The client, Mr. P has been diagnosed with cardiomyopathy and congestive heart failure.
The client, Mr. P has 4+ oedema, laboured breathing and moist crackles throughout lung fields. He is 76 years old and faces difficulty in maintaining diet restrictions and managing polypharmacy. He has only his wife in his family who herself is weak and cannot go outside house due to her own poor health. Patient is hopeless and blames God for his miserable life.
Approach to Care for Mr. P
Care plan for Mr. P is developed taking into consideration that now he is an in-patient. Approach to care will include several interventions like nutritional therapy, medication and other treatments. Mr. P suffers from cardiomyopathy which is one of the leading causes for heart failure. His heart muscles are quite weakened therefore, any medication chosen for him must suit his heart conditions. ACE inhibitors and beta blockers are prescribed medications and will be acting as the primary interventions to treat cardiomyopathy led congestive heart failure (Falk, 2014). Both these forms of mediations will stabilize the patient. Next approach requires Mr. P sticking to his diet requirements and regime. Mr. P has 4+ oedema, therefore, it is required to consider fluid volume excess related to pump. Patient will be administered with Digitalis for improved cardiac output and on diuretics for mobilizing edematous fluid (Nelson, 2016). Mr. P will be kept on regular monitoring for daily fluid intake and fluid output.
Treatment Plan
The overall treatment plan will be comprised of patient education, medical care accessibility, pharmacological and non-pharmacological treatment plans and cardiac interventions. In this particular case, cardiac rehabilitation holds the best chance for enhanced patient outcome as patient will be actively assisted with cardiomyopathy and heart failure so as to maintain maximum emotional, physical and mental health (Falk, 2014). Inpatient exercise program will be an integral element of treatment plan for Mr. P.
Patient (and Wife) Education
Patient and family education involves implementing methodologies that will address inability of Mr. P and his wife to fulfil his nutritional requirements by adhering to strict diet plans and managing polypharmacy. These can be done by interactive participation, encouragement and education. For example, Mr. P will be asked to measure his own weight and participate in making his own plan of care. He needs strong and consistent support from his wife therefore it is important that his wife is motivated and healthy enough to take care of him.
Teaching Plan
The teaching plan will not only include teaching Mr. P but also his wife because she is the only family he has got. Teaching plan will focus on positive lifestyle changes, therapeutic and psychological support that can be given to the patient. Mr. P will be encouraged to speak out any issues he faces regarding his diet changes or his adherence to the medication (Messina, 2016). His wife needs an emotional counselling and she needs to be motivated so that she understands that it is only her who can motivate her husband to recover fast. Also, she provides the food to the patient therefore, she must know the benefits of food items that have less sodium, caffeine and cholesterol. Also, Mr. P should have proper understanding of importance of regular weight measurements. He should also be made aware of the implications of not being adhered to medication and diet restrictions.
References
Falk, K. (2014). Disease Management in diverse care settings Sergey Makov New York City College of Technology Nursing Case Management NUR 4030. Disease Management.
Messina, W. (2016). Decreasing Congestive Heart Failure Readmission Rates Within 30 Days at the Tampa VA. Nursing administration quarterly,40(2), 146-152.
Nelson, D. (2016). Care report for a Dogue De Bordeaux with congestive heart failure due to dilated cardiomyopathy. The Veterinary Nurse, 7(6), 358-363.
