...Educating Congestive Heart Failure Patients Cynthia Jones The University of Texas at Arlington School of Nursing In partial fulfillment of the requirements of N3645 Cynthia Jones, RN October 1, 2012 Online RN-BSN Educating Congestive Heart Patients In comparison to the general population, the quality of life for patients with congestive heart failure is greatly impaired until patients are educated on the signs, symptoms and treatment of congestive heart failure. How can nurses use non-physical aspects of nursing to assist congestive heart failure patients improve their quality of life and decrease hospital visits? Patients with congestive heart failure receive physical aspects for treating the disease with the use of medications and surgery, but if patients were educated on the signs and symptoms at the onset of heart failure, outcomes should improve. When researching articles for information regarding congestive heart patients, I searched for articles in The Journal of American College of Cardiology, The Journal of Family Social Work, and the International Journal of Nursing Technologies and Classifications. I decided on these articles because they were published in reputable journals and provide correlations to the research question. In the first article seventy-six caregivers of patients with congestive heart failure used The McMaster Model of Family functioning (problem solving, communication, roles, affective responsiveness and affective...
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...Decision Making by Caregivers of Family Members With Heart Failure Julie Sanford, DNS, RN University of South Alabama, Mobile Judith Townsend-Rocchicciolli, PhD, RN James Madison University, Virginia Annie Horigan, MSN, RN Duke University, North Carolina Pat Hall, PhD, CRNP Diagnostic Medical Clinic, Mobile, Alabama Heart failure (HF) is a major cardiovascular problem and the number of people living with HF continues to climb. Throughout the illness continuum, patients and their family caregivers are involved in decision making. As the illness worsens and patients can no longer make decisions, decision making becomes the responsibility of their caregivers who may have little preparation for the role. The purpose of this grounded theory study was to examine how caregivers of family members with HF make decisions. A nonlinear decision-making process consisting of several actions was identified, which included actualizing; seeking input, information, or support; reflecting; choosing; evaluating; and validating the decision. Keywords: decision making; heart failure; caregiving; grounded theory eart failure (HF), a complex cardiovascular syndrome, is increasing in incidence throughout the world. In 2003, the World Health Organization (WHO) noted that cardiovascular disease accounted for more than 16.7 million deaths (29.2%) of all deaths worldwide with 7.2 million of these deaths attributed to ischemic heart disease. According to the American Heart Association (AHA)...
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...your name] The following questions pertain to: Sanford, J., Townsend-Rocchicciolli,J.,Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70. 1) Describe the population for this study. The population that this study utilized was caregivers who took care of family members who had HF in the Southeastern part of the U.S. 2) How was the sample selected? What are the strengths and weaknesses of this sampling strategy? The sample was recruited from adult day care facilities, cardiology offices, and inpatient hopitals. The strength of this sample was the amount of variation it included, which accounted for caregivers from each of the four stageso f HF, and spanned a variety of nationalities, employment statuses, and genders. The only weakness in th sampling strategy was that there were only 20 participants. 3) Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study? The caregivers interviewed in the study were not vulnerable at all They simply explained their experiences regarding their process of decision making in the comfort of their own homes. The only potential risk was possibly causing emotional trauma by having caregivers discuss various ramifications of this condition...
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...Family involvement plays a crucial part in prevention of disease or healing processes. McCubbin and McCubbin (1993) developed the Resiliency Model of Family Stress, Adjustment, and Adaptation which identifies how families cope with hardships and/or stressors such as chronic illnesses, addictions, deaths, etc. Stress is a concern central to most families. Family involvement provides a greater overview of the care patients should receive to cope with stressors. Therefore, nurse practitioners (NP) have the duty to involve each individual patient in his or her care as well as any identified family member. This paper will focus on the importance of implementing the Resiliency Model of Family Stress, Adjustment, and Adaptation as a foundation to...
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...from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven of 32 studies addressed this as an outcome; two of the three that compared satisfaction between groups showed a significant difference. Evaluations used many different measures, only one of which was designed for the end of life. In conclusion, researchers have conceptualized satisfaction in palliative care, and...
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...Nursing Theory Plan of Care Nur/513 May 16, 2011 Introduction Nursing theories describe and explain the phenomena of interest to nursing in a systematic way in order to provide understanding for use in nursing practice and research. Nursing theories provide a framework for nurses to systematize their nursing actions: what to ask, what to observe, what to focus on and what to think about. They provide a framework to develop new and validate current knowledge. Researchers use nursing theories to define commonalities of the variables in a stated field of inquiry, guide nursing research and actions, predict practice outcomes, and predict client response. Analysis of the Congruence and Theoretical Statements Henderson define nursing as helping people, sick or well, in the performance of those activities contributing to health and its recovery that they would perform unaided if they had the necessary strength, will or knowledge (Fitzpatrick & Whall, 2005). It is the function of nurses to help people become independent as rapidly as possible. She saw how nursing could focus on the patient and on developing a good nurse-patient relationship. She believed that the patient-focused nursing was the most beneficial kind of nursing. Henderson emphasized the use of nursing care plan. To develop effective care plan, collection of necessary information is important. She developed the 14 Basic Needs in her Theory (Fitzpatrick & Whall, 2005) as basis of individualized nursing...
