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Diabetes treatment in the elderly: Kathryn

Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. BiDil [package insert]. Lexington, MA: Nitromed Inc.

Heart failure case study powerpoint

De Smet PA. Herbal remedies. Eur J Heart Fail. Bonadkar RA, Guarneri E. Coenzyme Q The effect of coenyzme Q10 in patients with congestive heart failure. Ann Intern Med. Efficacy and safety of calcium channel blockers in heart failure: focus on recent trials case study of patient with congestive heart failure second-generation dihydropyridines. Am Heart J. Use of thiazolidinediones and risk of heart failure in people with type 2 diabetes.

Diabetes Care. Hollenberg NK. Considerations for management of fluid dynamic issues associated with thiazolidinediones. Am J Med. Avandia [package insert]. Actos [package insert]. This study, however, did not describe specific impact made by a nurse versus a pharmacist.

Roblek et al examined the impact of pharmacist intervention on reduction of clinically significant drug-drug interactions DDIs in hospitalized patients with ADHF management. Patients in the intervention group received alerts about clinically significant DDIs. Primary endpoint was number of DDIs at discharge and secondary endpoints were rehospitalization or death within 6 months of discharge.

Of the patients enrolled, 66 clinically relevant DDIs were identified. This study showed that pharmacist intervention can significantly reduce the number of patients with clinically relevant DDIs but may not translate to improvement in longer term outcome.

Dempsey et al described the patient population served in a new innovative Ambulatory Cardiac Triage, Intervention, and Education infusion unit and to document the prevalence of comorbidities and drug therapy-related issues DRIs in order to define the most effective role of a pharmacist in the unit. DRIs were identified and classified.

Sixty patients were interviewed. The study indicated that the prevalence of DRIs is high even among HF patients managed in a subspecialty cardiovascular practice. Pharmacists can contribute significantly in resolving DRI. Overall, pharmacists can play a significant role in identifying adverse drug events and drug interactions in patients who have heavy medication burdens. Interventions focused on medication regimens optimization, identification of early symptom deterioration, and arrangement of medical follow-up if necessary.

Referrals were also made to a community pharmacist for regular medication review. Inthe same group of investigators reported the results for an extended month follow-up of all surviving patients. Goodyer et al conducted a study to evaluate if intensive medication counseling provided by pharmacists to elderly patients with chronic HF can impact HF outcomes. Adherence was measured by a pill count, and medication knowledge was assessed using a questionnaire.

Patients in the intervention group demonstrated significant improvement in 6-minute exercise test at the end of the study, as well as improvement of leg edema, while the control group did not. Varma et al 21 assessed the impact of a structured pharmaceutical care program for 83 patients with HF aged over 65 years. Patients were required to self-monitor using diary cards. Physicians and community pharmacists reviewed these cards and mailed them to the researchers.

From these assessments, patients who received interventions demonstrated better adherence with drug therapy and improved exercise tolerance compared with those in the control group. Gattis et al conducted the Pharmacist in Heart Failure Assessment Recommendation and Monitoring Study to examine the benefits of having a pharmacist as part of the HF management team on ambulatory patient outcomes.

Primary endpoint was the combination of all-cause mortality and nonfatal HF events help with psychology essays emergency department visits and hospitalizations for HF.

Although, effect on all-cause mortality was not significant, nonfatal HF events were significantly reduced. The investigators suggested that close patient follow-up led to the early recognition and management of signs and symptoms of fluid overload, thus preventing deterioration.

In addition, patients in the intervention group were more likely to receive target ACE inhibitor doses. Patients were randomized to medication education provided by pharmacists or routine care. In addition, there was a significantly longer time to readmission for the patients in the intervention group.

This study assessed the benefits of beta-blocker use and the cost to the health care system. This program involved many different health professionals. The specific role of pharmacists included patient medication education and collaboration with physicians to optimize patient medication regimen. One hundred and seventeen patients were enrolled.

The pharmacist, with the help of the nurse, emphasized weight monitoring and instructed patients when to contact a DHFP nurse in the event of experiencing worsening symptoms. The program also demonstrated reduction in hospitalization rates 1. The doses of ACE inhibitors used also increased, although not significantly.

case study of patient with congestive heart failure

The Nurse's Role in Heart Failure: Early Intervention

The role of pharmacists as part of a pilot HF program to help prevent exacerbations and hospitalizations among HF patients was evaluated. In this pilot study, there was no difference in the number of hospitalizations between the intervention and control groups. This is a large effect compared with most other treatments in heart medicine e. In addition to the effects on mortality, many patients also experience improvement in symptoms and quality of life.

CRT reduces the risk of recurrent hospitalisations for worsening heart failure which may largely offset the cost of device implantation. Health economic analyses suggest that CRT is highly cost-effective Reference 4 above and so is an efficient use of health service resources.

