In order to treat various types of heart diseases, Beta-adrenergic blockers (ẞ-blockers) are used. Heart diseases treated using ẞ -blockers include decreased ability of the heart to contract or expand efficiently, enlarged heart muscles, irregular heart beat, lack of circulation to the organ and high blood pressures. Increased pressure of the eye and migraine headache can also be treated using ẞ -blockers. In clinical medicine, no other class of man-made drugs has had such widespread applicability. In order to slow the activity of the enzyme ACE, ACE inhibitors are used. It decreases the production of angiotensin II.
Hence, the blood vessels dilate or enlarge and reduction of blood pressure take place (Frishman, 2003). Some of the common side effects of these classes of medications can be divided into several categories. Side effects from diuretics include the occurrence of impotence. Diabetic patients may find that diuretic drugs increase their level of blood sugar. In most cases, this is corrected by a change in anti-diabetic dosage, insulin, diet or medication. When diuretics are used continuously, some people suffer from gout. It is not a common effect and it can be controlled by other treatment. Mineral potassium supply in the body also can be decreased by the intake of these drugs.
As a result, there will be symptoms such as being fatigued, weakness and leg cramps. Potassium loss can be controlled by eating foods containing the mineral. You can maintain your potassium loss by taking tablet or liquid that has potassium along with diuretic if your doctor prescribes it. Diuretics like triamterene (Dyrenium), spironolactone (Aldactone) and amiloride (Midamar) are called as ‘potassium sparing’ agents. These diuretics do not allow potassium to be lost from the body. Though they can be prescribed alone, they are normally prescribed along with other ones. Some of these combinations are Moduretic, Maxide, Dyazide or Aldactazide.
In contrast, side effects of beta-blockers include impotence, asthma symptoms, slowed heart beat, depression and fatigue, cold feet and hands and insomnia. Patients will be will be closely monitored if they have diabetes and taking insulin. The should consult a doctor if you are planning to become pregnant and you have been prescribed beta-blockers. For women who become pregnant while taking beta-blockers, they should consult their health care provider as soon as possible to ensure safe medications. Moreover, side effects of ACE inhibitors are characterized by kidney damage in rare instances, chronic dry or hacking cough, loss of taste and/or skin rash. While on this class of medicine, women should avoid pregnancy. Someone who becomes pregnant while taking ACE inhibitor or an ARB should consult the doctor immediately. During pregnancy, these medications are extremely dangerous for both mother and the baby.
These drugs can even cause the death of a new born, as well as excess potassium, severe kidney failure and low blood pressure. During the 2nd and 3rd trimester, these medications are considered Pregnancy Risk Category D, which can cause fetal injury. When present bilaterally or in a single remaining kidney, ACE inhibitors are contraindicated in clients with renal stenosis. Following the use of ACE inhibitor, these medications are contraindicated in clients with a history of angioederma. As they are at a risk of developing neutropenia, in clients with renal impairments and collagen vascular disease, these drugs have to be used cautiously.
In order to detect infection, the patient should be closely monitored. When patients are going to take ACE inhibitor, they should be asked to temporarily stop taking diuretics for a few days. Informing patients regarding the status of ACE inhibitors is vital to be included in the process of treatment, they have to get their dose of medications adjusted.
If prescribed by the provider, patients should only take potassium supplements. Supplements of salts containing potassium also should be avoided. In order to avoid toxicity, lithium level of the patient also should be monitored. Concurrent use also should be avoided. If there is any signs and symptoms of swelling of tongue and skin wheals, patients have to notify it to the doctor. Subcutaneous injections of epinephrine should be used to treat sever effects and medication should be discontinued. All these advice should be provided to the patient before the start. The amount of salt in the diet should be reduced for people with heart failure to improve their symptoms.
In most of the foods, the mineral sodium can be found. When too much salt is consumed, human body retains high amount of water and this will lead to fluid build-up related to heart failure. People who have heart failure, following a low-salt help to alleviate swelling, enhanced blood pressure levels and reduced capacities for breathing.
