body, decreases the fluid retention in the lower extremitie s and thereby reducing the load of the heart to pump blood with more pressure (van Vark et al., 2012). It was important to design an effective nursing care strategy for a patient admitted to emergency care department with complaints of potential congestive heart failure. During designing the effective nursing plans and interventions for the patient, some of the clinical conditions need to be taken into consideration such as the current medications of the patient along with effectively monitoring the test results from the physical examination of the patient. The ECG recordings of Mrs. Mckenzie showed sinus bradycardia , whereas the chest x-ray depicted cardiac enlargement and lower lobe infiltrates. In this case, the condition of lower lobe infiltrates could be referred to mycoplasma pneumonia (Carthon, Lasater, Sloane, Kutney-Lee, 2015). A number of care plans and interventions could be designed for the patient depending upon the need. Some of these have been discussed in order of priorities such as administering supplemental oxygen. The patient had a history of myocardial infarction and had been complaining of chest pain and shortness of breath. The tests reported the presence of lower limb infiltrates which could be due to early stage pneumonia. Therefore, putting the patient on supplemental oxygen could have reduced the chances of occurrence of hypoxia (Hemphill et al., 2015). Since the patient had reported sinus bachycardia and recorded an abnormally low heart rate of 54 beats per minute. Thus, apical pulse monitoring on every hourly basis could help in keeping a record of any abnormality within the heart rate of the patient (Buck et al., 2015). The nurse should also keep a record of the vital signs of the patient such as awareness of surroundings and responsiveness. The condition of the patient could be followed up with the help of the ABCD pathway; where A refers to airway, b breathing, c- cardiopulmonary resuscitation and D- disability and E-exposure. From the diagnosis, it was confirmed that Mrs. Mckeinze had potential heart failure. Therefore, apart fr om the interventions mentioned above the nurse needs to focus upon the medication plans of the patient. Some of the medications, which were offered to the patient over here are digitoxin, frusemide, analine etc. The digitoxin helped in prolonging the refractory period of the atrioventricualr junction and helped to increase the cardiac efficiency output. The frusemide administration would help in curing the fluid buildup due to heart failure. Therefore, providing the patient with such medication would have been beneficial as the patient showed signs of cardiac enlargement, which could be entitled to the fluid buildup. The nurse can use electric thoracic bioimpedance technique (TEB) for measuring the cardiac output (Riegel, Dickson Faulkner, 2016). The test should be repeated within 72 hours in order to analyze the overall condition of the patient. 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