Question

Patient Teaching to a 79 years old patient who has heart failure and newly diagnosed

1. Create a patient scenario (3-4 sentence that describes your client's situation that necessitates teaching)

2. Assessment data indicating a learning need (include pertinent positive/negative data)

3. Nursing diagnosis that indicates the need for patient teaching (NANDA stem, r/t and AEB)

4. expected outcome (use action very and time frame in terms of the client)

5. methodology/tools (what equipment, instructions aids, method of communication)

6. content outline (sequence of instruction being provided to the client that describes the teaching topic)

7. Method of evaluation (identify how you would measure how the client achieves the learning outcome)

Answer 1

1) Heart failure is the inability of the heart to maintain adequate cardiac output to meet the metabolic demands of the body.

Scenario: Mr Federick 79year old gentleman driver by profession, suddenly admitted to the hospital with the complaint of severe shortness of breath and dry cough. He is known case of hypertension for 10years and diabetes mellitus for 5 years and recently diagnosed Obstructive Sleep Apnoea.He is a chronic smoker for the past 20years. At the time of admission patient is conscious, alert but restless. Vitals showing HR-146/mt, BP-170/100mmHg Spo2-72%.Her condition slightly improved after giving high fowlers position and adminsitering oxygen at 6 litre per minute.

On examination, lungs reveals dullness to percussion in both bases, rhonchi and inspiratory crackles are heard bilaterally. Neck veins are prominent and distended when the patient is sitting upright. S1 and S2 heart sounds are diminished and S3 is heard at the apex. Bilateral peripheral limb edema was also present. Chest x ray shows bilateral pleural effusion with increased haziness and increased transverse diameter of heart. Blood counts was also at the high level, D Dimer value of 8000ng/ml and BNP value of 1000pg/ml. Echo reports of dilated left ventricles with low ejection fraction.

With all these patient is diagnosed as Left sided Heart Failure

Teaching involves

1) Assist in identifying risk factors such as cigaratte smoking and importance of smoking cessation

2) Instruct the patient to avoid large amount of caffeine cocoa and carbonated beverages.

3) Instruct the client with low sodium, low fat and low cholesterol diet

4) Instruct the client about the importance of medication regimen which include digoxin, a diuretic, ACE inhibitors, Beta blockers and Vasodilators.

5) Advise the client to notify the side effects of medications.

6) Instruct the client regarding Fluid restriction.

7) Instruct to monitor daily weights.

8) Advise to avoid isometric exercises which increase pressure in the heart.

9) Instruct to balance periods of rest and activities.