Diabetes Mellitus and Congestive Heart Failure †Free Samples

Question: Discuss about the Diabetes Mellitus and Congestive Heart Failure. Answer: Introduction: Congestivecardiac failure is such a chronic progressive condition where the heart functioning as the pump is not adequate for meeting the needs of the body. In other words, affects the pumping power of the heart muscles(Aoyama, 2011). Congestive cardiac failure originates when the ventricles are not able to pump the sufficient blood to the different part of the body . In the case of the Mrs. Sharon McKenzie cause of the congestive cardiac failure is as a result of hypertension which in the case of Mrs. Sharon McKenzie is to be high risk hypertension. Along with this, the narrowing of the coronary arteries can also be the cause of the heart disease (Aoyama, 2011). The incidence of the disease among Mrs. Sharon McKenzie is believed to be higher due to swelling in her ankles and feet and shortness of the breath are the few symptoms related to the disease. Having the history of the Myocardial infarction(MI) for 12 years which occurs due to damage to the heart muscle is also one of the in cidences of the cardiac failure(Aoyama, 2011). Mrs. Sharon McKenzie is77 year old and hence is the common risk factor among the patients of the elderly age. The risk factors which are more vulnerable among the case of the 77 year old woman is the decline in the renal function as a result of the age and with this, there is a decrease in the volume distribution of the digoxin . Among this, there is also an enlargement in the number of comorbid circumstances, together with chronic obstructive pulmonary disease and cardiovascular, which heighten susceptibility to cardiac failure disease (Odawara, 2011). In the case, Mrs. Sharon likely to drop into such condition as a result of the medication digoxin, and other digitalis is drug alongside with the advanced effectual drugs that interrelate within such as flecainide, verapamil, amiodarone, quinidine, and others (Horvath Bers, 2014). Likewise, Mrs. McKenzies was as well taking medicine like furosemide, enalapril, and warfarin (Horvath Bers, 2014). The daily intake of the 250 mcg of digoxin, is said to be the high dose among the adult patients and mainly among the patients suffering from the congestive cardiac failure, as in the case (Horvath Bers, 2014). The body obtains the healing effect as soon as it stores around 8 to 12 mcg/kg with minimum danger of toxicity among patients having risk of the heart failure and breathing rhythmor normal sinus (Horvath Bers, 2014). Congestive cardiac failure is a life threatening condition and severely impacts the patient and their families (Odawara, 2011). The ill health of Mrs. Sharon McKenzie also suffers her family members mentally disturbed. Certain times the patient suffering from the cardiac failure lacks the social support, higher the support socially higher will the rate of healing (Farmakis, Triposkiadis, Lekakis Parissis, 2016). Common signs and symptoms: The individuals suffering from the cardiac failure will observe certain signs and symptoms which are discussed in the table below with the pathophysiology Signs and symptoms pathophysiology Severe ventricular arrhythmias: The patients complain dizziness, fluttering, lightheadedness, pounding, quivering, chest discomfort, breath shortness, and painful fast heart beats are reported commonly among the patients (Taytawat, 2013). Arrhythmogenesis is most likely the general procedure and marks from re-entry. It results in the change in the state of mood and mind too(Taytawat, 2013). Triggered action happen as early after depolarization and overdue after depolarization begin spontaneous numerous depolarization, impetuous ventricular arrhythmias Hypokalemia: The symptoms of the low potassium results tiredness, pain in arms, weakness, pain in the muscles of legs and this at times is so severe that causes the inability of moving the arms and legs(Taytawat, 2013). Tingling Vomiting or Nausea Bloating and Abdominal cramping Constipation Feeling the heart beat erratically The rate of passing the urine is too high concurrently feeling thirsty(Taytawat, 2013). Low levels of the potassium results myositis hyper excitable or hypo-polarized (Taytawat, 2013). Hyperkalemia The higher rate of the potassium in the blood affects the functioning of the heart. Hyperkalemia symptoms include Slow heart rate Abnormal heart rhythm Weakness (Desai, 2012) Hyperkalemia result due to rise in the level of potassium in the body and secondary due to an imbalance of intake vs. emission or as of misdistribution between extra and intra cellular space (Desai, 2012) Neurologic Symptoms: Visual disturbances, confusion, and disorientation. bright spots, blurry vision, or practicing blind spots (Aoyama, 2011) Urinate the less or more. The body also becomes swollen (Aoyama, 2011). Neurological symptoms physiologies are not simple to judge and are to be too complex and getting of them are mostly incomplete authentic physiologies of neurological symptom are interrelated and intricate (Aoyama, 2011) Sinus Node Dysfunction: Include weakness, syncope, effort intolerance and palpitations. Diagnosis through ECG Pacemaker required for the Symptomatic patients(Desai, 2012) SND causes abnormalities in Sinus node impulse structure and propagation that also causes malformation in the atrium and in the heart conduction system (Desai, 2012). While studying the sign and the symptoms it is clear that in the case Mrs. Sharon McKenzie