Congestive Heart Failure and Hypertension Case

The case study is focused on an 82-year-old female patient who suffers from several chronic conditions, including congestive heart failure and hypertension. She also has a difficult home situation since her husband died recently, and she lives alone now. Upon discharge from the hospital, it is essential to outline the key problems faced by this patient and propose interventions to enhance her well-being. The present paper will seek to present and explain each issue evident in the case study and provide recommendations for addressing them.

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The most critical problem is the increased fall risk, which is evidenced by the patients’ age and the list of her medications. According to de Vries et al. (2018), Digoxin, Lasix, Calan, Furosemide, and Minipress are among the drugs that increase fall risk in the elderly. Since the patient takes a combination of these drugs, the risk of falls is the first priority issue in the case. Interventions to address this problem that would be best suited for the patient are de-cluttering, the use of walking aids, physical therapy, and patient education.

De-cluttering and the use of walking aids would help to reduce the risk of stumbling and losing balance, while physical therapy would increase the patient’s strength and balance. Patient education about fall risk would prevent the patient from overestimating her abilities and promote adherence to recommendations.

The second priority issue is depression, as the patient lives alone and has recently lost her husband. Depression can develop as a result of low social support or traumatic events, and thus this problem needs to be addressed. Interventions for depression in the elderly include group therapy, antidepressants, individual cognitive behavioral therapy, and patient education. The first three interventions are recommended based on evidence-based practice guidelines, whereas patient education would increase awareness of mental health resources available in the community (U.S. Department of Health and Human Services, 2011).

The third priority problem in the case is the patient’s compliance with prescribed treatment plans. Due to old age and depression, as well as a large number of medications, the patient might forget to take some of the drugs or take them at the wrong time. This issue threatens patient outcomes and needs to be addressed through interventions such as at-home nursing care, adherence therapy, medicine reminder cards, and a pharmacist consultation (Marcum, Hanlon, & Murray, 2017).

At-home nurse and medicine reminder cards will help the patient to remember the treatment plan, while a pharmacist consultation will motivate her to comply with the plan by explaining the dangers of non-compliance. Adherence therapy is an intervention designed specifically to ensure medication compliance (Marcum et al., 2017). It provides patient education and helps patients to build skills necessary for adhering to the treatment plan.

Lastly, the fourth priority problem is the lack of social support, which is evidenced by the fact that the patient lives alone and is rarely visited by her daughter. Interventions that should be considered in this case include group therapy, long-term care, community-based socialization for the elderly, and family education. Group therapy and community-based socialization would assist the patient in finding new sources of support and making friends.

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Moving to a long-term care facility should also be considered since this intervention would also address the patients’ other risks. Family education by care providers would motivate the patient’s daughter to visit more often and provide care, thus establishing a support structure within the family.

Overall, the problems found in the case could influence the patient’s quality of life and pose a threat to her health outcomes. The recommendations provided in the paper would help to address each issue and promote patient well-being. In particular, long-term care and group therapy should be used, as these interventions target a wide range of problems and risks. If the patient does not accept these options, it is critical to enhance the safety of her home environment and to build an adequate support system based on other suggestions offered in the analysis.

References

De Vries, M., Seppala, L. J., Daams, J. G., van de Glind, E. M., Masud, T., van der Velde, N.,… van der Cammen, T. (2018). Fall-risk-increasing drugs: A systematic review and meta-analysis: I. Cardiovascular drugs. Journal of the American Medical Directors Association, 19(4), 371-379.

Marcum, Z. A., Hanlon, J. T., & Murray, M. D. (2017). Improving medication adherence and health outcomes in older adults: An evidence-based review of randomized controlled trials. Drugs & Aging, 34(3), 191-201.

U.S. Department of Health and Human Services. (2011). Practitioners’ guide for working with older adults with depression. Web.

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