Mr. P’s case is an exceedingly difficult situation that needs superior nursing skills and knowledge. As a nurse, I will develop an instrument for assessing Mr. P and his family’s knowledge of congestive heart failure (American Academy of Nurse Practitioners, 2010, p. 57). Together with the patient and family members, I will review causes of coronary heart failure especially its connection with cardiomyopathy, and its effect on the body. Eventually, I will explain the treatment plan relevant to this case.
In Mr. P’s case, cardiomyopathy itself is the underlying cause of congestive heart failure. Cardiomyopathy impairs heart muscle contraction and this causes the heart to pump less blood to other parts of the body resulting in accumulation of fluid in the tissues. This phenomenon underscores why the patient has a high level of edema, moist crackle throughout his lung fields, and labored breathing.
Because of cardiomyopathy, the appropriate treatment plan for CHF is a heart transplant. However, because of the cost of the procedure, Mr. P should consider palliative care. In palliative care, professional nurses will supervise his compliance to drugs, nutrition restriction, and rest. Palliative care will relieve the wife of the duty to watch over Mr. P because nurses in palliative care unit will take that responsibility. Nurses in the palliative care should implement a treatment plan that focuses on the removal of excess water accumulated in the tissues, increase the capacity of the blood vessels to contain blood held back in tissue, and reduce exertion on the lungs and heart.
A treatment program for CHF, according to the American Heart Association (2011), includes rest, right diet, adjusted daily activities, and medications. The available medications include angiotensin-converting enzyme, beta-blockers, vasodilators, digitalis, and diuretics. These different classes of drugs have set goals. Vasodilators and ACE inhibitors dilate blood vessels, with the latter dilating those afferent to the kidney. This allows large volumes of blood to reach the kidney, so that the body loses water through urine as opposed to its accumulation in body parts, which causes edema. Increased blood vessels’ lumen reduces resistance to blood, and makes the heart work easily.
Beta-blockers target the muscle of the heart ventricles. Beta-blockers increase the contraction force of the heart muscle (American Heart Association, 2011), so it can pump as much blood as it receives from body and this scenario lessens congestion.
Finally, a psychological counselor may help Mr. P overcome his state of hopelessness and see his life beyond his current circumstance. Another option is to enroll in cardiac rehabilitation program to help Mr. P implement a lifestyle modification (Eshah & Bond, 2009, p. 133), and learn to adhere to his medication. Worth noting, his participation in social security program, such as disability insurance, will help greatly in addressing his problem because, with disability insurance, he can access heart transplant procedure, and solve his problem. Therefore, it is necessary to enroll in relevant social security programs.
Because of her problem with managing the medical bills, I will advice the wife of the patient to take health insurance for her husband, and even enroll for Medicaid so that medical expenses can be reduced. The other program she can enroll in is the managed care.
Reference list
American Academy of Nurse Practitioners. (2010). Health promotion/risk reduction and disease prevention. Journal of the American Academy of Nurse Practitioners 22 , 57-59.
American Association for Clinical Chemistry. (2011). Complete Blood Count. Web.
American Heart Association. (2011). Coxngestive heart failure. Web.
Eshah, N. F., & Bond, E. A. (2009). Cardiac rehabilitation programme for coronary. International Journal of Nursing Practice, 15, 131-139.
Lichtin, A. E. (2008). Anemia Due to Excessive Bleeding. Web.
Mayo Clinic. (2011). Mayo Clinic. Web.
The National Hematology Disease Information Service. (2008). Anemia of Innflammation and Chronic Disease. Web.
U.S. Department of Health and Human Services. (2011). Medlineplus. Web.