People with heart failure should not consume more than 2 grams of salt daily and keep it less than 1500mg if possible. A study conducted by Frank B. in 2002 published in the journal ‘Current Opinion in Lipodology’ revealed that analysis of dietary patterns are multifactorial and are very complex and there is a connection between diet culture and chronic disease risk including heart failure. According to Hu, risk of coronary heart disease can be reduced if a person intake more of whole grains, folate, fruits, fiber and vegetables. Reduced mortality rate from ischemic heart disease may be resulted from the marine diet high in n-3 fatty acids, such as that consumed by many populations, suggested studies including a 2001 study by Eric Dewailly and colleagues published in “The American Journal of Clinical Nutrition. Dr. James H. O’Keefe Jr. and Loren Cordain, Ph.D., in the January 2004 edition of the peer-reviewed journal “Mayo Clinic Proceedings” suggested that mismatches between the human Paleolithic genome and contemporary dietary patterns may play important role in the present epidemics of atherosclerotic cardiovascular disease, diabetics, hypertension and obesity (Hughes, 2011).
The perceived need to do so is considered as one of the factors responsible for initiating dietary change. 1. There are significant practical implications for this phenomenon of ‘optimistic bias’ for the promotion of dietary change and health, as lack of awareness of personal behavior is connected with decreased motivation to change.
There is a general understanding of one’s own behavior, which is often connected with the conviction that healthy eating messages are aimed at people more vulnerable than us. Education concerning nonpharmacologic therapy, exercise testing with hemodynamic monitoring and specialized testing such as echocardiograms are common when treating heart failure. Telephone care, patient education, interval examination can be conducted by Nurse practitioners (NP) functioning as providers in CHF clinics. In order to avoid unnecessary emergency room visits, the NP is available to see deteriorating patients between scheduled visits.
Within an NP in CHF clinics, improved patient satisfaction, decreased hospitalizations and reduced patient costs have been reported (Quagliett, Atwood, Ackerman & Froelicher, 2000) Using huge muscle groups, regular physical activities like swimming, running or walking generates cardiovascular adaptations that promote skeletal muscle capacity for strength and stamina. For patients experiencing cardiovascular disease, Habitual physical activity also prevents the development of coronary artery disease (CAD) and reduces symptoms. The RN can promote adherence to a daily physical activity routine (Kresevic, 2012).
The regimen may well feature the supply of community service and caregivers support like physical, nursing, homecare and occupational therapy in order to make sure sufficient intake of protein and calorie and prevent further decline. They may educate on safety care needs as well as communicate to support networks the causes of functional decline related to acute and chronic conditions. They will execute careful documentation of all patient response and intervention strategies, while also assisting elder adults and family members in evaluating realistic functional capacity with interdisciplinary consultation.
Physical activity recommendations are not exactly followed by coronary heart disease patients though it has great benefits in the treatment of these patients. Patients attending rehabilitation programmers for cardiac problems have a lot of importance for behavioral strategies. In order to motivate patients to be physically active, tailoring consultation according to patients’ needs and sending motivational reminders are successful and it has been suggested by many researches. At the same time, there are no proved evidences to show it will be highly effective in the case of coronary heart disease.
CHD patients will be helped to increase their level of PA if behavioral intervention delivered through tailored individualized consultation supported by motivational SMS text message reminders (Alsaleh, Blake & Windle, 2012). There have been a number of studies conducted to examine the effect of the programs of management of heart failure designed to promote results in clients with heart failure. In intensity and content, all these programs differ. Most of the programs can be grouped as either “home based management program” or “heart failure outpatient clinic” though there are a large number of within model variations.
In delivering care for heart failure, combination of these models or new approaches like telemonitoring also is used (Jaarsma, 2005). For instance, in order to lead the team meetings, PACE usually uses a facilitator. It is the responsibility of the team for coordinating 24-hour care delivery, the plan of care, periodic reassessments, periodic reassessments and the initial assessment. It is the duty of the team to care planning meeting and daily monitoring of the meeting. The psychosocial, functional and medical condition of each beneficiary should be reported by each member of the team regularly (Cooper & Fishman, 2003).
The development of new technological applications and digital models may well facilitate the ability of nurse practitioners to develop superior healthcare practices in transitioning patients. Data analytics, smart technology, and more sophisticated computer modeling may well provide the key to identifying better ways to yield superior outcomes in this matter as well as develop long terms outcomes in terms of reversing adverse trends. Although these measures will not be full proof, they may well prove potent in reducing many of the circumstances that contribute to inhibiting optimal outcomes in terms of patient transitions.
Of course, the very nature of organizational and communication trends as well as technology involve constant change and evolution, whereby complacency is punished by new evolutions and the destruction of old models. It will be imperative that those individuals and institutions that are entrusted with providing and developing strategies and tactics to empower healthcare practitioners and patients remain vigilant, life-long learners in their ability to recognize and leverage new trends in this realm.