Task Force on Practice Guidelines. Journal of the American College of Cardiology Vol. Europace 14 suppl 3 : ii1-ii55 doi Submitting Institution University of Hull. Summary Impact Type Health. Various therapeutic approaches, including medicine treatments using thrombolytic drugs, anti-thrombics, beta-blockers, calcium antagonists, etc.

In spite of all these measures, these diseases are responsible for nearly half the deaths in industrialized countries [8] and is one of the most important causes of mortality in Iran [9]. Accordingly, it seems necessary to think of measures to deal with this situation. An important factor in the development of syndromes or different spectra of the disease is inflammation and damage to the wall of the vascular endothelium [10].

Various studies have shown that low-level lipoprotein oxidation plays an important role in the pathogenesis of atherosclerosis. Experimental studies in different experimental animals showed that antioxidants reduce low-level lipoprotein oxidation and decrease the rate of atherosclerotic plaque formation [11].

Generally, epidemiological studies have shown that the increased intake of antioxidants as food or supplementary products is associated with a reduction in the risk of cardiovascular diseases [12]. Despite the dramatic advances in the diagnosis and treatment of these diseases in the last three decades, this group of diseases is still a major health problem in the world and an important problem in developing countries. Today, with scientific advances and developments, coronary angiography is used as an invasive investigation in case study of patient with congestive heart failure diagnosis of known or suspected coronary artery disease.

According to the latest data from the American Heart Association in the United My homework, one million patients are undergoing invasive and diagnostic heart tests. In Iran, about 16 to 18 thousand cases of angiography are performed annually.

In most cases, invasive diagnostic tests cause stress and anxiety for the patient. Most hospitalized patients experience some degree of anxiety, one of the most common type happens before coronary angiography [13].

However, it can be said that the increased number of heart disease, increased cases of hospitalization and the high cost of care and treatment challenges put pressure on the health system in the current century.

For this reason, the prevention of heart disease complications and their successful treatment is essential because it requires preventive and therapeutic measures such as physical activity, proper diet and the continuation of drug use.

This can be done only through active participation of patients in treatment while implementing the recommendations given by team members [14]. There are also many reports declaring that the beneficial effects of effective medicinal herbs as well as traditional and complementary therapies have been observed along with the main treatment of cardiac patients in improving the life quality of patients, which might be used more by the patient while leading to lower costs []. In this regard, it was necessary to evaluate and make a scientific report based on a combination of modern and traditional Iranian medicine with new methods and medications that have the highest therapeutic effect in the shortest period of time.

Medical History and Examination according to Modern Medicine. The patient is a year-old man, with no history of a heart problem, a history of high blood pressure and high blood fat for more than 10 years. The patient is a senior office worker, resident and born in Bojnurd city, weighing about 95 kg with height of about cm.

Although the patient suffered from short chest pain for three days, he travelled to Tehran for an official mission. The patient suddenly experienced persistent pain at the back of the chest six hours before his visit.

This pain increased until the time of referral to the Emergency department heart failure case study pharmacy Tehran's Mehr hospital at 23 o'clock in December The patient was diagnosed with acute coronary syndrome and transferred to the cardiac care unit for 4 days due to his unstable angina. The main complaint was chest pain along with nausea, vomiting, and cold sweating. The patient received coronary artery angiography at the time and by diagnosis of cardiovascular obstruction, according to Figure 1, was considered as an angioplasty candidate willingly submitting his surgical intervention to another time.

After discharge, the patient was treated regarding his blood pressure, blood fat and acute coronary syndrome. One month after being referred to Bojnurd, the patient was referred to the Hajtaleb traditional medicine center based on the advice of a relative. During this period, the patient was treated with modern methods. He was anxious and depressed as a result of being hospitalized in cardiac care and undergoing angiography.

The patient had a hot and wet temperament, with good physical fitness and no problem regarding clinical symptoms. The patient's pulse was full and felt warmer when touching the skin; the patient did not use proper nutrition for prevention.

On the other hand, he did not follow the advice of doctors to abstain and keep hygiene. The Agency for Healthcare Heart failure case study powerpoint and Quality ARHQ developed a list of "never events" which identified events within health care that should "never" happen.

Among them was that medication errors should never lead to death or disability. And while a medication error was the main topic in the case presented, neither death nor a serious disability was the outcome.

A Pharmacist’s Guide for Systolic Heart Failure

However, the health care system as a whole and on an individual institute basis has been working to create a safer environment for patients. Many improvements utilized today incorporate information technology and computers. Hospitals are utilizing computerized physician order entry CPOE which can check for drug-drug interactions, allergies, multiple doses, or incorrect drug orders and can help to reduce redundancies and medication errors.

One function of CDSS is to send computer-generated reminders to hospital staff to ensure that standard protocols or guidelines are being properly followed. As even computers and electronics are not infallible, and power outages have been known to occur, health care professionals need to maintain an awareness of their actions and common errors that may occur.

