Questions regarding all three aspects should be asked during intake because this disease should be treated holistically meaning that everything should be factored in.
IV. DISEASE Management MODEL

A disease management plan is necessary for the congestive heart failure patient because so many other illnesses are associated with this disease. The plan is designed to improve the patient's health, while at the same time reducing medical costs.

Disease Management Model

Purpose

To manage as well as reduce congestive heart failure and the illnesses generally associated with it.

Target Population

Patients who already have congestive heart failure or those who are at risk.

Goals

To reduce the chances of developing other illnesses and diseases associated with congestive heart failure.

To cut down on hospital admissions by ensuring patients follow instructions for at home care as well as regular follow up visits.

To cut down on medical costs by monitoring patients at home self-care programs and encouraging them to stick with it.

In…...

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Bibliography

Jones, M., Edwards, I., and L. Gifford. (2002). Conceptual models for implementing biopsychosocial theory in clinical practice. Manual Therapy, 7(1), 2-9.

The heart is an important muscle in the body: the body depends on the heart muscle to pump oxygen and nutrient-rich blood throughout the circulatory system. There are four chambers in the heart, which collect the blood from the body and send it back out to the lungs and the other parts of the body. When a heart muscle valve fails, the circulation of the blood is reduced, and this creates big problems for the person (Savarese & Lund, 2017). In Arizona, there are 223 cardiovascular deaths per 100,000 people that occur annually (United Health Foundation, 2019). Since congestive heart failure is not a seasonal issue but rather a lifestyle issue, these figures are fairly constant from year to year. This is in line with national figures, as there are 5 million people in the US with congestive heart failure (Savarese & Lund, 2017). Congestive heart failure can affect people of…...

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References

Conrad, N., Judge, A., Tran, J., Mohseni, H., Hedgecott, D., Crespillo, A. P. & Rahimi, K. (2018). Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. The Lancet, 391(10120), 572-580.

Savarese, G. & Lund, L. H. (2017). Global public health burden of heart failure. Cardiac failure review, 3(1), 7.

United Health Foundation. (2019). Arizona summary. Retrieved from  

https://www.americashealthrankings.org/explore/annual/measure/CHD/state/AZ 

Alterations of Hematology and Cardiovascular Systems
Mr. P is a despondent 76-year-old patient who is considering death because of his condition of cardiomyopathy and congestive heart failure. The patient's condition is worsened by the fact that he has already been hospitalized a number of times with congestive heart failure symptoms. While Mr. P has obtained different kinds of treatment, he is still struggling to consistently and sufficiently respond to instructions from physicians. As a result, Mr. P needs an effective treatment plan and approach to care that will help improve his condition, which is rapidly deteriorating and affecting his wife who is overwhelmed with huge medical bills.

In light of Mr. P's condition and circumstance, the most suitable approach to care will be an individualized care approach given that the patient has constantly struggled with following doctors' advice consistently and sufficiently. The individualized care approach will be based on correct diagnosis of…...

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References

Goswami, V.J., Ooi, H.H. & Suleman, A. (2014, October 6). Dilated Cardiomyopathy Treatment & Management. Retrieved December 7, 2015, from  http://emedicine.medscape.com/article/152696-treatment 

Grady et al. (2000, November 7). Team Management of Patients with Heart Failure. Circulation, 102, 2443-2456.

Congestive Cardiac Failure: Nursing Perspective
Congestive heart failure is a congenital condition that affects millions of American's every year. Heart failure often manifests in a chronic condition for victims of the disease.

There are several nursing interventions important for control and maintenance of the condition. Congestive heart failure can result in serious complications including edema, respiratory disorders and can lead to premature death. Treating congestive heart failure appropriately is critical to a patient's outcome. Perhaps even more critical to a patient's outcome is patient education targeted at prevention and healthy living. Nursing management of the condition depends upon appropriate medical evaluation, medication administration, monitoring and patient education. These ideas are explored in greater detail below.

Congestive heart failure is often congenital in nature. Congestive heart failure usually manifests when the cardiac muscle is old and tired and stops circulating properly. This may result from damage to the heart; alternatively myocarditis and cardio…...

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References

AMA. (2004). "Congestive Heart Failure." American Heart Association, Inc. {Online} Available:  http://www.americanheart.org/presenter.jhtml?identifier=4585 

Adomeit, A; Baur, A; Salfeld, R. (2001). "A New Model for Disease Management." The McKinsey Quarterly.