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...fit each individual’s needs and provide the best outcome possible. I conducted an interview with Mrs. L., a 89 year-old homemaker, and her daughter, Ms. L, a 63-year old mortgage broker. Mrs. L. was being admitted for congestive heart failure after her daughter noticed a marked increase in weight gain over a period of one week. Mrs. L’s BNP was 863 and neither the patient nor the mother understood the significance of this level; moreover, they did not understand the nature of the blood test or what it represented. They were told in the emergency room that the BNP was 863 and “your mother is going to be admitted to the telemetry unit.” Mrs. L.’s hemoglobin was 7.2 and both women understood the meaning of hemoglobin level as the patient suffers from chronic anemia. Not being satisfied with the information they received in the emergency room and the lack of the physician to address the issue and potential complications, the daughter opted to wait until mom was situated on the telemetry unit. At this time she stated, “the teaching began.” The nurse assigned to her mom was informed, patient, and willing to discuss any issues and concerns. Additionally, she printed out information from the hospital’s computer system regarding congestive heart failure and the possible causes, treatments and effects of medication, which she found very helpful. The daughter stated this gave her an opportunity to take home the information, read through...
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...Heart Failure Western Governors University Pathopharmacological Foundations for Advanced Nursing Practice Heart Failure It is estimated that about five million people in the United States are living with heart failure with an overwhelming number of 550,000 newly diagnosed cases each year, costing the nation roughly $32 billion dollars per year (Centers for Disease Control and Prevention, 2016). Heart failure is a complex, pathophysiological condition in which the ventricles of the heart is weakened and unable to pump effectively to meet the body’s needs for nutrients or has lost adequate filling capacity. Clinical presentations of heart failure depends on which ventricles have failed to pump blood adequately; left ventricular failure, also known as congestive heart failure (CHF) is more common than right ventricular failure (McCance & Huether, 2014). The most common symptoms of heart failure are shortness of breath, fatigue, and peripheral edema. HF is not a disease, but rather a manifestation of a diseased heart. Large number of disorders can lead to heart failure, and with the aging population and many surviving primary cardiac events, it is no surprise that the most common reason for hospitalization in patients older than 65 years old is heart failure (McClintock, Mose, & Smith, 2014). Heart failure has become a major public health problem because it is the only cardiac condition that continues to increase in prevalence (McClintock, Mose, & Smith, 2014)...
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...when the arteries that supply blood to the heart muscle become hard and narrow, causing the heart to be deprived of blood and oxygen. Managing coronary artery disease can be difficult and stressful for some patients. Research about this topic is commonly explored and has positive reviews when management interventions are implemented. There have been patients who have benefited from different behavioral and pharmacological techniques that produce healthy outcomes. However, patients do not have the knowledge or resources to obtain the correct information on their own. Nurses, as advocates, should educate patients on proper care of this illness. Annotated Bibliography Driscoll, A., Hare, D. L., & Toukhsati, S. R. (2015)....
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...18 Progress in Cardiovascular Nursing Winter 2008 www.lejacq.com ID: 6611 Heart failure (HF) is the leading cause of hospitalization for persons older than 65 years and often necessitates assistance from family caregivers.1,2 Approximately 40% of older adults are readmitted within 3 months postdischarge, resulting in significant health care costs.2,3 Indeed, more than one million hospitalizations attributed to HF cost the patient and United States health care system over $27 billion a year.1 Hospitalizations related to HF are complicated by the aging process, comorbidities, and psychosocial concerns that affect successful management.2 In a study of patient outcomes post– hospital discharge, Naylor and colleagues4 demonstrated that the use of advanced practice nurses (APNs) was effective in improving outcomes for patients with HF. The feasibility of adapting this approach is limited, however; costs for home visits by an APN are high, a shortage of APNs employed in home care exists, and funding for home care has decreased with the Medicare Prospective Payment System.5 An alternative strategy for promoting self-management of HF is the use of electronic home monitoring (EHM). EHM is a form of telemedicine in which medical/nursing management interventions are provided to individuals at a distance from the health care provider.6 The primary objective of this pilot study was to examine the effectiveness of postdischarge telemonitoring by an APN...
