Tuesday, May 5, 2020
Heart Failure & Subsequent Alternative Treatments
Question: Discuss about theHeart Failure Subsequent Alternative Treatments. Answer: Institution The annotated bibliography presented is based on the case study of Charlie, a 75-year old overweight man who arrives at the healthcare centre breathless, and with visible peripheral oedema, and tachycardia. Two years ago Charlie was diagnosed with chronic heart failure as a result of ischaemic cardiomyopathy and hypertension but states that in the past few days he has felt increasingly unwell. The annotated bibliography presents articles with the most comprehensive information in relation to the condition of Charlie. Faris, R. F.W. (2006). Diuretics for heart failure. . Cochrane Database of Systematic Reviews, 1-23. Retrieved from https://dx.doi.org/10.1002/14651858.CD003838.pub2 This is a research article prepared and implemented with the objective of the impact of diuretics- the advantages and disadvantages-for Chronic Heart Failure. The research is motivated by the information about the high global rate of mortality and morbidity as a result of heart failure. Diuretics is treated as a first-line form of treatment I cases of congestive heart failure. However, Faris (2006) it is more of a symptomatic treatment and the healing effects are not yet clear. The research involved literature reviews from various articles from different resource databases. The research involves two researchers that collaborate for the production of the most comprehensive article through independent research. The research involves experimentation with two groups, one being the control group. The results come after fourteen trials, with five hundred and twenty five participants and the use of placebo with the control group. The outcome shows lower mortality rates among the members of the group under diuretics with a death odds ratio of 0.24 where the confidence level is 95%. There is also the reduction of the admission of heart failure patients from results collected from two trials. The diuretics patients also show an increase in the capacity of their ability to exercise. Justification of Source The source offers relevant information in relation to problems related to heart congestion and heart failure because of the impact of diuretics on various problems such as the treatment of blood pressure and body fluid cleansing process through urinating (diuresis)(Web MD, 2017). The article plants curiosity for further information about diuretics and the specific process of the treatment where the main action is the elimination of unneeded body salts and water. The source also gives insight through the encouragement of the use of the method of treatment over others where diuretics are reported to be responsible for the reduction of the swelling experienced in the congested lungs. Although it focuses on the reduction of pressure through the catalysis of the draining of excess body fluids, the treatment is effective in most heart related complications because the same is required for the treatment of the symptoms of ischaemic cardiomyopathy and swelling caused by hypertension. The treatment of such symptoms is recognized as essential for the management of Chronic Heart Failure and the reduction of the chances of recurrence (Clevaland Clinic, 2017; Logan, 2011). Recommendation for Clinical Practice The article is essential among nurse practitioners is the information about the impact of the application of diuretics. The knowledge gives hope for further research on diuretics and its impact on heart failure where improvements can be made within the same field of study. The article provides tangible evidence where there is a record of the statistics of the rates of mortality among the patients using the treatment and others not subscribed to the treatment options. Gorthi, J. H. (2014). Reducing heart failure hospital readmissions: A systematic review of disease management programs. Cardiology Research , 126-138. Retrieved from https://dx.doi.org/10.14740/cr362w The essay discusses the role of th Hospital Readmissions Reduction Program (HRRP) in the efforts to reduce the instances of severe heart failure and the subsequent readmission of heart failure patients. Diuretics is mentioned ads one of the most effective disease management programs essential in the reduction of the re-admission of patients into hospitals for heart failure. The essay discusses various methods applied in the management of heart failure patients including home visits, outpatient interventions, and tele-management. The outpatient consultations and home visits are discussed as unfavourable where favour inclines. That is contrary to the research by Hale et al., (2016) that hypothesizes that remote home visits are effective in the reduction of the chances of random hospital admissions as a result of heart failure. The population under study includes heart failure patients and the use of various medication approaches in the alleviation of the heart problems. The Cochrane handbook guidelines and the Meta-analysis of Observational Studies in Epidemiology (MOOSE) are used for the identification of the studies. There is the search of the medical terms and the use of valid articles. The works used are those that also include the hospitalizations as a result of heart failure and the subsequent measurement of efficacy through the number of re-admissions and / or mortality. The results show that three out of the seven home visits conducted for the comparison of home visits to usual care showed a significant improvement on the outcome of the patients. None of them show evidence of the reduction in the rates of mortality (all-cause mortality), and only one showed evidence of the reduction of the all-cause hospitalization. There are two studies that show evidence of the reduction of heart failure hospitalizations and three studies that include home visits show no significant change. Justification of Source The source is relevant in the study of the health condition of Charlie because as a 75-year-old, he