Antoni, M; Ironson, G; Saab, P; Schneiderman, N. (2001). "HEALTH PSYCHOLOGY: Psychosocial and Biobehavioral Aspects of Chronic Disease Management." Annual Review of Psychology

Arocha, J; Patel, V. (1995). "Novice Diagnostic Reasoning in Medicine: Accounting for Evidence." Journal of the Learning Sciences, Vol. 4

Congestive Cadiac Failue
M Wad is a 71-yea-old male who epots feeling a non-adiating, "heavy" discomfot in the lowe etostenal and epigastic egion paticulaly when he bends ove o walks shot distances. He also epots a futhe 7 days of dyspnoea duing modeate exetion. On examination his blood pessue was 165/95 mm HG, pulse 90 -100 bpm, espiatoy ate of 24 with inspiatoy cackles at both lung bases.

The following blood tests whee odeed: a full blood count (FBC), Uea Electolytes and Ceatinine (UEC), Live Function Tests (LFT), CK and Toponin. All esults wee within nomal limits.

An Ateial Blood Gas was also collected esulting in: pH [HIDDEN], pCO2 38.7mmHg, PO2 69.8mmHg, HCO3 24.0mmol/L, BE -0.7mmol/L and O2 SAT 89.3%

M Wad also has an ECG that showed nomal sinus hythm, and a chest x-ay showing cadiac enlagement and lowe-lobe infiltates, suggesting the pesence of acute exacebation of congestive cadiac failue.

The following questions…...

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references  http://www.umm.edu/patiented/articles/what_causes_congestive_heart_failure_000013_2.htm 

 http://www.medicinenet.com/congestive_heart_failure/page4.htm 

   http://www.lef.org/protocols/heart_circulatory/congestive_heart_failure_05.htm http://my.clevelandclinic.org/heart/services/tests/labtests/bnp.aspx 

   http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1228&context=hsm_pubs http://www.heartfailure.org/eng_site/hf_signsympt.asp 

 http://www.netdoctor.co.uk/health_advice/examinations/ecg.htm

M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increase urination at night. The patient is currently on several medications including Lotensin and Lasix for the hypertension, along with Glucophage for the Type II diabetes mellitus. From an analysis of M.K.'s lab results, this report will offer clinical findings and treatment recommendations, as well as suggestions for what other conditions M.K. may be at risk for given her health history, lifestyle, and lab results as follows:
Vitals

BP

158/98 mm Hg

CBC

Hematocrit

57%

Glycosylated hemoglobin (HbA1c)

Arterial Blood Gas Assessment

PaCO2

52 mm…...

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References

American Heart Association (2015). Types of heart failure. Retrieved online:  http://www.heart.org/HEARTORG/Conditions/Heartfailure/Aboutheartfailure/Types-of-Heart-Failure_UCM_306323_Article.jsp#.WEy-h6IrKRs 

CDC (2016). High blood pressure facts. Retrieved online:  http://www.cdc.gov/bloodpressure/facts.htm 

Cheung, M.M. & Li, C. (2012). Diabetes and Hypertension: Is There a Common Metabolic Pathway? Curr Atheroscler Rep. 2012 Apr; 14(2): 160 -- 166.

Elliot, W.J. (2003). The economic impact of hypertension. J Clin Hypertens (Greenwich). 2003 May-Jun;5(3 Suppl 2):3-13.

Treatment of Heart Failure in Nursing Home Residents
Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF with LVSD (left ventricular systolic dysfunction) (NCGC, 2010).

In order to treat chronic HF, non-pharmacological as well as pharmacological therapy ought to be utilized for patients. While this condition is quite frequently witnessed among patients living in nursing homes, whether the suggestions put forward in the pharmacological therapy guidelines are implemented within this cluster of patients is unclear (Daamen, et al., 2016).

Issue

Owing to the lack of awareness of the precise prevalence of chronic HF, this phenomenon is often witnessed among aged…...

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Bibliography

Barents, M., Horst, V., Voors, A., Hillege, J., & Jongste, M. (2008). Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J., 123 -- 128.

Davidson PM, Cockburn J, Newton PJ, et al. (2010). Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? Eur J. Cardiovasc Prev Rehabil. 2010;17:393 -- 402

Dinkelaker S. (1999) Can A Nurse-Managed Medication Discharge Planning and Follow-Up Program Affect Readmission Rates of Patients with a Diagnosis of congestive Heart Failure?

Daamen, M., Hamers, J., Gorgels, A., Tan, F., Schols, J., & Rocca, H. (2016). Treatment of heart failure in nursing home residents. J Geriatr Cardiol., 44 -- 50.

