Introduction
Let us begin by finding out what is Congestive Heart Failure (CHF) and Atrial Fibrillation (AF) as well as their main causes. According to the American Geriatrics Society (2003), CHF is a cardiovascular condition that is common in older people, and the ailment increases considerably with age. American Geriatrics Society (2003) defines CHF as a disease in which the heart is not able to drive enough blood to the body tissues required to meet the metabolic needs of the body. The Royal College of Physicians (2006) defines Atrial Fibrillation (AF) as an atrial tachyarrhythmia distinguished by primarily uncoordinated atrial activation with resultant worsening of atrial mechanical function.
Congestive Heart Failure (CHF) and Atrial Fibrillation are mainly associated with aging even though other risk factors cause them. The Royal College of Physicians (2006) argues that there are several risk factors responsible for developing AF and that there is an escalating occurrence and frequency of AF with increasing age. In addition, AF is usually related with and made complex by CHF and strokes The Royal College of Physicians (2006).
The Main Four Sallie Mae’s Health Problems
Some of the main health problems that Sallie Mae is bound to face include: Breathing problems, weight gain in a short period of time, fluid overload, and psychosocial stress. A patient with CHF frequently suffers from shortness of breath. American Geriatrics Society (2003) states that one of the most common complaints with severe or worsening CHF is shortness of breath American Geriatrics Society (2003) adds that patients may also experience pedal or peripheral edema, cough, or fatigue. This explains why CHF patients need to be transported in an upright position because shortness of breath and cough often get worse when they lie flat, American Geriatrics Society (2003). The AGS (2003) also provides that CHF patients tend to report putting on additional weight within a short period of time like in the case of Sallie Mae.
Other problems that she might encounter include psychosocial stress and fluid overload. According to Emmiline Edwards as cited in Kukanyika (1992) psychosocial stress is not only one of the problems facing CHF patients but also one of the factors that worsen and contribute to heart diseases. Sallie Mae faces the risk of experiencing psychosocial stress especially because she does not have a close person who can keep her company apart from her daughter whom we are told works full time and thus may not have ample time to be with her ailing mother.AGS (2003) provides that CHF patients develop problems connected to fluid overload.
Possible Medical and/or Nursing Interventions
Some of the possible medical and/or nursing interventions that can ease Sallie Mae’s conditions include the usual multiple medications that patients with CHF normally take, American Geriatrics Society (2003). According to AGS (2003), a physical exam is also crucial in the evaluation of a CHF patient which Sallie Mae’s nurse can undertake. According to AGS (2003), the common medications with CHF includes Angiotensin-converting enzyme (ACS) inhibitors (captopril and Altace), Angiotensin-receptor blockers (ARBs) (losartan and Hyzaar, Digoxin and potassium supplements among others.
Scripted Dialogue Portion
I:” How are you, Ms. Sallie Mae. My name is———and I am pleased to let you know that I will be your nurse this week. How are you feeling now?”
Sallie Mae:” I am fine thank you. Welcome, I am grateful to have you here this evening.”
I:” Thank you, Ms. Sallie. I am also happy to be with you and encouraged that you are taking heart and determined to defeat this condition.”
Sallie Mae (Smiling):” OH! It is part of this short life my daughter you know does not mind.”
I:” It is important to note that CHF which stands for Congestive Heart Failure is a common cardiovascular condition among a person of your age…even though your case is worsened by the accompanying Atrial Fibrillation(AF) and hypertension. All the same, your condition can also improve for the better especially if you will take all the medications as prescribed to you by the doctors without failure. You also need someone close to living with so that you can minimize the probability of suffering from psychosocial stress which worsens CHF.”
Sallie Mae (boldly).I am grateful for your advice and I promise to cooperate fully.
I: “See you tomorrow. Thank you for your audience”
Reference List
American Geriatrics Society, (2003).Geriatric Education for Emergency Medical Services. Sudbury, MA: Jones & Barlett Learning.
Kukanyika, S. (1992). Atrial fibrillation: national clinical guideline for management in primary and secondary Pulmonary Disorders and Health. Durby, PA: Diane Publishing.
The Royal College of Physicians, (2006). Atrial fibrillation: national clinical guideline for management in primary and secondary Care. London: Royal College Physicians.