The Congestive Heart Failure (CHF)

The state of heart failure may denote a circumstance when the heart falls short to eject sufficient oxygenated blood to the rest of the body. The failure of heart to pump the blood prevails due to the chronic condition caused by diverse heart problems. When the heart pressure increases, the power to pump reduces below normal. The condition forces the heart to pump blood at a decreased rate. This condition generates a deficiency of nutrients and oxygen in the body due to the failure of enough blood. As a result, cardiac cavities turn out to be coagulated and inflexible since the heart reacts by broadening to contain extra blood. Such circumstances tend to support the heart to let the blood move (AHA, 2011). However, the muscles of the heart remain non-proficient and unable to pump enough blood due to weakness.

The conditions damaging an individual’s heart muscles renders kidney functionless and allow the body to hold salt and water. The entire body suffers congestion following the swelling of fluids in almost all parts of the body. These conditions result from circumstances that overload the heart function, infections from drug abuse, heart attack, and coronary artery illnesses (AHA, 2011). Thus, without human interventions the conditions result into congestive heart failure (CHF). This paper discusses the pathophysiology, prevalence, and the management obstacles when dealing with Cardiomyopathy heart failure. The paper also highlights the interventions that can help the Left-sided heart failure patients through nursing (Heidenriech, Trogdon & Khavjou, 2011). Finally, the education given to the patients for home discharge concludes the discussion section.

Pathophysiology of congestive heart failure

Pathophysiology signifies the functional body changes that accrue from congestive heart infection. In fact, this is a union of both physiology and pathology. Physiology is a control in biology describing the operational mechanisms and processes that occur inside an organism. In contrast, pathology is a discipline in ecology that tends to illustrate the typical and pragmatic conditions during the state of heart failure. Since the fiscal 1970, the complete conception of CHF has gone under essential transformations. This includes the primal expression of heart failure phenotypic, CHF natural unfolding, and the way it originates. Thus, is becomes important to recognize and correct the risk factors associated with the intensification of Cor pulmonale (Francis & Tang, 2003).

The broad definition of heart failure as a clinical syndrome has transpired over years. The state is a set of symptoms distinguished with fatigue and dyspnea of the heart. The heart suffers certain abnormalities in the structure due to increased stretching. Certainly, with physical exertion or at respite the heart gets fatigued. In the United States for instance, there are a number of causes of congestive heart failure (Francis & Tang, 2003). Normally, the heart might fail owing to the infiltrative disorders and lymphatic inflammatory myocarditis (cardiomyopathy) caused at the clinically silent stage. Heart failure commences at an index event stage that involves genetic alterations. Besides, the Left- sided heart failure augments from the genetic cardiomyopathies, primary cardiomyopathy, and valvular heart disorders. The other causes include pitiable management of heart attack and coronary artery syndromes (Lynn & Debera, 2001).

Initially, heart failure patients noticeably possess messed up functions of systolic systems. The patients in addition suffer from large ventricles that develop into dilation. The manifestation of tricuspid and mitral regurgitation eventually occurs (CDC 2013). The apparent results increase based on the disturbance of regular papillary muscle and its structural design along with the dilation of ventricles. With respect to the Right-sided heart failure, there can be no single index event. The index events might be clinically insidious and protracted, explosive, observable, or silent. The extended and dangerous index occurrences often signify valve cardiac disorders. In mild index occurrences, the explosive onset of cardiac viral inflammation is common. The clinically obvious events encompass acute myocardial infarction as silent events consist of genetic transmutation expression (Heidenriech, Trogdon & Khavjou, 2011).

Conversely, CHF patients happen to be less active in their physical state. The edema condition results from the possibilities of substantial retention of water and salt in the body. A number of clients suffer death following a progressive break down of blood pumping (Wang, Zhang, Ayala & Fang, 2010). In order to put a stop to or delay Cor pulmonale, it is sensible to administer the risk factors primarily and aggressively. This involves the management of chronic diabetes, cardiac vessels infections, and feebly managed hypertension. In addition, aggressive and early management of coronary artery infections and hypercholesterolemia is significant (Roger, Lloyd-Jones & Berry, 2012).

