NURSING 7121 Heart Failure Management

Question:

Mr Paul Carson is a 76 year old Polish Male, with poor English language skills, who has just been admitted to your medical ward as a direct admission via GP (no admission to ED). He has been admitted for investigation, following provisional diagnosis of congestive heart failure by the GP.

He has no previous admissions for this condition. Paul has no known allergies.

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You are the primary Registered Nurse providing care for Mr Carson.

PMHx:

Social History:

 

Medical Findings

Medications

 

Coronary Heart Disease  

Widowed

GP didn’t have an ECHO machine  

Coversyl 2.5mg Daily

Osteoporosis

One son – lives in Melbourne, sees Mr Cason x 3 times per year. Was due to visit this week but had to cancel due to work commitments

CXR – not attended. Direct admission

 

Colecalciferol 800 IU daily

Hypertension

Currently living in own home utilising community nursing services x 2 times per week. Assistance with washing and dressings to leg ulcer

Blood tests – not attended. Direct admission

 

Fosamax 70mg weekly

L total hip replacement 1997

Strong ties to the local Polish community who check on Carson daily. Coach of local soccer club

RR – 30 – laboured breathing. Has been getting worse last month

 

Panadol Osteo 1330mg TDS

Gall stones 2005

2 glasses of red wine per day

HR – 99 – no ECG attended as yet

 

Long term ulcer on L lower leg

Minimal exercise due to shortness of breath on exertion. Coaching from the sidelines now 

SpO2 – 97%

 

 

Ex-smoker. 1 packs per day x 50 years

States he has no appetite. Some slight weight gain

BP – not attended

 

 

 

 

Noted bilateral oedema of calves

 

 

 

Cough and wheeze

 

 

 

Short of breath

 

 

 

Use of accessory muscles

 

 

 

Increasing need to urinate at night

 

 

 

Has not yet been seen by an admitting physician

 

 

Outline the following:

Describe the aetiology of CHF and discuss what the likely cause of the condition is in Mr Carson
Your initial nursing care for Mr Carson on his admission to your ward, taking into consideration what has and has not been attended already
What client education you will provide as this is his first admission for this condition and what recommendations or lifestyle changes you would recommend for Mr Carson
Describe the likely progression of Mr Carson’s probable condition and the subsequent treatment options
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