is suffering from the congestive cardiac failure and hence requires the treatment related to the disease. Two common classes of drugs used for congestive cardiac failure patient: The drugs classes which will be beneficial for treating Mrs. Sharon McKenzie an elderly patient suffering from the congestive cardiac failure are discussed below: The first drug class which proves to be beneficial during the treatment is the angiotensin-converting enzyme (ACE) inhibitors which results in the broadness among the blood vessels and further reduces the amount of the work that is to done by the heart along with this many direct helpful consequences on the heart. Such drug helps in the reduction of the symptoms and also the need or requirnment for the hospitalisation and is helpful in increasing the life of the individual(Higgins et..al, 2013) . The ACE inhibitors get the better outcome among the patients with systolic dysfunction, several patients with hypertension practices congestive heart failure as a result of the diastolic dysfunction that is associated with the left ventricular hypertrophy(Yu, Chair, Chan Choi, 2016). ACE inhibitors result in reversing the left ventricular hypertrophy among the patients suffering from hypertension. The meta-analysis effect of certain antihypertensive agents recommends that ACE inhibitors be the largely effectual agent in dipping the left ventricular hypertrophy(Yu, Chair, Chan Choi, 2016). The other class of the drug which is to be suggested is the Beta-blockers which lowers the heart rate and blocks the unnecessary blockage that is present in the heart(Yu, Chair, Chan Choi, 2016). Such classification of the drug is also uselful in the heart disease and is mainly used with the ACE inhibitors for providing an additional benefit. Beta blockers may for the time being worsen indicators but in the long-term results an improvement in the functioning of the heart(Yu, Chair, Chan Choi, 2016). Beta blocker class drugs are supportive in improving the purpose of the deteriorating LV and require preventing or reversing progressive LV dilation, chamber, sphericity, and hypertrophy(Kollia, Giakoumidakis Brokalaki, 2016) . The drug Beta blockers as well decrease the rate of the heart beating and the stress among the LV wall (Kollia, Giakoumidakis Brokalaki, 2016). The recent research in the laboratories also proves that the beta blockers satisfy the cardiomyocyte apoptosis in the heart failure. Discussed are the basic benefits and advantageous of a beta blocker for the heart patients at any of the higher stage (Kollia, Giakoumidakis Brokalaki, 2016). Nursing care strategies: Mrs. Sharon was an elderly patient of age 77 years, she needs a due care and soft treatment. She is also having the past history of the MI which is also to be kept in mind while suggesting her medications and treatment related to the congestive cardiac failure. In the case of congestive cardiac failure will have a regular monitoring of the renal function with this the auscultator and edema of lungs(Hutchinson, Meyer Marshall, 2015). The major aim of the treatment is decreasing the level of the cardiac failure and conforting the immediate medical help while confronting the breath shortness which includes the wide-ranging supportive care; Discontinuing the digoxin and avoidance of additional exposure; management of the specific antibody fragments such as digoxin immune Fab; treating certain specific complications such as electrolyte abnormalities and dysrhythmias (Hutchinson, Meyer Marshall, 2015). The supportive care comprises to attach patients to the cardiac check, providing IV fluids to the patient with volume depletion or hypotension, supplemental oxygen, or repletion of electrolytes among the patients having the electrolyte abnormalities (Benjamin, 2012). In the case of Mrs. Sharon McKenzie, hyperkalemia is corrected with insulin/glucose in the case measured as life-threatening, as a result of risk constructing hypokalemia, because the level of potassium in her case is low i.e. 2.5 mmol/l (Benjamin, 2012). In a study, it is cleared that insulin act together straight with Na(+)/K(+) ATPase force and modify the effect of digoxin (Nielsen, Duncan Pozehl, 2018). This ropes the decision that patients suffering from diabetes, insulin proves to have the cardio protective effects after digoxin intoxication (Benjamin, 2012). Calcium is not applied for treating the hyperkalemia patients with assumed digoxin toxicity and may induce the cardiac arrest (Nielsen, Duncan Pozehl, 2018). Bradycardia management Mrs. Sharon McKenzies ECG report reveals sinus bradycardia, which is to be treated through atropine. Atropine is advised after every 3 to 5 minutes till there is a reply or maximum dose 3mg is reached (Nielsen, Duncan Pozehl, 2018). In the case, Mrs. Sharon McKenzie shows the hemodynamic insufficiency or hypotension, dizziness or altered consciousness signs, digoxin resistant Fab is provided as the primary management(Benjamin, 2012). The monitoring and the change in the medicine are also one of the significant nursing strategies at the time of congestive cardiac failure. Preferably, digoxin is to be discontinued and an altered medicine for control of rate or the dissimilar inotrope is to be prescribed for atrial flutter or respectively(Benjamin, 2012). References Aoyama, N. (2011). Treatment for Heart Failure with Preserved Ejection Fraction During the Acute Phase.Journal Of Cardiac Failure,17(9), S125. Benjamin, I. (2012). 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