(NHS Institute for Innovation and Improvement, 2008)
The Angiotensin-converting enzyme inhibitors are stated to be "recommended as first-line treatment in all people with left ventricular systolic dysfunction (LVSD) "with or without symptoms of heart failure." (NHS Institute for Innovation and Improvement, 2008) Additionally it is stated that strong evidence exists that ACE inhibitors "...increase life expectancy in people with LVSD and reduce the risk of hospitalization -- the effect is greatest in those with more severe LVSD or more severe symptoms, but benefit occurs for all degrees of severity." (NHS Institute for Innovation and Improvement, 2008)

Prescribed for individuals who are intolerant of ACE inhibitors due to cough are

Angiotensin-II receptor antagonists which provide an alternative to angiotensin converting enzyme (ACE) inhibitors." (NHS Institute for Innovation and Improvement, 2008) There is stated to be evidence that AIIRAs supports life expectancy improvement and symptoms for those with heart failure due to left ventricular…...

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Bibliography

Clinical Practice Guideline for Heart Failure Due to Left-Ventricular Systolic Dysfunction (2000) Kaiser Diagnostic and Treatment Documents. February 2000. Online available at: http://*****/cajud/heart/leftven.html

Heart Failure: Age from 16 Years Onwards (2008) Clinical Knowledge Summaries. NHS Institute for Innovation and Improvement. Online available at: http://www.cks.nhs.uk/heart_failure_chronic/evidence/references#

NHS Confederation and BMA (2005) New GMS contract. Department of Health. www.dh.gov.uk.

NICE (2002) Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. Technology appraisal no.39. National Institute for Health and Clinical Excellence. www.nice.org.uk [Accessed: 19/06/2007]. [Free Full-text]

Care Plan
Morbidity and Mortality Statistics:

Hypertension affects around 1 in 3 Americans and according to the CDC only 52% of people have this condition under control (CDC.gov, 2016). In older men, two-thirds have hypertension, and one-third of white men have hypertension. There are nearly 1000 deaths from hypertension daily in the United States, around 360,000 per year. Hypertension is related to first heart attacks, strokes and chronic heart failure.

The patient also suffers from orthostatic hypotension, which is when blood pressure drops when going from a lying or sitting position to standing. The largest risk for elderly people is the increased risk of falling that this brings. The patient may have fallen because of this condition. It is caused by, or linked to, high blood pressure and prolonged bed rest, as well as other conditions not faced by this patient. Anemia or vitamin B12 deficiency is another potential contributor to this (CDC.gov,…...

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References

CDC.gov (2015). Postural hypotension. CDC.gov. Retrieved May 14, 2016 from  http://www.cdc.gov/steadi/pdf/postural_hypotension-a.pdf 

CDC.gov (2016). Atrial fibrillation fact sheet. CDC.gov. Retrieved May 14, 2016 from  http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm 

CDC.gov (2016) Heart disease facts. CDC.gov. Retrieved May 14, 2016 from  http://www.cdc.gov/heartdisease/facts.htm 

CDC.gov (2016). High blood pressure. CDC.gov. Retrieved May 14, 2016 from  http://www.cdc.gov/bloodpressure/index.htm

Care:
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…...

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References:

Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model

Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.

Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from  http://ccn.aacnjournals.org/content/23/1/73.full.pdf 

Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing

The patient should drink less, participate in more physical activity and should eat a better diet. The blood pressure and cholesterol both need to come down immediately.
Question 6

The patient needs to take the recommendations in question 5 or he likely has a very dim future if his BP and cholesterol is not lowered a lot. Blood pressure should be measured after the patient has rested for at least five minutes. He should be instructed in advance of the appointment what not to eat or drink so that the test result is not improperly influenced (e.g. drinking caffeine).

Question 7

There is no advancement or progression in symptoms but blood pressure is still entirely too high. It needs to drop by at least 30 points to be within a non-hypertension range. Needs to be made clear to patient that while he is feeling fine for now, that will change if the proper…...

eflection

A reflection on the case shows me that ethical and moral guidelines must be instilled in pharmacy as a profession. It is therefore necessary for the pharmacies to collaborate with other key stakeholders in ensuring that proper guidelines are put in place together with polices aimed at ensuring an ethical and moral pharmaceutical practice. Case esolution Model (CM) (Brincat & Wike,1999) is therefore an important model since it has taken me through all the necessary steps that can allow me to effective conclude this case amicably.

eferences

World Health Organization (2001). The ole of the Pharmacist in Self-Care and Self-Medication.Available online at http://apps.who.int/medicinedocs/pdf/whozip32e/whozip32e.pdf

Brincat, C.,Wike, vs (1999). Morality and the Professional Life: Values at Work. Pearson; 1st ed.

