Congestive heart failure is a disease where a patient’s heart pumps insufficient blood in the body. The condition is caused by the functional condition of the heart that causes the blood to be pumped at a slow rate. The disease affects the cardiovascular structure of an individual. It can be caused by diseases that affect and destroy heart tissues. The diseases include cardiomyopathy, coronary artery condition and heart failure ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
Typical Presenting Signs and Symptoms of Congestive Heart Failure
Congestive heart failure affects individuals who are the ages of sixty-five years and above. The congestion heart disease can be triggered by the radiotherapies ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
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The signs and symptoms of congestive heart failure condition include:
The affected individual experiences difficulties in breathing (dyspnea) when carrying out activities. The condition can worsen resulting in fluid backs up in the lungs and interference of oxygen in the blood. At this stage, the patient can also experience difficulties in breathing during the night ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
The patient experiences challenges in taking part in physical activities that they could carry out before. The patient is limited to taking exercises or walking due to fatigue ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
The fluids are retained in an individual’s body which causes swelling in the legs and feet. The swelling can appear in the evening or after sitting for a long time. It could cause weight gain due to the fluids that are retained in the body. The swelling can be adverse which can affect the lips and abdominal parts ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
Concomitant Diseases Related to the Diagnosis of Congestive Heart Disorder
The examination of congestive heart failure is associated with high levels of fatality, depression, and suffering. The concomitant diseases related to the diagnosis of congestive heart disorder include ischaemic heart disease, cardiomyopathy, psychiatric disorders, diabetes, pulmonary infections, valvular diseases and high blood pressure ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
Pathophysiology of Congestive Heart Disorder
The contracting muscles of the patient diagnosed with congestive heart disorder become weak. It results in the reduction of cardiac output. The pathophysiology of the condition occurs when the heart cannot pump blood at the required rate of the metabolic tissues. The heart can pump the blood with the assistance of the advanced diastolic rate ("Congestive Heart Failure: Types, Causes, and Treatment," 2018) .
Differential Diagnosis
| Differential Diagnosis | Signs/Symptoms | Tests |
| Aging or physical inactivity | Gaining weight, physical inactivity during rest or carrying out activities, fatigue, and heart failure. | Cardiopulmonary physical activity examination can be carried out. A clear differentiation can be made after measuring the exchange of gas or the saturation of oxygen in the blood. |
| Pulmonary fibrosis | A Cough, wheezing, physical inactivity during rest or carrying out tasks and background history of smoking or exposure to industrial fumes. | The examination of the pulmonary functions will give results on the pulmonary condition. |
| Postpartum cardiomyopathy | Dyspnea, systolic disorder, consistent coughs, postpartum high blood pressure, unidentified heart diseases and chest pains. | The echocardiography tests will distinguish the signs of the cardiomyopathy condition. |
Source: ("Congestive Heart Failure: Types, Causes, and Treatment," 2018)
References on Evidence-based Practices on Congestive Heart Failure
Baptiste, D. L., Mark, H., Groff-Paris, L., & Taylor, L. A. (2013). A nurse-guided patient-centered heart failure education program. Journal of Nursing Education and Practice , 4 (3), 49.
Krive, J., Shoolin, J. S., & Zink, S. D. (2014). The effectiveness of evidence-based congestive heart failure (CHF) CPOE order sets measured by health outcomes. In AMIA Annual Symposium Proceedings (Vol. 2014, p. 815). American Medical Informatics Association.
McKeown, P., & McKeag, N. (2013). In women, increased dietary antioxidants are associated with reduced risk of developing heart failure. Evidence-Based Nursing, 17(3), 72.
Xu, Y. Z., Friedman, P. A., Webster, T., Brooke, K., Hodge, D. O., Wiste, H. J., Cha, Y. M. (2010). Cardiac resynchronization therapy: Do women benefit more than men? Journal of Cardiovascular Electrophysiology, 23(2), 172-178.
Expected Outcomes
The evidence-based education program would be useful in reducing the symptoms and cases of patients with heart failure. The patients can acquire self-management skills that would assist them in handling and preventing the disease (Baptiste, 2013) . The evidence-based practice of orders sets can be useful in improving the condition of the patients with congestive heart disease (Krive, Shoolin & Zink, 2014) . The diet antioxidants can reduce the rates of women with congestive heart failure (McKeown and McKeag, 2013). The heart resynchronization treatment can assist men and women in managing the cardiac conditions. It would be useful in reducing the rates of congestive failure (Xu et al., 2010).
Clinical Note (SOAP format)
Subjective: Peter is a 72-year-old male accompanied by his wife in the emergency room. He states that he has had a dry cough in the past one week. He has been feeling tired over the past five days. He has increased his weight with 25 pounds over the past three weeks. He recently woke up at night with difficulties in breathing.
HPI: The 72-year-old male was presenting a cough and restlessness. Peter complains of gaining weight and dyspnea. His parents’ are deceased where his father died of diabetes and the mother of congestive heart failure. The possible diagnoses at this point can be congestive heart disease, pulmonary diseases, pneumonia or effects of asthma.
Peter has not undergone any surgery or treatment. He is not allergic to the surroundings, food or drugs.
Objective:
Physical examination
Blood pressure: 124/76, RR: 23, Pulse: 54 BPM, Temperature: 96.6 F
Overweight with observation in the SOB
Genital parts have no discharge
Abdominal section is soft
Skin is warm and dry.
The three laboratory tests would include chest X-ray, BPM, and CBC. The three diagnostic analyses include sleeping, depression and EKG examinations.
Assessment:
The patient has congestive heart failure. It is in the second stage and this possible for the condition to be managed to avoid further development of signs.
Plan:
The following evidence-based methods are appropriate in improving the patient’s conditions:
The nursing education program on self-management skills and practices-2 weeks
Evidence-based care order sets-3weeks
Heart resynchronization treatment-4 weeks
Alternative evidence-based practice:
Dietary antioxidants-2 weeks
References
Baptiste, D. L., Mark, H., Groff-Paris, L., & Taylor, L. A. (2013). A nurse-guided patient-centered heart failure education program. Journal of Nursing Education and Practice , 4 (3), 49.
Congestive Heart Failure: Types, Causes, and Treatment. (2018). Retrieved from https://www.healthline.com/health/congestive-heart-failure
Krive, J., Shoolin, J. S., & Zink, S. D. (2014). The effectiveness of evidence-based congestive heart failure (CHF) CPOE order sets measured by health outcomes. In AMIA Annual Symposium Proceedings (Vol. 2014, p. 815). American Medical Informatics Association.
McKeown, P., & McKeag, N. (2013). In women, increased dietary antioxidants are associated with reduced risk of developing heart failure. Evidence-Based Nursing, 17(3), 72.
Xu, Y. Z., Friedman, P. A., Webster, T., Brooke, K., Hodge, D. O., Wiste, H. J., Cha, Y. M. (2010). Cardiac resynchronization therapy: Do women benefit more than men? Journal of Cardiovascular Electrophysiology, 23(2), 172-178.
