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

Heart failure prevents the heart from supplying enough carbon monoxide for metabolic operations (Chisholm-Burns et al., 2016). The patient’s heart failure is classifiable as class III and stage C. Her symptoms are visible and cause her difficulties in engaging in everyday activities like walking across blocks. She reports having been tired for about three months and having breathing challenges. Her situation only improves when she is at rest. Alternatively, she has to rely on two pillows for more comfort when sleeping. Her echocardiogram readings prove that the symptoms are due to an increase in the probability of systolic left ventricular failure.

Her symptoms are improving through continuing the use of her Beta-blocker medication because her EF is less than 40%. In worst situations, the doctor should offer an alternative prescription to Verapamil due to its contraindications, especially when the heart failure becomes congestive (Stams et al., 2012). Verapamil is a calcium channel blocker, thus lessens the heart’s functionality. Otherwise, the HCTZ is a correct prescription for her high blood pressure that could trigger heart failure if it persists. Additionally, they can take diuretics and hydralazine or an aldosterone antagonist in case the ACE/ARB/ARNI are inefficient. These considerations would  improve her symptoms. Alternatively, the long-term solution involves surgery to avert the long term impact of heart failure Hypertension/Heart Failure Discussion Essays.

The physicians should also consider monitoring parameters such as the regular assessments of one’s chest, arterial pressure, and the jugular venous pressure to avoid uncontrolled hypertension (Nicholls & Richards, 2007). Additionally, the patient’s body weight should also be examined to monitor factors such as an increase in their sodium intake and variances in their heart rate to prevent situations such as over diuresis. These monitoring techniques are manageable through approaches like telemonitoring at the patient’s home. Non-pharmacologically, the patient should exercise regularly or simple walking despite feeling tired. She should also focus on a low sodium and cholesterol diet such as the DASH diet. Seemingly, her situation will become better. Any medical decisions must depend on the patient’s condition, the drug’s side effects, and a proper follow-up plan.

References

Chisholm-Burns, M. A., Wells, B. G., & Schwinghammer, T. L. (2016). Pharmacotherapy principles and practice. McGraw-Hill.

Nicholls, M. G., & Richards, A. M. (2007). Disease monitoring of patients with chronic heart failure. Heart, 93(4), 519-523.