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...ACUTE RENAL FAILURE Overview Acute renal failure is the most common disease in the acute care setting. It is estimated that acute renal failure occurs in up to 25% of all patients admitted to the hospital with a critical illness (Broden, 2009). It is even noted that patients who are admitted to the intensive care unit with no prior renal insufficiencies seem to have worse outcomes than do patients who have preexisting acute renal failure (Broden, 2009). Acute renal failure is a rapid decrease in kidney function, leading to collection of metabolic waste in the body. The pathophysiology of acute renal failure is reduced blood flow to the kidneys, toxins, infections and obstruction (Broden, 2009). There are three types of acute renal failure. They are pre-renal azotemia. This is caused by poor blood flow to the kidneys. The most common causes of this are hypovolemic shock and heart failure. The second type is intra-renal acute renal failure. This is caused by infections, drugs, tumors, glomerulonephritis, and obstruction. The third type is post-renal azotemia. It is caused by an obstruction outside of the kidneys (Dirkes, 2011). Assessment Data Ongoing comprehensive assessments are critical for the acute renal failure patient. The nurse must be attentive to the signs and symptoms of renal disease as well as complications with other organs and systems. The primary effect of acute renal failure is a decrease in urinary output that leads to fluid retention and edema. Oliguria...
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...Diane Jaynes Why Proper Nutrition? Liberty University Thesis Statement Identifying and treating infants with Non-Organic Failure to Thrive that was brought on by poor adaptation and influencing parent behaviors, results in a more successful remedy with greatly improved outcomes for the child and family. Proper nutrition is essential for appropriate growing and development for infants and will have a substantial influence on the child’s health present and future. Abstract: Proper nutrition early in infancy is very important for the physical and emotional development of a child and issues can follow the individual into their adulthood. Physicians have put into place assessments that can be done on infants around 6-8 weeks and again around 8-9 months that can detect early problems such as failure to thrive. Small kids that have been diagnosed with Autism tend to have issues with proper nutrition because of the sensitivity of foods and end up with a diagnosis of failure to thrive also. A feeding checklist for non-organic failure to thrive patients, is a great tool for helping medical personal observe feeding interactions with the infants and their parents that helps with recognizing feeding issues with the parents or caregivers. Medical professionals have advised that extensive time prior the initial conception, the nutrition of the parents has an impact on the infant’s growth all the way into adulthood and beyond (Shepard, 2009). All females that are at...
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...The last moments of an individual's life are important to themselves and families and friends they are leaving behind. It is a moment filled with terror and pain with the thought of not seeing those that we love anymore and contemplating their loss. The purpose of the end- of- life care is to; offer comfort and excellent choices for the dying person at the final chapter of their life (Gwande, 2010). Another purpose is to support their independence, giving them time to grieve for their loss of their life in the near future and give them the chance to care for their own and those of their family and friends psychological and spiritual. This is possible if they can be able to talk to the family and offer their thoughts it lets them go having said what is in their hearts and offering their support. The family will need this support even when death finally occurs. The end-of-life care also aims at providing efficient and appropriate health care and offer one a place of their choice for care whenever possible (Stein,...
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...Running head: COMPASSION FATIGUE: CARING FOR THE CAREGIVER Compassion Fatigue: Caring for the Caregiver Kimberly Flowers Grand Canyon University Spirituality in Health Care HLT-310V Patricia Mullen March 24, 2012 Compassion Fatigue: Caring for the Caregiver Introduction Compassion represents an “acknowledgement of another’s suffering and is accompanied by the expression of a desire to ease or end that suffering.” (Van der Cingal, 2009, p. 124) This is a fundamental characteristic usually found in health care workers and nurses especially. In one twelve hour shift, a nurse’s job can change from taking vitals and administering medications to performing life saving measures or even holding a dying patient’s hand as they transition from this world to the next. And in that same few hours, a myriad of emotions can flood the soul with such force it leaves one drained and exhausted. This would be a very difficult roller coaster of emotions for anyone, but multiply that times three or four days per week for many years. It is no surprise that health care workers are extremely susceptible to emotional and physical fatigue, also known as compassion fatigue. Compassion fatigue is that fatigue brought on by giving so much of one’s self for an extended period of time without taking time to revive or replenish one’s own physical, emotional and spiritual needs. This paper will explore the nature and causes of five major...
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...Case of Jesica Santillon, deaths occur in the US each year because of medical mistakes; the biggest factor being miscommunication or lack thereof between multiple health care professionals. In the Case of Jesica Santillon, Duke University Hospital, one the nation’s top medical center, transplanted a heart and two lungs into 17-year-old Jesica Santillon in a rare and difficult operation, whose miscommunication resulted in her receiving organs of the wrong blood type, and ultimately an untimely death. Jesica was smuggled by her parents from Mexico to the United States in search of treatment to a life-threatening heart and lung disorder that doctors in Mexico could not fix. Through charity, enough money was raised for her to receive a transplant, however the procedure went wrong and lead to severe brain damage. When informed by the doctors that they planned to stop treatment, her mother announced at a press conference via a translator that “they are taking her off of the medicine little by little in order to kill her. They want to rid themselves of this problem.” It is evident that social and cultural barriers made it difficult for doctors to communicate with Jesica’s family. Barriers in communicating such include a negative relationship, poor credibility, and communication mismatch such as the language barrier and use of a translator. Though Dr. James Jaggers, the chief of pediatric surgery at Duke University, was a highly skilled and well-regarded physician at a prestigious...
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