Congestive heart failure (CHF) is considered to be a “leading cause of hospitalization for those over the age of 65” (Azad & Lemay, 2014, p. 329). The condition represents a serious economic burden for patients and hospitals. Moreover, it may adversely affect the quality of life and become a source of distress for the patient’s relatives as it can be observed in the case of Mr. P and his wife.
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Approach to Care and Treatment Plan
A comprehensive model of care known as holistic care is suitable for Mr. P’s situation. Holistic care is “behavior that recognizes a person as a whole and acknowledges the interdependence among one’s biological, social, psychological, and spiritual aspects” (Zamanzadeh, Jasemi, Valizadeh, Keogh, & Taleghani, 2015, p. 215). Based on this, the treatment plan should address lifestyle, environment, medication, and health knowledge of the patient.
Both behavior and emotions can significantly increase the load on the heart. Therefore, the nurse should advise patients to change unfavorable behaviors. The nurse should also emphasize the importance of a safe environment for the patient’s health, encourage family members to decrease his exposure to noise and environmental pollution, which may lead to respiratory distress and increase demand in oxygen (Amakali, 2015). Additionally, Mr. P should refrain from eating unhealthy foods with high fat and salt content to minimize the risk of fluid retention and the consequent increase in the load on the heart (Amakali, 2015).
Along with the primary intervention techniques mentioned above, it is important to educate the patient and his family on coping mechanisms and acceptance of the current health status, self-care practices including self-monitoring, lifestyle change, healthy dieting, self-administration of medication, etc. It is possible to say that verbal education in the form of an open dialog may be beneficial for Mr. P and his wife. By instructing in this way and allowing them to ask questions, the health practitioner may significantly raise their awareness of CHF-linked problems, boost their confidence needed for home-based self-care, and encourage the adherence to prescribed treatment. However, it can also be recommended to design self-management guidelines and provide Mr. and Ms. P with sufficient information resources to which they can refer when in doubt. These resources may include printed materials and brochures, as well as the list of contacts and available support sources.
According to Amakali (2015), the patient should be educated about the major effects of CHF, e.g., general slow circulation, decreased oxygen content, and low cardiac output, i.e., insufficient delivery of blood to various body organs. After this, Mr. and Ms. P will be informed about possible physical experiences associated with these CHF manifestations. The nurse should discuss such symptoms as weakness, coldness, dizziness, shortness of breath, and so on, and instruct the patient and his wife on how to deal with them and prevent exacerbation. The patient should be provided with self-monitoring guidelines and informed about situations when the symptoms should be reported to the healthcare practitioner.
The nurse should talk about risky behaviors and psychological factors that may aggravate the patient’s condition. Together with the patient, they need to evaluate all potential behavioral risks and develop a realistic intervention plan. Additionally, they should identify the products that can be consumed by Mr. P and which of them should be avoided. Then, his wife should be educated on how to prepare healthy meals.
The nurse must evaluate the patient’s barriers to the regular intake of prescribed drugs. A more suitable regimen should be developed for him afterward. Moreover, his wife should be encouraged to control compliance with the selected treatment regimen. To make it easier for Mr. and Ms. P to adhere to the treatment plan, the schedule for medication supply and follow-up treatment can be designed.
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Since CHF is associated with various unfavorable concomitant conditions, polypharmacy, and impaired functionality, the approach to care should address multiple sides of the problem. Thus, patient and family education, promotion of self-care practices, and other methods of complementary treatment suggested in the paper can contribute to greater patient satisfaction and better outcomes.
Amakali, K. (2015). Clinical care for the patient with heart failure: A nursing care perspective. Cardiovascular Pharmacology, 4(2), 1-5. Web.
Azad, N., & Lemay, G. (2014). Management of chronic heart failure in the older population. Journal of Geriatric Cardiology: JGC, 11(4), 329–337. Web.
Zamanzadeh, V., Jasemi, M., Valizadeh, L., Keogh, B., & Taleghani, F. (2015). Effective factors in providing holistic care: A qualitative study. Indian Journal of Palliative Care, 21(2), 214–224. Web.