Clinical Treatment Guideline assignment_Updated

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Feb 20, 2024

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CONGESTIVE HEART FAILURE A CLINICAL TREATMENT GUIDELINE
THE HEART
ETIOLOGY OF CONGESTIVE HEART FAILURE - Heart failure can be caused by weakened, damage or stiffness of the heart • When the heart is damaged or weakened, the heart chambers may stretch and get bigger causing the heart not to be able to pump out the blood it needs to. • Stiffness of the ventricles which is the main pumping chambers of the heart can cause it not to fill up enough of blood and also not be able to pump effectively sue to the stiffness. - The damage of the heart can be caused infections, heavy alcohol use, illicit drug use and some chemotherapy medications. - Certain conditions can damage or weaken the heart and cause heart failure like: • Coronary artery disease or heart attack • High blood pressure • Heart valve disease • Myocarditis
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DISEASE PROCESS OF CONGESTIVE HEART FAILURE -When congestive heart failure occurs the heart is not able to pump enough blood to meet the body’s needs. As the heart weakens, the blood begins to back up into the body causing build up of fluid in the ankles, arms, heart and even the lungs.
LEFT-SIDED CONGESTIVE HEART FAILURE -Left-sided heart failure affects the left ventricle. The weakening of the LV causes ineffective pumping of the ventricle, leading to fluid backing up into the lungs which causes symptoms like shortness of breath, coughing, crackles etc.
RIGHT-SIDED CONGESTIVE HEART FAILURE -Right-sided heart failure affects the inability of the right ventricle to pump efficiently, causing fluid to back up into the belly, legs and feet causing edema in the extremities and ascites of the abdomen.
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SYMPTOMS OF CONGESTIVE HEART FAILURE
OVERVIEW OF CLINICAL PRACTICE GUIDELINE FOR CONGESTIVE HEART FAILURE Who? The clinical practice guideline was developed by the Anerican Heart Association(AHA),American College of Cardiology (ACC) and Heart Failure Society of America (HFSA) (Heidenreich et al., 2022).
OVERVIEW OF CLINICAL PRACTICE GUIDELINE FOR CONGESTIVE HEART FAILURE How? The AHA, ACC and HFSA came together and created a guideline for the management of heart failure. By doing this it made it easier for people to find information on management of heart failure in one place without confusion on which guideline to follow.
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OVERVIEW OF CLINICAL PRACTICE GUIDELINE FOR CONGESTIVE HEART FAILURE Why? The guideline is created to provide patient centered recommendations for clinicians to use to help prevent, diagnose, and manage patients with heart failure (Heidenreich et al.,2022).
OVERVIEW OF CLINICAL PRACTICE GUIDELINE FOR CONGESTIVE HEART FAILURE When? The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure replaced the 2013 ACCF/AHA Guideline for the Management of Heart Failure and the 2017 ACC/AHA/HFSA Guideline for the Management of Heart Failure(Heidenreich et al.,2022).
APPROPRIATE USE OF GUIDELINE -Clinical practice guidelines provide recommendations applicable to patients with or at risk of developing cardiovascular disease. -There are guidelines for preventing the syndrome of clinical heart failure in patients with PRE-HF. -Also non-pharmacolgical interventions providing patients with self-care support in HF. -There are also recommendations for specialty referral for advanced HF. -The guideline also provides recommendations for assessment of patients hospitalized with decompensated HF. - The guideline also provides management of comorbidities in patients with HF.
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APPROPRIATE USE CONT. Recommendations for patients at risk for HF.
PHARMACOLOGIC MANAGEMENT Loop diuretics inhibit reabsorption of sodium or chloride at the loop of Henle, whereas thiazide and thiazide- like diuretics act in the distal convoluting tubule and potassium- sparing diuretics (eg, spironolactone) in the collecting duct. Loop diuretics are the preferred diuretic agents for the use in most patients with HF.
PHARMACOLOGICAL MANAGEMENT Inhibition of the renin- angiotensin system is recommended to reduce morbidity and mortality for patients with HF. ARNi, ACEi, or ARB are recommended as first- line therapy.
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DEVIATION Reason one Deviation from the guideline may come in if the patient has other comorbidities that requires attention, therefore requiring clinicians to consider patients comorbidities when caring for patient’s heart failure.
DEVIATION Reason two Also deviation can occur if the individual is allergic to a certain treatment. Loop diuretics are the first line of treatment for heart failure. If the individual is allergic to Loop diuretics then another class of medication would need to be used.
DEVIATION Reason three Lastly, deviation can occur if the guideline treatment the patient is receiving is not working, then another method would need to be tried to see what care of plan works for the patient.
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RECCOMENDATIONS -Outpatient follow-up with your primary care provider is important in order to help manage the disease correctly and ensure that the medications being taken is working accordingly (McAlister et al.,2016). -Heart failure exacerbation can occur and require hospitalization or an emergency department visit particularly with a familiar physician for a better outcome for the patient and their symptoms (McAlister et al.,2016). -It is important for patients to take their medications as ordered, follow the diet advised and go for frequent check-ups to manage the disease process.
LIFESTYLE CHANGES Tracking your daily fluid intake -An individual with heart failure needs to track their fluid intake because the body tends to retain fluid when the person has HF. -There is a fluid restriction given to people with heart failure in order to give them an idea of how much fluid the patient should be consuming in a day.
LIFESTYLE CHANGES -Diet Eating a heart healthy diet is the suggested diet for individuals with heart disease. This diet entails fruits, veggies, whole grain, low-fat dairy, saturated fats and sodium restriction. Overall having a healthy dietary pattern is important when it come to CHF.
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LIFESTYLE CHANGES -Physical Activity Establishing a physical activity regimen is important for the management of CHF and for an individuals overall health. Discuss with a physician a good workout regimen in order not to over do the physical activity and to find something more suitable to you.
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LIFESTYLE CHANGES -Getting adequate rest In order to get proper sleep at night use pillows to prop your head up. Avoid big meals right before bed. Also elevating your feet up for a couple of hours everyday can help with swelling.
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LIFESTYLE CHANGES -Avoiding or limiting caffeine and alcohol For alcohol the rule of thumb is one to two drinks a dayfor men and one drink per day for women however talk to your provider about what is good for you. Consume a moderate amount of caffeine a day. No more then a cup or two of coffee a day.
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REFERENCES American Heart Association(2022). Lifestyle changes for heart failure . Retrieved April 26, 2023, from https://www.heart.org/en/health-topics/heart- failure/treatment-options-for-heart-failure/lifestyle-changes-for-heart-failure Freepik. (2020). Guideline images - free download on Freepik . Retrieved April 25, 2023, from https://www.freepik.com/free-photos-v vectors/guideline Heidenreich, P., Bozkurt, B., & Chair, V. et al. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure . Retrieved April 10, 2023, from https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063 McAlister, F. A., Youngson, E., Kaul, P., & Ezekowitz, J. A. (2016). Early follow-up after a heart failure exacerbation. Circulation: Heart Failure , 9 (9). https://doi.org/10.1161/circheartfailure.116.003194 Mayo Foundation for Medical Education and Research. (2023, March 11). Heart failure . Mayo Clinic. Retrieved April 8, 2023, from https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142 Miranda, G. M. (2021, March 18). How the Heart Pumps Blood . News. Retrieved April 8, 2023, from https://www.news-medical.net/health/How-the-Heart-Pumps-Blood.aspx Wikimedia Foundation. (2023). Heart failure. Wikipedia. Retrieved April 10, 2023, from https://en.wikipedia.org/wiki/Heart_failure
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THANK YOU
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