NR 507 Week 3: Discussion Part Two
Chamberlain University NR 507 Week 3: Discussion Part Two– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 507 Week 3: Discussion Part Two assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NR 507 Week 3: Discussion Part Two
Whether one passes or fails an academic assignment such as the Chamberlain University NR 507 Week 3: Discussion Part Two depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NR 507 Week 3: Discussion Part Two
The introduction for the Chamberlain University NR 507 Week 3: Discussion Part Two is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NR 507 Week 3: Discussion Part Two
After the introduction, move into the main part of the NR 507 Week 3: Discussion Part Two assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NR 507 Week 3: Discussion Part Two
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NR 507 Week 3: Discussion Part Two
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NR 507 Week 3: Discussion Part Two
Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 F, R = 20. After a thorough work-up, he is diagnosed with congestive heart failure.
- What is the etiology of congestive heart failure?
- Describe in detail the pathophysiological process of congestive heart failure.
- Identify hallmark signs identified from the physical exam, diagnostic lab work and symptoms.
- Describe the pathophysiology of complications of congestive heart failure
- What teaching would you provide this patient to avoid heart failure symptoms?
In addition to the textbook, utilize at least one peer-reviewed, evidence-based resource to develop your post.
What is the etiology of congestive heart failure?
Heart failure is a chronic disease where the left ventricle, the right ventricle, or both, are unable to squeeze effectively, be it from enlarged ventricles or myocardial hypertrophy or compromised cardiac output. If the left ventricle is unable to pump blood through the aorta to the body efficiently, a decrease in oxygenated blood to the body is present and blood back up into the lungs. If the right ventricle is not pumping efficiently, a decrease in blood to the lungs is present and there is a backup of blood into the right atrium and body. Risk factors for heart failure include any disease process that can reduce heart contracture or alter ventricle filling, such as hypertension, coronary heart disease, diabetes mellitus, stenosis, regurgitation, cardiomyopathies, and arrhythmias (Rogers & Bush, 2015). Even though this is a disease that can be caught early and managed well, its prevalence is a serious public health concern and accounts for countless hospitalizations each year (Marques de Sousa, dos Santos Oliveira, Oliveira Soares, Amorim de Araújo, & dos Santos Oliveira, 2017).
Describe in detail the pathophysiological process of congestive heart failure.
In general, the pathophysiologic mechanisms of CHF in infants and children are very similar to those in adults. The same compensatory mechanisms are activated in the face of inadequate cardiac output. An acute decrease in blood pressure stimulates stretch receptors and baroreceptors in the aorta and carotid arteries, which in turn stimulate the sympathetic nervous system. With the release of catecholamines and the stimulation of β receptors, heart rate and the force of myocardial contraction increase (McCance et al., 2013). Venous smooth muscle tone also increases, which increases the return of venous blood to the heart. Sympathetic stimulation also decreases blood flow to the kidneys, skin, spleen, and extremities so that maximum flow to the brain,
heart, and lungs can be maintained. Decreased blood flow to the kidneys causes the release of renin, angiotensin, and aldosterone. If chronic, this cycle results in retention of sodium and fluid by the kidneys, which in turn increases volume in the circulatory system (McCance et al., 2013). These neurohumoral and hemodynamic changes create abnormal ventricular wall stress and cause the myocardium to hypertrophy. The myocardial fibers also stretch to accommodate the increased volume. Hypertrophy and fiber stretch temporarily increase contractility and hence the force of ventricular contraction. These mechanisms eventually fail to maintain cardiac output as CHF progresses.
Identify hallmark signs identified from the physical exam, diagnostic lab work, and symptoms.
57-year-old with dyspnea on exertion, fatigue, frequent dyspepsia, nausea, occasional epigastric pain, trouble breathing at night especially while lying on back, vital signs of 180/110 blood pressure. After a thorough assessment, to diagnosis heart failure and rule out other disease processes, such as valvular dysfunctions, a chest x-ray, and echocardiogram (Echo) would be ordered. A chest x-ray will reveal if the heart is enlarged and if there is any fluid in the lungs. An echo will measure the heart’s ability to pump, therefore conveying the EF. A serum BNP should be obtained to assess the severity of the disease (McCance et al., 2013). BNP is secreted via the ventricles when pressures within the ventricles change, the higher the serum level, the more severe the disease progression (McCance et al., 2013).
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Describe the pathophysiology of complications of congestive heart failure.
When heart failure occurs, they heart may not be strong enough to pump out as much blood as the body needs. As it tries to move more blood, the heart gets larger. It also pumps faster, and the blood vessels narrow to get more blood out to the body. As the heart works harder, it becomes weaker, and the damage increases. The body gets less oxygen, and the symptoms such as shortness of breath, swelling in the legs, and fluid buildup are present. In a normal heart, the upper chambers (called the atria) and lower chambers (the ventricles) squeeze and relax in turn to move blood through the body. If the ticker is weak, these chambers might not squeeze at the right time. The heart might beat too slowly, too quickly, or in an irregular pattern. When the rhythm is off, the heart can’t pump enough blood out to one body. Atrial fibrillation (AFib) is one type of abnormal heart rhythm that heart failure can cause. It causes the heart to quiver and skips instead of beating. An irregular heartbeat can lead to clots and cause a stroke. Also as the heart damage gets worse, the heart has to work harder to pump out blood, and it gets bigger and can damage the valves. Just like your other organs, they need a steady supply of blood to work as they should. Without the amount of blood, they need, they won’t be able to remove enough wastes from your blood. This is called kidney failure. Damaged kidneys can’t remove as much water from the blood as healthy ones. Consequently, the body will start to hold onto fluid, cause high blood pressure and make the heart work even harder.
