Heart Failure and Nurses Essay

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PICOT Analysis on Chronic Heart Failure

One may describe heart failure (HF) as a complicated medical condition which may arise due to functional or structural cardiac disorders capable of hindering ventricular capability of ejecting or filling blood. Chronic HF (CHF) represents a serious health issue. Its prevalence in America stands at over 5.8 million, while over 23 million individuals across the globe are affected by this problem. The mortality rate linked to HF is 40% in the initial diagnostic year, which reduces to 10% subsequently. Individuals most impacted by the condition lie in the age group of over 65 years. This age group is associated with rather high healthcare costs and high mortality and morbidity rates. HF patients get admitted to hospitals often and their re-hospitalization rates continually increase. In this paper, peer-reviewed articles will be employed for shedding light on the clinical issue, its diagnosis, patient care and the potential positive impact of nurse interventions on HF patient outcomes.

Clinical Problem

HF can surface because of LVSD (left ventricular systolic dysfunction) which largely arises on account of impairment in the left ventricle's contraction. Diagnosed individuals possess a narrowed LVEF (left ventricular ejection fraction). HF takes another form: as PEF (preserved ejection fraction) which is characterized by impairment in left ventricle relaxation and preserved or normal LVEF. HF patients may experience dyspnea with recumbency or with exertion. Other associated signs include dependent swelling, early satiety, swift tiredness and cough.

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HF has been related closely to hypertension, valvular heart disease, myocardial infarction and coronary heart disease. Lastly, the condition may be a secondary element of diseases not linked typically to LVSD (for instance, infiltrative disorders (like sarcoidiosis and amyloidosis), pericardial disease, and hypertrophic cardiomyopathy).

HF-diagnosed individuals ought to be tested for LVEF, and the test ought to be repeatedly performed with modification in clinical situation when physical tests or patient history cannot easily explain it. Also, it ought to be tested six months following surgical revascularization (Nicklas et al. 2013).

Evidence-Based Solution

Appropriate clinical evaluation will be able to identify patients that may display response to electro-physiological device implantation and pharmacologic therapy. Experts revealed that beta blockers, aldosterone inhibitors, and angiotensin-converting EIs (enzyme inhibitors) help decrease HF morbidity and mortality rates. They also indicate the potential of biventricular pacemakers and cardiac defibrillators in improving results among particular patients with reduced LVEF (Nicklas et al. 2013).

Nursing Intervention

Healthcare professionals, including nurses, ought to aim at treating triggering/causal factors and decreasing cardiac workload. This may be achieved through approaches like oxygen delivery for relieving ischemia; the flow rate must depend on individual patient state and hospital policy. The maintenance of activity restrictions ought to be guided by the activity tolerance of patients. Nursing staff must constantly appraise and record electrocardiogram rhythm, mental health….....

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