Thursday, December 19, 2019

Congestive Heart Failure in the Elderly - A Nursing Approach

Congestive Heart Failure (CHF) is a foremost health problem worldwide, touching 4.8 million U.S. patients and accounts for 978,000 or 5-10% of all hospitalizations. Some estimates show 550,000 new cases of CHF diagnosed each year in the United States alone. Currently, CHF accounts for 20% of all discharges in the over age 65 categories; with the aging demographic, this statistic is expected to increase significantly. Overall, the cost of treating CHF is very high -$38 billion annually in the U.S., representing 5.4% of total health care costs and involves many physician visits - at least 11 million ambulatory visits per year. The mortality rate for CHF is high, with one in five persons dying within 1 year, more than half of the CHF patients†¦show more content†¦The study shows that disease-modifying medications were prescribed significantly more often in 2000 than in 1995, particularly in patients younger than 65 and in those aged 75 to 84 (Saczynski et al., 2009, p. 3). The study indicates that Beta-blockers and ACE inhibitors have been shown to improve survival and reduce hospitalizations in patients with Heart Failure. The second article mentioned about the elderly patients who have CHF not on or under dosage of Angiotensin Converting Enzyme (ACE) inhibitors. According to this article ACE inhibitors should be given for patients diagnosed asymptomatic left ventricular systolic dysfunction (LVSD) (EF40%) and symptomatic heart failure with systolic dysfunction associated with other heart problems such as myocardial infarction, pulmonary hypertension. The suggested dosage for the CHF patients mentioned in the article and due to age-related changes in pharmacokinetic drugs, it also recommended the initial dosage must be half the standard dose and gradual increase after assessing renal function. After studying a group of elderly CHF patients revealed that higher or standard dose of ACE inhibitors reduce the risks of major clinical events. 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