Introduction
Nursing process is defined as systematic planning aimed at providing patient-centered care. In the nursing process, a nurse identifies the specific needs of a patient and performs interventions to satisfy those needs to the best of his or her knowledge and ability. The nursing process is seen as dynamic and cyclical in that it presupposes the interaction of all five phases – assessment, diagnosis, planning, implementation and evaluation. The relevance of the nursing process lies with the fact that it allows nurses to deliver effective care following the adopted standards and thus minimize the risks for patients as well as nurses themselves.
Assessment
To confirm the diagnosis of acute cardiogenic heart failure, blood analysis as well electrocardiogram will have to be taken. The electrocardiogram will likely show the changes of the ST segment. The blood analysis will show a higher maximum level of creatine phosphokinase activity and high creatinine levels. Since acute cardiogenic heart failure may be combined with myocardial infarction, there may be troponin in the blood and the signs of heart damage in the electrocardiogram. A number of peripheral blood leukocytes are likely to be determined. Visually, the patient may look pale with profuse sweating and difficulties breathing. The skin may be pale and cold and experience shortness of breath, confusion, and sharp weakness.
Diagnosis
The priority NANDA label for this patient could be decreased cardiac tissue perfusion since this label is characterised by a critical decrease in myocardial contractility and tissue perfusion. Moreover, this label comprises symptoms of shock such as a client experiences: tachycardia, shortness of breath, possible signs of centralization of blood circulation such as pallor, decrease in skin temperature, and appearance of stagnant spots.
Plan
Treatment of heart failure is carried out by prescribing drugs that facilitate the work of the heart, improve the rheological properties of blood and hemodynamics. Such drugs include: B-adrenoreceptor blockers; cardiac glycosides; angiotensin receptor blockers; diuretics; nitrates. In addition, rhythm therapies are used, and a possible implantation of a three-chamber pacemaker. The latter ensures timely activation of the atria and both ventricles. A defibrillator is also often implanted as part of a pacemaker to counteract dangerous cardiac arrhythmias in conditions of severe heart failure.
The treatment of acute heart failure is, first of all, saving the patient’s life and stabilizing a critical condition. But the establishment of the cause that led to heart failure is also important and cannot be delayed. The elimination of heart failure syndrome is closely related to the treatment of the underlying disease. The purpose of emergency treatment of acute heart failure carried out in a hospital is to stabilize hemodynamics and save life. The symptoms of acute cardiogenic heart failure may decrease as a result of a successful set of measures, but in the future it is necessary to continue treatment and actions aimed at more accurate detection of the underlying disease.
Evaluation
The treatment of acute heart failure in this population is aimed at increasing patients’ life expectancy. The prognosis is not good due to the age and related heart decease of the patient. However, if hypertension is well treated and a patient leads a healthy lifestyle and follow the doctor’s recommendations, a good long-term prognosis is possible. Diabetes mellitus type 2 should also be controlled by “testing the blood sugar the adequate number of times [and] carrying out specific exercises” (Portela et al., 2021, p. 1). The effective intervention would decrease the symptoms of acute cardiogenic heart failure, while if the treatment is ineffective, the patient will die.
Conclusion
Acute cardiogenic heart failure is an acute state that necessitates urgent measures to save life. Medication includes B-adrenoreceptor blockers, cardiac glycosides, angiotensin receptor blockers, diuretics, and nitrates. In complex cases, possible implantation of a three-chamber pacemaker may be needed. The prognosis is good provided hypertension and diabetes type 2 are treated and the patient keeps diet and leads a healthy lifestyle.
Reference
Portela RA, Silva JRS, Nunes FBBF, Lopes MLH, Batista RFL, Silva ACO. (2022). Diabetes mellitus type 2: factors related to adherence to self-care. Rev Bras Enferm., 75(4), 1-8.