The aim of this scenario-based assignment is to discuss the therapeutic intervention in the care of a patient with Congestive Cardiac Failure (CCF). CCF is defined as a syndrome in which the heart fails to pump enough blood supply to meet the body’s metabolic requirements (Hangen and Galura, 2011). A brief summary of the patient’s medical history will be given while discussing one specific nursing problem in terms of heart/pulse rate. Also, an overview of aetiology will be given as well as pathophysiology in order to explain the rationale for treatment and monitoring. Relevant research relating to the literature will be utilised throughout in order to critically analyse the care provided for the patient and determine if the patient received evidence based up-to-date care.
In accordance with the statement from the Nursing and Midwifery Council (2008) code of conduct regarding patient confidentiality, no personal details of the patient involved will be disclosed. Therefore, the patient will be identified as Mrs S. Mrs S. is an 88 years old female patient who lives on her own, and was admitted into a rehabilitation ward following a hip operation due to a fall at home. She has a past medical history of Congestive Cardiac Failure (CCF), diverticulitis, and asthma. Also, Mrs S presented with rapid weight loss, palpitation, feeling tired, peripheral oedema, fatigue, difficulty breathing when lying flat in the bed, waking up at night with shortness of breath, and anxiety. In addition to all that she had a pressure sore on her bottom that was not broken.
Malik et al (2004) referred to reflection in practice or on practice as essential to bring about positive change in care delivery. Reflecting on Mrs S’s care needs all of the following observations are important: temperature, heart rate, respiration, blood pressure, urinalysis, drug administration, electrocardiogram, weighing, and care of pressure areas; however for the purpose of this assignment heart rate/rhythm will be discussed.
According to Watson (2005), the normal mechanism of the heart beat is initiated when the electrical impulses are conducted to the left atrium and right atrium. This causes the atria to contract, pushing the blood into the left and right ventricles. This electrical impulse is then sent out to the ventricles causing them to contract. This pushes the blood out and around the body, and then relaxes to load the heart with blood again. An uninterrupted sequence of alternate myocardial tightening and relaxing occurs regularly on an average of 60 to 80beats per minute (Mader, 2010).
Singh (2008) explained that the heart rate can be assessed for rate, rhythm and volume by counting the pulse rate at symmetrical locations on the body for 60 seconds to determine the heart rate. The pulse rhythm identifies whether it is regular or irregular while the volume explains whether it is palpable, not palpable, weak, thread, decreased, moderate, impaired, full and bounding (Crumbie, 2007)....