What teaching would you provide this patient to avoid heart failure symptoms?
To help prevent recurrence of heart failure symptoms in patients I would stress the importance of home control and monitoring of daily weight. Patients must be instructed to check their weight in the morning after urinating and before breakfast, wearing light clothes and using the same scale. An increase of 1.3 kg or more in body weight in two days, or of 1.3 – 2.2 kg in one week may be an indication of fluid retention (Roger & Bush, 2015). I would also educate on the use of their medication and diet. It is import to teach patients that they must always take their medication, even when they feel well in order to obtain efficient treatment. Also, fluid restrictions and managing salt intake would be highlighted. Most importantly, self-care education, including the control of non-pharmacological measures, would be part of the daily management, reinforcement, improvement, and evaluation of self-care abilities.
References:
Marques de Sousa, M., dos Santos Oliveira, J., Oliveira Soares, M.G., Amorim de Araújo, A., & dos Santos Oliveira, S.H. (2017). Quality of life of patients with heart failure: Integrative review. Journal of Nursing UFPE/Revista De Enfermagem UFPE, 11(3), 1289-1287. doi: 10.5205/reuol.10544-93905-1-RV.1103201720
McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby.
McMurray, J. J., Gerstein, H. C., Holman, R. R., & Pfeffer, M. A. (2013). Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. The Lancet Diabetes & Endocrinology, 2(10), 843-851.
Rogers, C. & Bush, N. (2015). Heart failure: Pathophysiology, diagnosis, medical treatment guidelines, and nursing management. Nursing Clinics of North America, 50(4), 787-799.
Sample Answer 2 for NR 507 Week 3: Discussion Part Two
The first action to take is to Teach our patients that uncontrolled hypertension can lead to congestive heart failure. Thus, coronary disease and hypertension trends in population studies both suggest that the attributable risk of hypertension for HF should remain high. (Finally, the rising tide of diabetes puts a strain on the heart and cause it to work harder. Obesity raises the concern of an increasing role of these two entities in the genesis of HF. Being obese notwithstanding uncertainties with regards to the exact cellular and molecular mechanisms by which obesity and diabetes impact both systolic and diastolic left the ventricular function, there is mounting evidence for their causal link to HF independently of clinical coronary disease and hypertension. (Roger, 2013). To this end, the population burden of HF attributable to obesity and diabetes was recently examined in the ARIC study for obesity, while complete elimination of obesity/overweight could prevent almost one third (28%) of new HF cases, a more realistic 30% reduction in obesity/overweight could prevent 8.5% of incident HF cases. (Roger, 2013). For diabetes, a relatively modest 5% reduction in its prevalence would lead to approximately 53 and 33 fewer incident HF hospitalizations per 100,000 person-years in African-American and Caucasian persons, respectively. These results indicate that even modest modification of these risk factors would favorably impact the burden of HF. (Roger, 2013). Education is one of the importance of controlling and preventing worsening CHF. Daily weight is essential to maintain fluid imbalance.
Reference
Roger, V. L. (2013). Epidemiology of Heart Failure. Circulation Research, 113(6), 646–659. http://doi.org/10.1161/CIRCRESAHA.113.300268
Sample Answer 3 for NR 507 Week 3: Discussion Part Two
As nurses, especially as a bedside clinician, we are in a prime spot to begin education with the patient and family, whether newly diagnosed or reinforcement due to exacerbation. In our hospital, as I am sure many others, there is an emphasis on heart failure education, along with other core measures such as acute myocardial infarction and stroke, to assist with the thirty (30) day readmission regulations and to improve patient outcomes. I find that patient education, while in the intensive care unit, can at times be difficult due to their medical status, but initiation in small increments with the family or caregiver is important.
As stated by Rogers and Bush (2015), non-compliance with medications plays a major role in heart failure exacerbation due to the often amount and complexity of the medication regimen. As a family nurse practitioner, understanding why the patient is unable, or unwilling, to take certain medications is an important piece of the puzzle to prevent complications. Scheduling medications such as diuretics around activities, travel, or sleep patterns can be a challenge, so communication with the provider is very important. Referring the patient to a heart failure clinic and telemonitoring are methods to increase lifestyle and medication compliance, as well as creating a support network for the patient and their family (Rogers & Bush, 2015). As you stated above as well, reiterating signs of increasing fluid volume and failure are key for early intervention and long term success for the patient.
Reference
Rogers, C.R., & Bush, N. (2015). Heart Failure: Pathophysiology, diagnosis, medical treatment guidelines, and nursing management. Nursing Clinics of North America, 50(4), 787-799.
Sample Answer 4 for NR 507 Week 3: Discussion Part Two
Thank you for your informative post. I agree that teaching patients with congestive heart failure (CHF) should include activity, medication, weight loss, and blood pressure control. Management of CHF is important to decrease or avoid exacerbations. I see many patients in the hospital who have a diagnosis of CHF exacerbation. At times, exacerbation of CHF is related to non-compliance and in some cases related to flu or pneumonia complications.
Armstrong (2014) explains how there are many treatment options for the management of CHF. It is important to control hypertension and lipid disorders. Long-term control of HTN has reduced the incidence of heart failure by 50%. Diuretics, beta-blockers, and ace-inhibitors also help prevent heart failure in patients with CHF. In advanced stages of CHF an implantable defibrillator may be needed, especially those with an ejection fraction of less than 30%. Other ways a patient can help prevent further complications are to restrict sodium in the diet, treat sleep disorders, and incorporate a daily exercise routine based on tolerance level.
Reference
Armstrong, C. (2014). ACCF and AHA release guidelines on the management of heart failure. American Family Physician, 90(3), 186-189. https://www.aafp.org/afp/2014/0801/p186.html