Heart Failure- Case Study [Name of Writer]
[Name of Institution]
Heart failure
Clinical Course of Care
Clinical course of care means how the disease changes its behavior from time to time; it may improve or deteriorate, depending on the care that is being provided. Clinical guidelines should be followed, but the team has to practice the best individualized care in order to treat the patient well. Clinical guidelines based on heart failure are the primary focus of several medical platforms. Mortality, morbidity and expenditures are associated to a widespread condition known as Heart Failure.
Case Study
This paper deals with a case study of a female Lydia who is 68 years old and is suffering from Heart Failure. She is a heavy smoker and when she was rushed to the emergency department she was complaining of breathlessness that worsened in the past 5 days, slightly productive cough, and panting since the past 3 days and the beginning of orthopnea. She has a history of persistent pulmonary disease, heart failure and hypertension. She had been admitted in the hospital for pneumonia 3 months back and had been through a chronic heart failure 11 months ago. Lydia’s left ventricular expulsion ratio was 47% that was calculated 4 months ago. As per physical examination, her temperature was 37 degrees C, heart rate was 98 beats/mins and the recorded blood pressure was 170/110, the weight of her body was 175 pounds which had increased 10 pounds since it was last recorded 4 months ago. She was suffering from wet unhealthy sounds of the lungs and wheezing, that could be felt more dominantly of the left side, 8 cm of the venous tightness, perceptible sound of fourth heart, gentle cavity edema in the right leg. There was no penetration observed in radiography of the chest but congestion of pulmonary venous. There was no dead tissue found or ischemia but the ECG showed the rhythm of sinus to be normal and hypertrophy in left ventricle. Lab reports showed nitrogen level blood urea of 45 mg, approximated glomerular filtration rate of 50 ml/min, cardiac troponin I of 100 mg, serum creatinine level of 1.2 mg, count of white blood cell of 12 475 cells/mm3 and the liver enzymes had also increased at a mild ratio. Lydia was already on medication as follows, for hypertension and heart failure she was advised 100 mg triamterene, daily once a day 10 mg bisoprolol, daily twice a day enalapril. The natriuretic level of peptide in the brain was not provided as sample on presentation. Clinical Care Environment Generally, all the patients are recommended to possess a thorough physical examination, radiography of the chest, evaluation of laboratory, echocardiogram, electrocardiogram for maintaining medical history (Daniels et al 2012). Physical inspection and medical history tends to be the foundation of the assessment procedure. The patients are classified with the help based on the sufficiency of the level of congestion, whether it’s wet or dry, and peripheral perfusion as to whether it’s cold or warm. The highly recommended tests of the laboratory comprise of serum electrolytes, serum creatinine, urinalysis, blood urea …show more content…
High blood pressure check; is the first step when assessing the patient with heart failure. It is likely to prevail in the majority and subsequent and urgent treatment should be done, or the patient would suffer more on account of organ damage. Enzyme inhibitors, aldosterone antagonists, beta blockers, and angiotensin were given to Lydia as long term treatment which would reduce breathlessness. Strong follow ups are required after discharging Lydia. Morphine can also be used with great care as prolonged use might result in …show more content…
The approach to the patients well being can be ensured when accurate diagnosis is followed by best therapy and treatment. References
Daniels LB, Clopton P, Potocki M, et al. (2012) Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of acute heart failure: results from the BACH multinational study. Eur J Heart Fail, 14:22–31.
Joseph SM, Cedars AM, Ewald GA, et al. (2009) Acute decompensated heart failure: contemporary medical management. Tex Heart Inst J. 36:510–520.
Maisel A, Mueller C, Adams K, Jr, et al. (2008) State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail.
[Name of Institution]
Heart failure
Clinical Course of Care
Clinical course of care means how the disease changes its behavior from time to time; it may improve or deteriorate, depending on the care that is being provided. Clinical guidelines should be followed, but the team has to practice the best individualized care in order to treat the patient well. Clinical guidelines based on heart failure are the primary focus of several medical platforms. Mortality, morbidity and expenditures are associated to a widespread condition known as Heart Failure.
Case Study
This paper deals with a case study of a female Lydia who is 68 years old and is suffering from Heart Failure. She is a heavy smoker and when she was rushed to the emergency department she was complaining of breathlessness that worsened in the past 5 days, slightly productive cough, and panting since the past 3 days and the beginning of orthopnea. She has a history of persistent pulmonary disease, heart failure and hypertension. She had been admitted in the hospital for pneumonia 3 months back and had been through a chronic heart failure 11 months ago. Lydia’s left ventricular expulsion ratio was 47% that was calculated 4 months ago. As per physical examination, her temperature was 37 degrees C, heart rate was 98 beats/mins and the recorded blood pressure was 170/110, the weight of her body was 175 pounds which had increased 10 pounds since it was last recorded 4 months ago. She was suffering from wet unhealthy sounds of the lungs and wheezing, that could be felt more dominantly of the left side, 8 cm of the venous tightness, perceptible sound of fourth heart, gentle cavity edema in the right leg. There was no penetration observed in radiography of the chest but congestion of pulmonary venous. There was no dead tissue found or ischemia but the ECG showed the rhythm of sinus to be normal and hypertrophy in left ventricle. Lab reports showed nitrogen level blood urea of 45 mg, approximated glomerular filtration rate of 50 ml/min, cardiac troponin I of 100 mg, serum creatinine level of 1.2 mg, count of white blood cell of 12 475 cells/mm3 and the liver enzymes had also increased at a mild ratio. Lydia was already on medication as follows, for hypertension and heart failure she was advised 100 mg triamterene, daily once a day 10 mg bisoprolol, daily twice a day enalapril. The natriuretic level of peptide in the brain was not provided as sample on presentation. Clinical Care Environment Generally, all the patients are recommended to possess a thorough physical examination, radiography of the chest, evaluation of laboratory, echocardiogram, electrocardiogram for maintaining medical history (Daniels et al 2012). Physical inspection and medical history tends to be the foundation of the assessment procedure. The patients are classified with the help based on the sufficiency of the level of congestion, whether it’s wet or dry, and peripheral perfusion as to whether it’s cold or warm. The highly recommended tests of the laboratory comprise of serum electrolytes, serum creatinine, urinalysis, blood urea …show more content…
High blood pressure check; is the first step when assessing the patient with heart failure. It is likely to prevail in the majority and subsequent and urgent treatment should be done, or the patient would suffer more on account of organ damage. Enzyme inhibitors, aldosterone antagonists, beta blockers, and angiotensin were given to Lydia as long term treatment which would reduce breathlessness. Strong follow ups are required after discharging Lydia. Morphine can also be used with great care as prolonged use might result in …show more content…
The approach to the patients well being can be ensured when accurate diagnosis is followed by best therapy and treatment. References
Daniels LB, Clopton P, Potocki M, et al. (2012) Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of acute heart failure: results from the BACH multinational study. Eur J Heart Fail, 14:22–31.
Joseph SM, Cedars AM, Ewald GA, et al. (2009) Acute decompensated heart failure: contemporary medical management. Tex Heart Inst J. 36:510–520.
Maisel A, Mueller C, Adams K, Jr, et al. (2008) State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail.