Research Paper on Heart Failure Disease

Introduction

In nursing practice, there is a need to conduct a diagnosis, offer treatment and perform a medical evaluation to patients who are experiencing forms of chronic diseases. There is a need for nurses to comprehend how treatment, pathology, regimens, and psycho-social issues affect patients and the kind of care that they obtain from the medical practitioners. Management of diseases is more than just observing a treatment. Evaluation is an essential aspect of conducting issues that affect a patient. Medical practitioners evaluate diseases from micro-level to macro-level. There is a need for nurses to conduct disease assessment to patients and individual population to respond to chronic illness. According to Booth, Roberts and Laye (2012), chronic diseases are those infections which are characterized by their permanency and their ability to subject an individual to disability.

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Reports by Center for Disease Control suggest that half of all adults are victims of one or more chronic diseases (CDC, 2011). These chronic diseases are a burden to healthcare systems. Examples of chronic diseases are a traumatic brain injury, depression, obesity, asthma, arthritis heart failure among others. Some of the causes of chronic diseases include poor diet, uncontrolled blood pressure, use of tobacco, lack of physical exercise among others. Due to the rising cases of chronic diseases, there is a need to come up with ways of stopping and reversing these ailment threats. The focus of this study is on heart failure disease. The primary purpose is to investigate path pharmacological issues which are related to heart failure. The research will investigate the various impressions of the condition on patients, their kin, and people at the local, national and international level.

Heart Failure Disease Process

Heart failure exists in two types. These are acute heart failure and chronic heart failure. The study focuses on chronic failure, which is the most common form of heart failure. It transpires when the heart is not capable of pumping enough blood throughout the body. It leads to the inadequate supply of blood throughout the body tissues away from the heart. However, acute heart failure occurs unexpectedly within several hours or days. Chronic heart failure disease is a gradual process in its development. At the initial stages, patients usually feel week, fatigue, swelling of feet and also persistent coughs. Patients also experience mild and severe heart failure. These patients also do not actively engage in physical exercises and cannot perform hard chores. Heart failure involves four processes.

According to Patel, et al., (2014), these are A, B, C, and D. The procedures vary from a high threat of developing heart failure to progressive heart failure. The chronic disease follows this gradual process. The heart propels less blood to the body tissues as the condition gets worse, thereby, moving to the next process. A patient is unable to go backward in these processes. The first stage (Stage A) is the pre-heart failure where one is at great risk of increasing heart failure due to family history. Some of the symptoms at this stage are diabetes, hypertension, coronary artery disease, past account of alcohol abuse, metabolic syndrome among others. Patel, et al., (2014) further adds that Stage B is a pre-heart failure which follows diagnosis with systolic left ventricular dysfunction with no symptoms of heart failure. Stage C involves patients who are diagnosed with the condition and are have signs and symptoms which are visible. Some of these symptoms include weak legs, shortness of breath, fatigue, swollen feet, waking up to urinate, and inability to exercise. The last stage (Stage D) involves patients who do not improve even with better treatment. It is the final stage.

Pathophysiology

There are several factors which cause heart failure. These factors range from the heart itself, and they include both internal and external factors which impact the function of the heart. The leading source of heart failure is coronary artery disease. The disease minimizes the flow of blood through the coronary artery, and this decreases the supply of oxygen to the cardiac muscle. Hypoxia and an impaired function of the cardiac muscle are then developed. Cardiac muscle infarction also causes heart failure. The body organs which have been infarcted cannot generate heart contradictions. The tissues that are not infarcted overtake these movements, and the movements stress these tissues. After a period, the non-infarcted tissues cannot keep up with the demands anymore, and this leads to heart failure. There are also fewer heart conditions which may lead to heart failure and valve diseases. These have congenital effects, diseases and inflammation of the heart muscle and chronic dysrhythmia (Kemp & Conte, 2012).

Heart failure can also be as a result of an impaired ability of the cardiac muscle to contract. The situation is referred to as systolic heart failure. Furthermore, impaired filling of the heart which is called diastolic heart failure can also cause heart failure (Kemp & Conte, 2012).

Changes in the signal transduction and excitation-contraction coupling causes systolic heart failure. These hinder the contraction of the cardiac muscle. It leads to a reduction in stroke volume and an increase in preload of the heart. Increase in preload is a compensation of the body which activates the Frank-Starling mechanism to maintain the capacity of the stroke to be up, due to loss of cardiac muscle contraction (Kemp & Conte, 2012). The stroke volume declines further when the preload does not increase to compensate. The heart becomes less able to replace through applying the Frank-Starling mechanism when the systolic in the heart failure progresses. The sarcomeres of the heart become exhausted due to extended maximal length. Systolic heart failure dilates when it becomes chronic. The dilated ventricle can perform adequately due to its ability to adapt to large end-diastolic volumes without having an outrageous rise in end-diastolic pressure.