Advancing the science of learning and behavior change in health care. Discussion In the patient highlighted in this case, instead of the standard IM injection of epinephrine for anaphylaxis, the patient received an IV dose of epinephrine, which is normally reserved for patients with a myocardial infarction.

Institute of Medicine: Washington, DC; Institute of Medicine. Preventing medication errors: quality chasm series. Cohen RM. He is employed as a college professor. Medication List Current Prescribed : Aspirin 81 mg orally daily Atorvastatin 80 mg orally daily takes every other day x 4 weeks Clopidogrel 75 mg orally daily Metoprolol succinate mg orally daily increased from 50 mg orally daily 6 weeks ago Lisinopril 5 mg orally daily increased from 2.

Office Visit Notes Chief Complaint:. He denies chest pain.Discussion With so many Americans suffering from heart failure, it is important that nurse practitioners be able to diagnose and treat CHF. Case Study of the Week: Mastoiditis I can tell that cough, cold and sniffle season is in full force by just…. Are you ready to Thrive? Learn More. Ruf says: May 12, at am.

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Post navigation Previous Post. PowerPoint PPT presentation free to view. Congestive Heart Failure. Pulmonary Edema associated with volume overload Ventricular unloading reduce afterload Acute: nitroglycerin, sodium nitroprusside Bruce D. Hettleman, MD. December 2, Heart failure case study powerpoint contraindicated in heart failure, due to impaired Developed by: Russell K.

Miller Jr. Congestive Heart Failure Functional Classification of Congestive Heart Failure Conclusions With chronic heart failure, atrial mycotes secrete increase amounts of atrial Coronary Artery Disease Manifestations of Heart Disease. Build a corporate level strategy - organizing your findings and recommendations in a way to answer the larger strategic objective of the firm.

It include using the analysis to answer the company's vision, mission and key objectivesand how your suggestions will take the company to next level in achieving those goals.

Business Unit Level Solution - The case study may put you in a position of a marketing manager of a small brand. So instead of providing recommendations for overall company you need to specify the marketing objectives of that particular brand. Heart failure case study pharmacy have to custom powerpoint services business unit level recommendations.

Case study of patient with congestive heart failure

The scope of the recommendations will be limited to the particular unit but you have to take care of the fact that your recommendations are don't directly contradict the company's overall strategy. For example you can recommend a low cost strategy but the company core competency is design differentiation.

Case study solutions can also provide recommendation for the business manager or leader described in the business case study. Step 8 -Implementation Framework The goal of the business case study is not only to identify problems and recommend heart failure case study powerpoint but also to provide a framework to implement those case study solutions. If you able to provide a detailed implementation framework then you have successfully achieved the following objectives - Detailed understanding of the case, Clarity of HBR case study fundamentals, Analyzed case details based on those fundamentals and Developed an ability to prioritize recommendations based on probability of their successful implementation.

Step 9 - Take a Break Once you finished the case study implementation framework. Step 10 - Critically Examine Duke Heart Failure Program case study solution After refreshing your mind, read your case study solution critically. Medtronic Corp. They are just awesome. The purpose case study of patient with congestive heart failure Medicaldump. If you have some documents that you would like to share or upload, drop me a mail at medicaldump-at-gmail-com.

Post a Comment. Follow Us! Be Our Fan. The prognosis in patients whose left ventricular dysfunction is asymptomatic is better than that in those whose left ventricular dysfunction is symptomatic. The prognosis in patients with congestive heart failure is dependent on severity, age, and sex, with a poorer prognosis in male patients. In addition, numerous prognostic indices are associated with an adverse prognosis, including NYHA class, left ventricular ejection fraction, and neurohormonal status.

These prognostic data refer to patients with systolic heart failure, as the natural course of diastolic dysfunction is less well defined. Survival can be prolonged in chronic heart failure that results from systolic dysfunction if angiotensin converting enzyme inhibitors are given.

EF ejection fraction. Treatment with angiotensin converting enzyme inhibitors prevents or delays the onset of symptomatic heart importance of healthy living essay in patients with asymptomatic, or minimally symptomatic, left ventricular systolic dysfunction.

The increase in mortality with the development of symptoms suggests that the optimal time for intervention with these agents is well before the onset of substantial left ventricular dysfunction, even in the absence of overt clinical symptoms of heart failure.

This benefit has been confirmed in several large, well conducted, postmyocardial infarction studies.

Heart failure case study pharmacy

Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet ; Predictors of total mortality and sudden death in mild to moderate heart failure. J Am Coll Cardiol ; Guidelines for the diagnosis of heart failure.

Eur Heart J ; The incidence and prevalence of congestive heart failure in Rochester, Minnesota. Mayo Clin Proc ; Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med ; The mode of death in heart failure has been extensively investigated, and progressive heart failure and sudden death seem to occur with equal frequency.

Some outstanding questions still remain, however. Although arrhythmias are common in patients with heart failure and are indicators of disease severity, they are not powerful independent predictors of prognosis.

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