Here are some additional questions that you should consider for this weeks discussion: What are some of both the short-term and long-term benefits seen with prescribing ACEI’s for heart failure? What are some side effects of ACEI’s? What can you switch to if your patient cannot tolerate an ACEI? If your patient had chronic kidney disease in addition to HTN and HF, what would his blood pressure goal be? Hypertension/Heart Failure Discussion Essays

Here are some additional questions that you should consider for this weeks discussion: What are some of both the short-term and long-term benefits seen with prescribing ACEI’s for heart failure? What are some side effects of ACEI’s? What can you switch to if your patient cannot tolerate an ACEI? If your patient had chronic kidney disease in addition to HTN and HF, what would his blood pressure goal be? Hypertension/Heart Failure Discussion Essays

In this scenario, a 50-year-old African American woman presents with lethargy for the last three months, trouble breathing at night and on exertion, arthritis, and edema in both feet. I would classify her with heart failure NYHA Functional Class II ACC/AHA stage C related to her signs and symptoms. CHF’s classic signs and symptoms are shortness of breath on exertion, trouble breathing at night, edema, and an EF of 30% (Chisholm-Burns et al., 2019).  EF percentages 40% and below indicate heart failure (Chisholm-Burns et al., 2019). I would first start by providing a full assessment of the patient concentrating on heart sounds, lung sounds, and edema evaluation. I would then review the medications. I would add furosemide 40mg daily to her current regimen to reduce her edema by increasing sodium and water excretion, so it is essential to monitor sodium levels when starting a furosemide patient (Chisholm-Burns et al., 2019).  I would recommend the re-evaluation of medication in one week with labs. Depending on her blood pressure, I would recommend an ACE inhibitor and a beta-blocker and d/c the verapamil to increase blood pressure control.  (Chisholm-Burns et al., 2019). I recommend daily weights, pulse, and blood pressure. If the patient experiences any weight gain over two pounds, she needs to contact her Provider immediately (Chisholm-Burns et al., 2019). Education for this patient would also include explaining that her chronic hypertension is why she now has HF (Hajar, 2019). As a provider, it is vital to explain why she must take her medication and monitor her weight.

In addition to medication changes, I would provide education on a reduced-sodium diet and encourage a daily exercise program. I would also explain the importance of managing heart failure to prevent future damage to the heart and other organs. HF is very serious and is irreversible. It is a  worldwide pandemic that affects 26 million people (Dokainish et al., 2017). HF is associated with high mortality and a large portion of all healthcare costs (Dokainish et al., 2017). HF and CHF patients are more likely to develop COPD, causing even more complications related to medication regiments and disease management (Canepa et al., 2017). When assessing HF patients for the first time, it is essential to evaluate comorbidities such as COPD (Canepa et al., 2017) Hypertension/Heart Failure Discussion Essays.

Canepa, M., Straburzynska-Migaj, E., Drozdz, J., Fernandez-Vivancos, C., Pinilla, J. M. G., Nyolczas, N., … Tavazzi, L. (2017). Characteristics, treatments and 1-year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long-Term Registry. European Journal of Heart Failure, 20(1), 100–110. https://doi.org/10.1002/ejhf.964