Standard of Practice

According to Borlaug (2014), standard of practice refers to the guidelines or protocol of care for specific populations. They provide instructions for nursing performance and play an essential role in determining the procedures for the provision of competent health care for patients. Standards of practice consist of three components. These are domain practice guidelines which are conventions of care for definite populations, expert performance standards which pinpoint role functions in direct supervision; and lastly, professional principles of care define analytical, intrusion and evaluation competencies. The criteria for the clinical practice of heart failure suggest the consideration for specialty referral.

Cardiology should involve the development of a cardiac management plan for patients with heart failure. The standards also dictate that the clinic should take into consideration a referral to a heart failure clinic in circumstances where they are unable to handle the situation. The rules also require the need to include some health professionals in the care team. These include social workers, pharmacists, dieticians, behavioral health consultant, and a mental health provider among others (Borlaug, 2014). Lifestyle modification should be enhanced, and these involve managing one's weight risk management counseling on tobacco use, alcohol, and caffeine; tracking daily fluid intake stress management, and symptoms, chronic infection management of diabetes and hypertension and also physical activity. The standards also dictate that the clinical practice should guide a patient's behavior while advocating for behavior change. Standard of practice also requires a set of goals to enable nurses' plan and track the progress of their accountability.

Pharmacological Treatments

Kemp and Conte (2012) explains that heart failure is associated with high morbidity and mortality in the western world. The condition is a disease with a considerable health impact. Since it is a dangerous medical condition, it obliges rapid medical attention to save a life. Pharmacological treatment helps in the management if patients with heart failure. Pharmacological treatment integrates all the two types of heart failure, which are acute health failure and chronic health failure. Since this work focuses on chronic heart failure, it established that acute heart failure also exists in two forms. These are diastolic and systolic. It is essential for medical practitioners to equip themselves with the knowledge of the grouping of commendations and levels of substantiation system that have been assigned to the American Heart Association

Lifestyle and change of habits and the use of medications are the vital ways which can be applied to prevent heart failure. Also, the high rates of hospitalizations can be reduced by creating an atmosphere where patients are in a position to be compliant with their medication. Monitoring of medications is also fundamentally based on their strategy of care. There is a need to provide information through education to patients on their medications before discharge from the hospital. Nurses play a central role in achieving this. The following are the aspects of pharmacological treatment of heart failure:

ACE Inhibitors

Nurses can administer ACE inhibitor drugs with a class 1, level A of endorsement. ACE inhibitors cause an affirmative effect on cardiac function through reduction of preload and afterload. ACE inhibitors increase cardiac output and ejection fraction. They are useful in the management of heart failure since they interrupt with stimulation of the renin-angiotensin-aldosterone system (McMurray, et al., 2012).

ACE inhibitors are launched at low intakes. Steady and regular ingestion of the dose follows, and it is tolerated. Medical practitioners should monitor serum and potassium levels at an interval of 1 to 2 weeks. It develops after initiating therapy. The medication should be used with a lot of care and caution in patients who exhibit low systemic blood pressures. Also, nurses should not administer an ACE inhibitor to patients who experience angioedema or renal failure symptoms. The medication should also, not be applied to patients who are pregnant.

The side effects if this medication is headaches, feeling dizzy, fatigue, coughing, hypotension and diarrhea. Coughing is the most common of these side effects, and most patients describe this cough as dry and nagging. These are however rescindable once the patient has been superseded from the drug.

Beta-Blockers

The treatment is recommended for heart failure patients who are still at stage A. The medication is administered with the lowest possible dose at its initiation stage. The reason for this small administration is to prevent excessive vasodilation such as hypotension, dizziness, and lightheadedness. There is a necessity to closely monitor blood pressure when this treatment is administered. On the same note, liver functions should be monitored Nurses should educate patients on the side effects of this medication, especially in its early stages of administration. However, these symptoms progress within 2 to 3 months of original treatment. (Safi, et al., 2017)

It is important to note that the knowledge of current commendations of drug therapy, mechanism of action, adversative effects, deterrents and acclaimed dosing schedule allows nurses to work together with doctors concerning the patient's plan of care, educating patients and their families.

Clinical Guidelines

It is essential to identify clinical guidelines that are vital for assessment, diagnosis and educating patients diagnosed with heart failure diseases. Clinical guidance is relevant because the...