HNN319 Study Guide - Final Guide: Heart Failure, Pulmonary Edema, Chronic Care
9 Jun 2018
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HNN 319- EXAM Revision
* Week 1: Models of Chronic Care
Describe models of chronic care
o National Strategic Framework for Chronic Conditions: focuses of
priority populations rather than specific diseases- Overarches the
more specific disease framework
o Wagners Chronic care model: all stakeholders know their roles and
work towards a common goal- this is more suited to first world
country health services
o Innovative Care for Chronic Conditions Framework: takes a more
prevention based approach to population health and is more flexible
and adaptable to any healthcare context- can be applied in any world
setting
o Flinders Program: focus is on the individual and self management goal
setting with the healthcare practitioner
o Shifting Perspectives Model: a cycle of illness versus wellness at the
forefront of the patients mind. This can affect the ability to reach
goals
Describe the pathophysiology of chronic heart failure and congestive cardiac
failure
o Chronic Heart Failure (CHF): a complex clinical syndrome with typical
symptoms that can occur at rest of on effort, and is characterised by
evidence of an underlying abnormality or cardiac dysfunction that
impairs the ability of the ventricle to fill or eject blood
▪ When the heart cant supply enough blood to meet the odys
demands
▪ Left-sided HF (systolic): pulmonary oedema, left ventricular
perfusion, damaged myocardium, respiratory alkalosis,
decreased cardiac output
▪ Right-sided HF (diastolic): can be caused by left-sided HF,
increased ventricular pressure, extravasation, pitting oedema,
JVP, pressure placed on the kidneys and adrenals
o Congestive Cardiac Failure (CCF): occurs when your heart muscle
doest pup eough lood as well as it should. Certai oditios
such as narrowed arteries in your heart or high blood pressure,
gradually leave your heart too weak or stiff to fill and pump efficiently
▪ the main pumping chambers of the heart; the ventricles
become larger or thicker, and either cant contract or cant
relax as well as they should. This triggers fluid retention,
particularly in the lungs, legs and abdomen
- * CONGESTIVE HEART FAILURE IS AN ACCUTE EPISODE OF CHRONIC HEART
FAILURE*
Identify potential and actual problems related to chronic heart failure
o increased venous pressure
o pitting oedema in ankles/legs or distended abdomen (ascites)
o decreased cardiac output
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find more resources at oneclass.com
o left ventricular perfusion
o damaged myocardium
o respiratory alkalosis (disturbance in acid and base balance due to
alveolar hyperventilation
* Week 2: Psychosocial Impact of Chronic Illness and Disability
Describe the psychosocial impact that chronic illness can have on the person in
relation to self, family and community
o Lifestyle
o Education
o Self-esteem
o Social relationships
o Physical wellbeing
o Impacts of chronic illness
▪ Shock
▪ Denial
▪ Loss and grief
▪ Anxiety and depression
▪ Stigma
▪ Social isolation (power and psychological)
▪ Powerlessness
o Patients should not be defined by their illnesses; therapeutic
relationships should be built based on trust and person centred care
Show an understanding of psychosocial care in a nursing context
o Cognitive therapy (individual or group therapy)
o Behavioural therapy (CBT)
Uderstad the eaig of Disability
o A physical or mental condition that limits a persons movements,
senses or activities
o A continuing condition that restricts everyday activities
o Attributable to an intellectual, psychiatric, cognitive, neurological,
sensory or physical impairment and or a combination of those
impairments
- Implement nursing interventions for potential and actual problems related
to chronic heart failure management
o
Prepare, perform and document venepuncture procedure and perform
o Equipment
▪ Bluey/gloves
▪ Tourniquet
▪ Vacutenor
▪ Butterfly needle
▪ Blood tube/s
▪ Alco wipes
▪ Gauze/tape for puncture site
o Procedure
▪ Apply tourniquet
find more resources at oneclass.com
find more resources at oneclass.com
▪ Locate vein (antecubital fossa)
▪ Pt to squeeze and relax hand to assist in finding vein
▪ Position arm in a straight line (on a pillow downwards)
▪ Swab with alcohol wipe and let dry
▪ Vautanor in dominant hand
▪ Non-dominant hand to stabilise and stretch the vein
▪ Insertion angle 15-30 degrees
▪ Release tourniquet once needle is inserted and blood tubes
have been applied
▪ Apply pressure to area once needle is removed
▪ Agitate blood tubes to prevent haemoligitis
▪ Label tubes with pt name, DOB, nurse initials and date/time
* Week 3: Care Partnerships and supportive care
Define the terms care partnerships and supportive care
o Care Partnerships: are therapeutic relatioships etwee pts ad the
nurse, with positive partnerships leading to more positive outcomes
and more satisfying roles to nurses
▪ Encompass the principles of person centered care
o Supportive Care: is the provision of support via medical, emotional or
practical means at any stage of the disease trajectory
Describe the pathophysiology of TIA and stroke
- TIA (Transient Ischemic Attack)
o Sometimes referred to as a mini stroke
o Is known as an Ischemic stroke (occurs as a result of a sudden
obstruction to a cerebral artery)
o The brain supplied by this artery becomes ischemic, and if the
situation does not improve quickly an infarct will occur
o Due to the high metabolic demands of brain tissue, irreversible
damage can quickly develop within minutes of the ischemia
o The obstruction is often due to a thrombus or embolism
o People can experience episodes of cerebral ischemia that include
neurological defects, but these symptoms usually resolve within 24
hours- this is known as a TIA
o TIAs can be experienced once or a series of episodes may occur
o TIA is an indicator of underlying thrombotic disease and is a warning
to the person that they are at a high risk of stroke
- STROKE
o Stroke is the more common name used for a cerebrovascular accident
(CVA)- blood clot or blockage that prevents oxygen getting to the
brain
o Stroke is a localized vascular lesion that develops suddenly within the
cerebral circulation where the vessel becomes blocked or bleeds
▪ This results in a cerebral infarction, where neurons will be
irreversibly injured because they do not regenerate
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
This can affect the ability to reach goals. Jvp, pressure placed on the kidneys and adrenals: congestive cardiac failure (ccf): occurs when your heart muscle does(cid:374)(cid:859)t pu(cid:373)p e(cid:374)ough (cid:271)lood as well as it should. This triggers fluid retention, particularly in the lungs, legs and abdomen. * congestive heart failure is an accute episode of chronic heart. * week 2: psychosocial impact of chronic illness and disability. Describe the psychosocial impact that chronic illness can have on the person in relation to self, family and community: lifestyle, education, self-esteem, social relationships, physical wellbeing. Show an understanding of psychosocial care in a nursing context: cognitive therapy (individual or group therapy, behavioural therapy (cbt) Implement nursing interventions for potential and actual problems related to chronic heart failure management. Insertion angle 15-30 degrees have been applied: apply pressure to area once needle is removed, agitate blood tubes to prevent haemoligitis, label tubes with pt name, dob, nurse initials and date/time.
