Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.
Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following
1.Describe your approach to care.
2.Recommend a treatment plan.
3.Describe a method for providing both the patient and family with education and explain your rationale.
4.Provide a teaching plan (avoid using terminology that the patient and family may not understand).
The essay deals with the case study of Mr. P hospitalised due to cardiomyopathy and congestive heart failure. The essay discusses the approaches to care, plan of treatment and education to patient and family. Lastly the teaching plan for Mr. P and his wife is discussed.
Approach To Care
It is evident from the case study that the patient needs to deal with medication, psychological, emotional, and social problems. Therefore, comprehensive care approach includes appropriate medication and assessment to address the breathing difficulty, crackles and pitting edema. The self management and stress management approaches are integrated from the cognitive behavioural therapy. Social worker will be involved to provide social and financial support and non-pharmacologic. Both the pharmacological and non-pharmacological approaches will help increase patient life span. Life style interventions will help better manage the disease and comorbidities (Rasmusson et al., 2018).
Recommend A Treatment Plan
The treatment plan comprises of taking detailed history of the patient illness due to genetic possibility. The patient will be administered with beta blockers to manage the heart rhythm and prevent myocardial infarction. Administer diuretics to minimise fluid accumulation. Administering isotropic agents may enhance the heart muscle contraction and morphine to control pain. Anticoagulants can prvent blood clots. Antidepressants may be administered to prevent anxiety and depression. Regular assessment will be conducted to evaluate the outcomes. The patient will be advocated for diet restrictions (low sodium and less fluid consumption) and provided with balanced diet plan (Spoladore et al., 2012). Oxygen supply is important to control hypoxemia. The patient will be further supported with good exercise program. The patient’s laboratory tests will reveal the lipid profile, blood cell count, glucose, thyroid and liver function results (Ahluwalia & Enguidanos, 2015).
A comprehensive education plan will be developed for the patients to explain the disease management process. The risk of chosen treatment option will be explained to family. The role of the diet and exercise will be taught to the patient, to ensure adherence. Further, explanation on factors such as poor diet and stress aggravating the disease will be highlighted. It may include alcohol, smoking and other addictions. Education plan will include the knowledge of the medication and side effects, to ensure proposed outcomes. The mode of administration of the medicine with the right dosage will be explained to prevent adverse outcomes due to medication error. The factors that may affect the medication efficacy will also be discussed in detail, to prevent comorbidities. Further, information on illness and coping strategy will be disseminated (Rice, Say & Betihavas, 2018).
Patient and the family must understand the value of teaching. The goal of the teaching is to explain Mr. P and his wife about cardiomyopathy and its symptoms in simple lucid language. Teaching plan may contain the use of resources like printed notes or pamphlets, video clips and creative pictures. Pictorial presentation will better help understand the complexity of illness. Other techniques to be used are the provision of list of medication with information printed about the symptoms and signs of worsening disease. The printed information would also contain the necessary contact numbers in case of emergency. The patient and family will be assisted with referral services. The teaching plan will also include the practical aspects such as demonstrating the way read of food package ingredients and identify the percentage of cholesterol and sodium (Rice, Say & Betihavas, 2018).
CHF is associated with substantial morbidity. Education plays a key role in improving the disease management skills of the patient. Social support will improve the living condition. The successful management of CHF can be ensured by patient’s submissiveness to medication plan and lifestyle interventions.