is pre-disposed to heart failure and chronic heart failure. The research article shows the evidence of the options available for the effective treatment of chronic heart failure and the related symptoms. As a 75 year-old, vulnerability to such health conditions is one of the results of aging because the immunity system is compromised(Logan, 2011). The heart muscles weaken and the body fluid regulation systems become less efficient. The identification of the most effective treatment plan is essential for the prior planning for Charlie for the most essential consultation plan and combination of treatment options. Recommendation for Clinical Practice There is need for further studies on the heart failure cases and blood pressure among the elderly populations and the subsequent research about the possibility of more effective customized approaches for more specific and successful results (Pinto, 2007; Tensoval, 2017). It is especially important after the treatment ischaemic cardiomyopathy and hypertension(AHA, 2016). Factors such as social trends are a prerequisite on the impact of the older generation in the near future where they shall make much more demands than the current old-old generation. There shall be need for an increase in Registered Nurses to handle the health demands that come with the same, especially in relation to chronic illnesses related to the heart such as those experienced by Charlie. There is the projection of a possible deficiency in the health care professionals with the diverse skill sets in the next 30 years(Australian Institute of Health and Welfare, 2014) Molloy, G. J. (2012). Interventions to enhance adherence to medications in patients with heart failure: A systematic review. Circulation Heart Failure, 126-133. Retrieved from https://dx.doi.org/10.1161/CIRCHEARTFA This research focuses on the application of prognosis of chronic heart failure (CHF) treatment and characteristics of the available treatments on the patients. It also focuses on the lack of adherence to the treatment options subscribed to the patient and the jeopardy of the methods of treatment on by the patients. It is one of the barriers of the lack of adherence to the available treatments. The prognosis remains poor despite the over twenty five years of research on the topic with most results reporting median survival rates after the first episode. According to this research, the improvement in the outcomes of heart attack patients that seek medical advice comes from the subscription of medications such as angiotensin-converting enzyme inhibitors, spironolactone, and -blockers. The population under focus is also the population with previous experiences of heart attacks and possible recurrence of the heart attacks. Justification of Research The research is essential in the nursing practice and the overall observation of the health of the older generation because of the lack of availability of adequate information about the most accurate approach for chronic heart failure. The research expounds on the impact of the administration with diuretics and the relevance of the consideration of the continuation of the treatment for the prevention of other old age related complications such as hypertension.(Faris, 2006) Application in Nursing Practice Adult gerontology is a field that has taken up more attention of the medical practitioners because of the previous cases of ageism and little understanding of the health condition of the aged population(South University, 2015). The most recent research in old age gerontology focusses on the provision of the long term health services such offered in clinics, hospitals, long term healthcare, rehabilitation, nursing homes, and correctional centres. The article helps in the understanding of the previous research results in the prognosis of chronic heart failure for the decision to adopt more effective better practices. It is especially important for the reduction of inadequate treatment as a result of the lack of adherence to the recommendations and prescriptions given by the doctors. References AHA. (2016, 8 24). Prevention and Treatment of Cardiomyopathy. Retrieved from AHA: https://www.heart.org/HEARTORG/Conditions/More/Cardiomyopathy/Prevention-and-Treatment-of-Cardiomyopathy_UCM_444176_Article.jsp#.WPxQAkWGN0w Australian Institute of Health and Welfare. (2014). Ageing and the health system: challenges, opportunities and adaptations . Australias health series, 1-15. Clevaland Clinic. (2017, 2 2). Ischemic Cardiomyopathy. Retrieved from Clevaland Clinic: https://my.clevelandclinic.org/health/articles/ischemic-cardiomyopathy Faris, R. F.W. (2006). Diuretics for heart failure. . Cochrane Database of Systematic Reviews, 1-23. Retrieved from https://dx.doi.org/10.1002/14651858.CD003838.pub2 Gorthi, J. H. (2014). Reducing heart failure hospital readmissions: A systematic review of disease management programs. Cardiology Research , 126-138. Retrieved from https://dx.doi.org/10.14740/cr362w Hale, T. M., Jethwani, K., Kandola, M. S., Saldana, F., Kvedar, J. C. (2016). A Remote Medication Monitoring System for Chronic Heart Failure Patients to Reduce Readmissions: A Two-Arm Randomized Pilot Study. J Med Internet Res, 184-191. Logan, A. G. (2011). Hypertension in Aging Patients. Medscaape, 113-120. Molloy, G. J. (2012). Interventions to enhance adherence to medications in patients with heart failure: A systematic review. Circulation Heart Failure, 126-133. Retrieved from https://dx.doi.org/10.1161/CIRCHEARTFA Pinto, E. (2007). Blood pressure and ageing. Postgrad Med J, 109114. South University. (2015, 10 30). The Role of Adult Gerontology Primary Care Nurse Practitioners. Retrieved from The South Way Foundation: https://www.southuniversity.edu/whoweare/newsroom/blog/the-role-of-adult-gerontology-primary-care-nurse-practitioners Tensoval. (2017). Hypertension in old age. Retrieved from Tensoval: https://tensoval.com/hypertension-in-old-age.php Web MD. (2017, 2017 4). Heart Disease and Diuretics. Retrieved from Web MD: 22
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