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Congested Cardiac Failure Health Assessment Essay

The nurse should then concentrate her physical examination on the heart itself. Ausculation of the heart should be performed carefully with a stethoscope. In performing the assessment, the nurse should listen to normal heart sounds first before trying to identify murmurs on the patient (Anon., 2010). The aortic, pulmonic, tricuspid and mitral valves should be ausculated to identify the rate and rhythm of any murmurs or other irregularities.

While these primary assessments help to provide a general view of the patient's symptoms, the real severity of CHF is measured according to the left ventricular ejection fraction (LVEF). This measures the fraction of blood that is pumped out of the left ventricle of the heart and determines the degree of congestion (Karapolat et al., 2008). This measurement can be determined by performing a transthoracic echocardiography. A normal ejection fraction lies between 50 -- 70%. One below 40% is defiend as systolic heart failure (Dickstein et al., 2008). While this is not part of the nurse's responsibility, she may propose the procedure to the attending physician.

Holistic Nursing Considerations

In a holistic nursing assessment, the nurse should function as an integrater. She must balance the patient's self-evaluation of his ailments and guide him to finding the source of his pain. At the same time, she must make physical assessments to make a diagnosis of the patient's symptoms. While the nurse applies tools of Western Medicine, he or she should also consider alternative modalities as part of her evaluation. Given his different cultural background, it is necessary to consistently explain the medical evaluation and be open to traditional remedial practices offered by the patient himself. In the holistic domain, the nurse should gather the information with a sense of interrelatedness and an understanding of the cumulative effect of disparate factors on the patient's health.

Bibliography

1. Blinderman CD, Homel P, Billings JA, Portenoy RK, Tennstedt SL, 2008. Symptom Distress and Quality of Life in Patients...

Journal of Pain and Symptom Management, 35(6), pp.594-603.
2. Jarvis, C, 2009. Physical examination and health assessment: First Canadian Edition. Toronto, Ont: Elsevier Canada.

3. Karapolat et al., 2008. Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure. Chinese Medical Journal, 121(7), pp592-596.

4. Adult Cardio-Respiratory Assessment. Adapted from First Nations and Inuit Health Branch, 2006. Clinical Practice Guidelines for Nurses in Primary Care. CRNBC Janurary 2010/Pub. 780.

5. Held et al., 2007. Glucose Levels Predict Hospitalization for Congestive Heart Failure in Patients at High Cardiovascular Risk. Circulation Journal of the American Heart Association. 115, pp.1371-1375.

6. Paterna, Salatore et al., 2008. Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend? Clinical Science, 114, pp.221-230.

7. McKee PA, Castelli WP, McNamara PM, Kannel WB, 1971. The natural history of congestive heart failure: the Framingham study. New England Journal of Medicine, 285(26), pp.1441 -- 6.

8. Dickstein K, Cohen-Solal A, Filippatos G, et al., 2008. "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)." European Heart Journal, 29(19), pp.2388 -- 442.

9. Smith et al., 2009. Elevated Depression Symptoms Predict Long-Term Cardiovascular Mortality in Patients with Atrial Fibrillation and Heart Failure: Circulation Journal of the American Heart Association, 120, pp.134-140.

10. American Holistic Nurses' Association. What is Holistic Nursing? Available…

Sources used in this document:
Bibliography

1. Blinderman CD, Homel P, Billings JA, Portenoy RK, Tennstedt SL, 2008. Symptom Distress and Quality of Life in Patients with Advanced Congestive Heart Failure. Journal of Pain and Symptom Management, 35(6), pp.594-603.

2. Jarvis, C, 2009. Physical examination and health assessment: First Canadian Edition. Toronto, Ont: Elsevier Canada.

3. Karapolat et al., 2008. Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure. Chinese Medical Journal, 121(7), pp592-596.

4. Adult Cardio-Respiratory Assessment. Adapted from First Nations and Inuit Health Branch, 2006. Clinical Practice Guidelines for Nurses in Primary Care. CRNBC Janurary 2010/Pub. 780.
10. American Holistic Nurses' Association. What is Holistic Nursing? Available at: http://www.ahna.org/about/whatis.html. Accessed October 16, 2002.
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