The prevalence of congestive heart failure

The health department has moved steps ahead in an all-purpose treatment for cardiovascular disease and medicinal technology. Yet, the rise in the prevalence of Right-sided heart failure is evident (WHO, 2013). In the contemporary world, heart failure is paramount with survivors of myocardial infarction that causes injury to the myocardial tissues increasing. Indeed, Cardiomyopathy heart failure is the leading diagnosis in most sanatoriums with individuals having more than sixty-five years in age. In the US, approximately six million individuals suffer from CHF or CCF. The yearly mortality rate can be approximated at fifty five thousand with Left-sided heart failure as the primal cause. In the fiscal 2008, heart failure remained as one of the contributing factors to the experienced two hundred and eighty thousand casualties in the US (Jones, & Greene, 2013).

Besides, it merely takes five years for half of the patients diagnosed with heart failure to die. The ordinary causes of such condition may include diseases that harm an individual’s heart. These are diabetes, high blood pressure as well as coronary heart infections (CDC, 2013). The development of heart failure increases due to a variety of factors inactive corporeal and obesity among others. Every year the American government spends almost thirty-five billion dollars towards lost productivity, medications, and services offered during healthcare intended for CHF patients. In comparison, the hospitalization charges amongst eighteen to sixty five years old adults were high (WHO, 2013). This ranged from seventeen and twenty five thousand US dollars at a time when congestive heart failure was observed as a primary and secondary diagnosis.

Barriers to the management of CHF

The main predicament in the management of CHF is the full discharge of rationalized clinical guiding principles towards heart failure. There is concern in relation to the outcomes of clinical guidelines on overheads reported in healthcare. Nevertheless, the guidelines consent to the timely and accurate diagnosis in conjunction with treatment of patients only if completely implemented. Failure to implement modernized clinical guidelines complicates the management of CHF. The patients cannot obtain apt therapy besides experiencing reduced hospital rates that augment to reduce chances of continued existence (Mant, Al-Mohammad, Swain & Laramee, 2011). Therefore, it becomes important for the government to implement chronic heart failure based recommendations. The execution of guidelines enables clinicians to make heart failure diagnosis possible via accessing and measuring serum natriuretic peptide. Additionally, patients are capable of saving cash from earnings that alleviate the management of congestive heart failure.

The CHF nursing intervention

Nursing interventions regarding the condition of heart failure may engage the use of devices, surgery, and medications. An early treatment as well as diagnosis of heart failure perks up the superiority of every life expectancy and the patients’ aspects (Roger, Lloyd-Jones & Berry, 2012). Under treatment, the patients are obliged to undergo substantial body activities daily, regulate salt consumption in their diets, and take medication as prescribed. The patients as well follow the symptoms of heart failure on a daily basis. Subsequently, they talk about their conditions with medical practitioners. The prescribed medicines assist the patient to get rid of excess salt and fluids in the body structure besides replacing potassium. The treatments drugs lessen the hazard of heart tempos that seem irregular and diminish heart damages (Smeulders, 2010).

The un-prescribed drugs might worsen the condition of congestive heart failure. In order to relieve the function of the heart, medication will help slow down the heart rate by opening up the vessels conveying blood. Generally, the prescription by practitioners reduces the levels of cholesterol in the body, safeguards blood from clotting, and ultimately enables the heart to pump normally (Wang, Zhang, Ayala & Fang, 2010). The other nursing intercession may be through medical surgery, use of devices, and heart transplant. The use of defibrillator is likely to put a stop to the uncharacteristic heartbeats that seem as threats to an individual’s life. The gadget works well by sending electrical impulses that bring the abnormal pulses of the heart to a halt. Equally, the patients might use a pacemaker to help in situations of elevated heart rates (Kochanek, Murphy & Kung, 2011).

The pacemaker helps patients by enabling both sides of the heart to contract at one-fell swoop besides controlling low heart rates. Medical practitioners can employ a surgery of heart valve. The doctors recommend valve surgical operation at a time when the patient is likely to suffer from cardiac failure. The doctors also employ the CABG (coronary bypass surgery) to the patients having congestive heart failure. The coronary bypass surgery helps the patients with heart failure by allowing an improved and smooth blood flow through the injured and destabilized muscles of the heart. At the end stage of heart failure, treatment may fail and a particular treatment step namely transplant of the heart is implied (Smeulders, 2010).

Patient education for home discharge

The quality of personal life expectancy, emotional functioning, social, and physical well being experience diverse effects from CHF. It becomes important to educate patients to be responsible and manage such medical situations at all levels. Unluckily, a number of patients fall short to stick onto the multifarious management even though congestive heart failure touches all facets of day-to-day existence. The patients find it difficult to deal with social and emotional consequences while at home. Therefore, the CHF nursing support focuses on the aspects of medication. Nurses offering psychological care and self-management behavior educate patients on how to administer and adjust to congestive heart failure (Mant, Al-Mohammad, Swain & Laramee, 2011). Similarly, a program by the generic cognitive-behavioral faction (CDSMP) helps the patients suffering from diverse chronic disorders to learn the same adaptive tasks from one another.

The patients through self-efficacy gain confidence and achieve particular psychological conducts that help them manage definite CHF conditions. On the other hand, CHF patients ought to report on the appointment by the doctors frequently under close monthly monitoring intervals. The regular check up of weight, blood pressure, pulsation, and heart rate facilitates an individual to stay healthier at home. The patients enquire from their doctors the amount of alcohol to consume and avoid consumption of excess salt (Kochanek, Murphy & Kung, 2011). While at home, they must evade smoking and engage in exercises to keep their body active. For instance, patients may ride on stationery bicycles and reduce weight in case of obesity. Changing the way of life such as lowering the cholesterol levels and allowing the body to rest after every activity is important. The above measures enable the heart to rest and reduce chances of increased congestive heart failure.

Conclusion

Congestive heart failure signifies a quantifiable disorder that typifies damaged heart function and structure. This state leads to fatigue and dyspnea at rest or by means of physical exertion of the heart. The pathophysiology of CHF does not have any single lesion and is thus heterogeneous. The etiologic factors explain nearly all heart failures that can transpire in the presence of whichever ill health. In real life, early acknowledgments and adjustments of the possible hazardous factors enable healthy and positive result to be obtained. The earlier documented CHF as a dilated cardiomyopathy at present surfaces as an assortment of the mutilation of genes. The heart re-modernization is an elementary rejoinder to the distorted loading conditions and myocardial damage of the heart. The remodeling of heart will enable the heart to manage its functions on the subject of grossly disfigured shape and size. The death and morbidity of patients increase due to the primary and secondary manifold changes. In due course, the timely recognition and corrective measures offered on perilous factors that develop heart failure is important for the management of CHF.

References

AHA. (2011). Congestive heart failure. Web.

CDC. (2013). Heart failure fact sheet. Web.

Francis, G & Tang, W. (2003). Pathophysiology of congestive heart failure. Reviews in Cardiovascular Medicine, 4(2), S14–S20.

Heidenriech, P., Trogdon, J.& Khavjou, O. (2011). Forecasting the future of cardiovascular disease in the United States: A policy statement from the American heart association. Circulation,123(8), 933–944.

Jones, D. & Greene, J. (2013). The decline and rise of coronary heart disease: Understanding public health catastrophism. American Journal of Public Health, 2(4), 1-13.

Kochanek, K., Murphy, S. & Kung, H. (2011). Deaths: Final data for 2009. National Vital Statistics Reports, 60(3), 1-67.

Lynn, F. & Debera, T. (2001). Congestive heart failure: Understanding the pathophysiology and management. Journal of the American Academy of Nurse Practitioners,13(6), 1-15.

Mant, J., Al-Mohammad, M., Swain, S. & Laramee, P. (2011). Management of chronic heart failure in adults: Synopsis of the national institute for health and clinical excellence guideline. Ann Intern Med, 155(4), 252-259.

Roger, V., Lloyd-Jones, D. & Berry, J. (2012). Heart disease and stroke statistics—2012 update: A report from the American heart association. Circulation, 125(1), e2–220.

Smeulders, E. (2010). Nurse-led self-management group programme for patients with congestive heart failure: Randomized controlled trial. Journal of Advanced Nursing, 66(7), 1487–1499.

Wang, G., Zhang, Z., Ayala, C. & Fang, J. (2010). Costs of heart failure–related hospitalizations in patients aged 18–64 years. American Journal of Management Care,16(10), 769–76.

WHO. (2013). Global burden of disease 2004 update: Disability weights for diseases and conditions. Web.

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