Passmore P, Kailis SG (1994).In pursuit of rational drug use and effective drug management: clinical and public health pharmacy viewpoint. Asia Pac J. Public Health. 1994;7(4):236-41.

outledge, PA., O'Mahony, MS., WoodhouseKW (2003).Adverse drug reactions in elderly patients.…...

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References

World Health Organization (2001). The Role of the Pharmacist in Self-Care and Self-Medication.Available online at  http://apps.who.int/medicinedocs/pdf/whozip32e/whozip32e.pdf 

Brincat, C.,Wike, vs (1999). Morality and the Professional Life: Values at Work. Pearson; 1st ed.

Passmore PR, Kailis SG (1994).In pursuit of rational drug use and effective drug management: clinical and public health pharmacy viewpoint. Asia Pac J. Public Health. 1994;7(4):236-41.

Routledge, PA., O'Mahony, MS., WoodhouseKW (2003).Adverse drug reactions in elderly patients. Br J. Clin Pharmacol. 2004 February; 57(2): 121 -- 126. doi: 10.1046/j.1365-2125.2003.01875.x PMCID: PMC1884428

Mr. P is suffering cardiomyopathy, congestive heart failure, 4+ pitting edema, labored breathing, and an inability to stick to a restricted diet or manage his polypharmacy. He is 76-years-old and in a state of declining health. The medical bills are mounting (and indeed have become overwhelming for Mrs. P who has never had to deal with the couple's financial affairs, as they were always taken care of by Mr. P). The couple is depressed/despondent: Mr. P over his inability to understand why God allows him to linger in this condition rather than just take him immediately, Mrs. P over her inability to have a moment of rest outside the home, where she tends to her husband. Life is difficult for the two. This paper will consider the condition of Mr. P, how it affects Mrs. P, and how the situation can be approached so as to provide a high degree…...

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References

Barry, C. B. (2000). Teaching the older patient in the home: Assessment and adaptation. Home Healthcare Nurse, 18(6): 374.

Connor, S. (2009). Hospice and Palliative Care. CRC Press. Boca Raton, FL: CRC

Press.

Those who are the vulnerable will have specific genes they inherit from their relatives, who were impacted by the condition. This increases their chances of having similar complications when they become older. (Kolata, 2010)
Congestive Heart Failure and Hypertension

Congestive heart failure and hypertension are interconnected with each other. According to a study conducted by the University of Texas, they found that there are 660 thousand new cases reported each year. This is accounting for 7% of all deaths associated with cardio vascular disease. One of the biggest factors that will determine if someone is at risk is hypertension. As this is used in 75% of all cases, to predict if someone will be impacted by congestive heart failure and the long-term effects it will have on them. (Merla, 2009)

Hypertension can lead to complications by increasing the chances of ventricle or systolic dysfunction taking place. This improves the chances of someone…...

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References

Heart Disease Fact. (2013). CDC. Retrieved from:  http://www.cdc.gov/heartdisease/facts.htm 

Heart Disease and Stroke. (2012). Lasker Foundation. Retrieved from:

http://www.laskerfoundation.org/media/pdf/factsheet2cardiovasc.pdf

Heart Failure. (2013). Mayo Clinic. Retrieved from:  http://www.mayoclinic.com/health/heart-failure/DS00061

Nurse Speech to Group of esidents in a Large Independent Living Facility
The information addressed today in this speech are those involving the body's regulation of the correct numbers and ratios of blood cells and how blood pressure homeostasis is achieved as well as age-related changes to the heart including coronary artery disease, congestive heart failure and myocardial infarction.

Homeostatis and the Body's Balancing Act

The work of Vikrant and Tiwan (nd) report that studies on the population indicate that blood pressure is a continuous variable and there is really not a line that divides normal and abnormal values. However, there is a point of balance also called internal equilibrium and this is known as homeostasis. This state of balance describes how the human body reacts to certain changes. This can be viewed by picturing a set of scales in which coins are poured in unevenly with one side heavier than the other.…...

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References

Vikrant, S. And Tiwan, SC (nd) Essential Hypertension -- Pathogenesis and Path physiology. Retrieved from: http://medind.nic.in/jac/t01/i3/jact01i3p140.pdf

Cor Pulmonale is pulmonary heart disease, which causes failure of the right ventricle. This comes as a result of high blood pressure within the lungs. Pulmonary edema is fluid accumulation in the lungs, often as a result of congestive heart failure. Both diseases would be unfortunate and difficult to deal with, but pulmonary edema would be preferable. There are medications and treatments that can be used in order to reduce the fluid in the lungs and keep the congestive heart failure at bay. The Cor Pulmonale, though, will damage the heart\'s right ventricle, and there is nothing that can be....