Congestive Heart Disease

Author Note

This paper is being submitted on 10/27/19, for Professor Joanne Maida’s NUR1172 Nutritional Principles in Nursing Course.

Congestive Heart Disease Outline

I. Identification of Alteration in Health

A. Definition of disease Congestive Heart Disease (CHD)

II. Role nutrition plays in the prevention of Congestive Heart Disease

1. The impact of diet on disease prevention

1. Types of foods that prevent CHD

III. Etiology/Progression

1. It is caused by the heart’s inability to pump blood as it should.

1. The heart fails to pump and fill blood effectively

1. Caused by other conditions that weaken the hear such as;

2. Hypertension

2. Coronary artery disease

2. Myocarditis

2. Cardiomyopathy

2. Faulty heart valves

2. Heart arrhythmias

Progression

1. Symptoms

1. Dyspnea (shortness of breath)

1. Weakness and fatigue

1. Nausea and lack of appetite

1. Increased urination at night

1. Chest pains –when caused by heart attack

1. Persistent coughing and wheezing with pink blood phlegm

1. Ascites (swelling of the abdomen)

1. Complications

1. Can cause kidney damage

1. Liver damage

1. Heart valve problems

1. Increased heart arrhythmias

IV. Treatment

A. Medications

1. Aldosterone antagonists

1. To decrease sodium reabsorption, thus, increasing water excretion by the kidneys.

1. Angiotensin II receptor blockers

1. To increase blood vessel dilation for increased blood flow

1. Beta Blockers

1. They are used to reduce blood pressure.

1. Diuretics

1. Target the kidneys to increase production of urine.

1. Calcium channel blockers

4. They reduce blood pressure by blocking calcium movement.

Therapy

1. Exercise

1. To increase cardiac system functioning

Surgery

1. Coronary artery bypass grafting (CABG)

1. Restores normal ventricular functioning

1. Valve repair

1. Can be done when the problem is caused by valve issues

1. Device Implant

1. To surgically impact a device to assist the heart to pump blood effectively such as ventricular assist devices, ICDs, and pacemakers.

1. Heart Transplant

1. This is an option when the heart is too damaged to function despite the treatments above.

V. Recommended Diet

1. Sodium free diets – to contain blood pressure

1. Foods with minimal sodium to reduce blood pressure

1. Reduce or eliminate salt in the foods

1. Reduced sugar and fats

1. It is important to contain weight to improve functioning of the cardiac system

VI. Nursing Assessment/Interventions

A. History and physical exam

1. Assessments

a. Electrocardiography

b. Coronary angiogram

c. Heart CT scan

B. Interventions to reduce risks and enhance heart functioning

1. Medications

2. Low sodium diet

3. Exercise

VII. Education

1. Dieting education

2. Smoking cessation

3. Self-care techniques

VIII. Adherence

A. Barriers to adherence

1. Income

2. Religious beliefs

3. Psychosocial issues

4. Fear of side effects

B. Strategies to promote adherence

1. Identify cost-cutting strategies

2. Address mental, psychosocial barriers

References

Arrigo, M., Parissis, J. T., Akiyama, E., & Mebazaa, A. (2016). Understanding acute heart failure: pathophysiology and diagnosis. European Heart Journal Supplements, 18(suppl_G), G11-G18.

Dharmarajan, K., & Rich, M. W. (2017). Epidemiology, pathophysiology, and prognosis of heart failure in older adults. Heart failure clinics, 13(3), 417-426.

Mentz, R. J., & O'connor, C. M. (2016). Pathophysiology and clinical evaluation of acute heart failure. Nature Reviews Cardiology, 13(1), 28.

Vedel, I., & Khanassov, V. (2015). Transitional care for patients with congestive heart failure: a systematic review and meta-analysis. The Annals of Family Medicine, 13(6), 562-571.