Congestive Heart Failure
Use THESE 2 evidence based practice guide lines (websites below):
1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
2. https://www.ncbi.nlm.nih.gov/books/NBK430873/#article-22661.s8
Discuss the similarities and differences that you read for those two EBP peer reviewed articles.
Submit scholarly paper, with writing style at the graduate level, including all of the following:
Reviews topic and explains rationale for its selection in the context of client care.
Evaluates key concepts related to the topic.
Describes multiple viewpoints if this is a controversial issue or one for which there are no clear guidelines.
Assesses the merit of evidence found on this topic i.e. soundness of research
Evaluates current EBM guidelines, if available. Or, recommends what these guidelines should be based on available research.
Discusses how the evidence did impact/would impact practice. What should be done differently based on the knowledge gained?
Consider cultural, spiritual, and socioeconomic issues.
ANSWER
Congestive Heart Failure
Congestive heart failure is a medical condition where the heart cannot pump enough blood to meet the body’s needs. CHF happens as a result of any disorder that impairs the ventricular fillings. Patients with CHF present with fatigue, reduced exercise tolerance and fluid retention. The study by Malik et al. (2021) and Heidenreich et al. (2022) both focus on evidence-based care for patients presenting with CHF and patients at risk of acquiring the disease. The aim of both studies is the management of heart failure. The study by Heidenreich et al. (2022) provides guidelines for healthcare providers to provide patient-centric recommendations for the prevention, diagnosis and management of patients with heart failure. The study by Malik et al. () focuses on understanding the pathophysiology of the disease, diagnostic approach, management and the importance of collaboration and communication among interprofessional teams to educate patients with CHF on the importance of medication compliance.
Congestive heart failure is a common disease worldwide. Malik et al. (2021) showed that between 2013 and 2016, 6.2 million in the US had clinically manifested heart failure. The prevalence of the disease increases as more patients receive therapy. Heart failure has a high morbidity rate, and it continues to become prevalent as they age. The major risk factors leading to CHF are metabolic factors with a sedentary lifestyle. Congestive heart failure is a lifestyle disease. Therefore, healthcare providers must guide their patients on the importance of improving their lifestyles to prevent the risk of heart failure. According to Heidenreich et al. (2022), heart failure is the leading cause of global morbidity and mortality. The study is therefore focused on providing guidelines for patients to improve the quality of care and ensure that the care provided aligns with the patient’s interests.
According to both studies, congestive heart failure is caused by functional abnormalities of the heart. It is also triggered by other factors such as coronary heart disease and myocardial infarction. Diabetes mellitus and coronary heart disease have become the predominant predisposing factors for heart failure. According to Malik et al. (2021), to properly treat a patient manifesting the symptoms of heart failure, it is important to get a detailed history of the symptoms and any underlying conditions the patient might have. This determines the ability to treat the patient and the factors that one should consider while helping the patient. According to the study by Heidenreich et al. (2022), there are different stages of patients with HF, and these stages determine the type of treatment the patient should get. According to this study, stage A patients are at risk of heart failure but do not have any symptoms. This category of patients includes patients with hypertension, diabetes, obesity exposure, positive family history of cardiomyopathy or a genetic variant of cardiomyopathy.
Stage B patients have no symptoms of HF or signs. They have evidence of increased filling pressures. They also have risk factors and increased levels of BNPs. Stage C have structural heart disease with current or previous symptoms of HF, and stage D have HF symptoms which interfere with their daily lives and have frequent hospitalizations. After diagnosis, treatment and management of the disease are important. According to Malik et al. (2022), the aim of therapy in patients with chronic HF is to improve symptom management and quality of life and reduce the number of hospitalizations. Heart failure can be classified into three groups depending on the percentage of the ejection fraction. Heart failure with reduced ejection fraction, heart failure with mid-range reduced ejection fraction and heart failure with preserved ejection fraction. For the management of HFrEF, patients are given diuretics, a renin-angiotensin system inhibitor and a beta-blocker (Malik et al., 2021). These help in reducing the morbidity and mortality of patients, especially African American patients with symptomatic HFrEF. For patients with an LVEF of less than or equal to 35% and an NYHA functional class of II to III, an implantable cardioverter-defibrillator is recommended for primary prevention of sudden cardiac death (Heidenreich et al., 2022).
The research in both articles is sound and up to standard with the current guidelines for dealing with heart failure. Both focus on managing patients with HF and those with the risk of heart failure. For patients who are progressive, both articles suggest that they are placed on a heart transplant list, and those who are too sick to get a heart can be placed under palliative care (Heidenreich et al., 2022). The research, in this case, is reasonable and gives the healthcare providers the guidelines to give patients the best possible care depending on their needs and interests. There are also patients who might decide that they do not want to suffer and thus do not want to be given the treatment recommended in the articles. Such patients still need care, and thus the physicians can keep them comfortable until their end.
According to the evidence-based research presented in both articles, congestive heart failure is a complex clinical disease with high morbidity and mortality. The evidence shown in both research articles shows that there are different stages of heart failure, and each stage is treated differently. Using the evidence presented in these articles, healthcare practitioners can guide their patients on the best treatment method depending on the severity of the condition. Heart failure is also a complex disease that requires interprofessional teams to work together. This means that it requires a lot of time and the collaboration and communication of medical practitioners to ensure that the patients who are receiving care are recuperating. It is also important to involve the opinion of social workers in the care of such patients. This is because different patients come from different socio-economic backgrounds. They also have different beliefs about factors such as heart transplants. It is important to respect the needs of the patient and thus the need for a social worker who will guide the patients and the healthcare practitioners.
Congestive heart failure can be hard on both the patient and the family. The aim of evidence-based research is to give patients and their families a fighting chance. However, it is important for nurses to guide their patients, especially those at risk of getting the disease but do not have it, to lead a healthy lifestyle. This means giving up on a sedentary lifestyle, exercising and eating healthy. Different patients come from different economic backgrounds; thus, as the nurses advise the patients, they should also be aware of how they should guide patients depending on their lifestyle. This is because some patients cannot afford to pay for the gym or do not even have enough time to exercise. Such patients can be advised to walk to work or cycle to work to ensure that they are physically healthy.
References
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., … & Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 79(17), e263-e421.
Malik, A., Brito, D., Vaqar, S., Chhabra, L., & Doerr, C. (2021). Congestive Heart Failure (Nursing). In StatPearls [Internet]. StatPearls Publishing.
