Home Care Chronic Disease Prevention Program

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Home Consideration Unending Ailment Counteractive action System. Melanie S. Bunn RN,MS A joint effort of Duke College, Division of Group Wellbeing and College of South Carolina, Institute of Medication. Homework survey. What did you do? What happened as you did that? Why do you feel that happened?

Presentation Transcript

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Home Care Chronic Disease Prevention Program Melanie S. Bunn RN,MS A coordinated effort of Duke University, Division of Community Health and University of South Carolina, School of Medicine

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Homework survey What did you do? What occurred as you did that? Why do you imagine that happened? This is what may have happened. How does this effect whenever you attempt this?

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Congestive Heart Failure (CHF)

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Chronic Disease Management Module 1:Health/Illness, Vital Signs, Exercise, Nutrition Module 2: Motivational Interviewing Module 3: End of Life Module 4: COPD Module 5: Stroke Module 6: Heart Attack Module 7: Hypertension Module 8: Diabetes Module 9: Congestive Heart Failure

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Objectives Discuss how the heart works and the effect of CHF on the heart Describe solid way of life decisions for the individual with CHF Demonstrate utilization of motivational talking with the individual with CHF

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What is Congestive Heart Failure? Influences five million Americans Heart is not pumping and additionally it ought to Blood and liquid move down into the lungs (clog, breathing is harder) Heart likewise can't supply the cells of the body with enough oxygen (makes weariness) Usually there is no cure

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How the heart works The heart is a muscle about the extent of your clench hand that pumps blood through the lungs and body www.hln-store.com

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How the heart works Adapted from :http://www.merck.com/media/mmhe2/figures/fg020_1.gif The heart is a muscle about the measure of your clench hand that p umps blood through the lungs and body

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Causes of CHF Heart assaults High pulse Abnormal heart valves Lung infection Diabetes Low blood number Thyroid sickness Heart arrhythmias Drugs, for example, cocaine and liquor

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Signs and side effects of CHF Shortness of breath frequently with exercises or while lying level Weakness and exhaustion Awakening shy of breath around evening time Need for expanded cushions during the evening – helps lungs deplete of overabundance liquid Coughing or wheezing Swelling of feet and legs or other "ward" regions Anorexia/loss of craving Weight pick up

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Diagnosis Electrocardiogram (ECG, "EKG") Chest x-beam Echocardiography ("Echo") Heart catheterization Stress test Blood tests

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Heart Failure Classification Class I No indications or constraint in normal action. Class II Mild manifestations and impediment amid normal action. Agreeable very still. Class III Marked constraint in action because of side effects, notwithstanding amid not as much as normal action. Agreeable just very still. Class IV Severe impediments. Indications while very still.

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Treatment Lifestyle changes Monitoring for changes Medications Surgery

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TREATMENT: Lifestyle decisions Exercise, physical action Nutrition low immersed fat, low salt eating regimen Lose weight Quit smoking Avoid liquor Modify liquid admission Monitoring illness weights swelling prescriptions signs and side effects

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Exercise General suggestion: 30 minutes most days of the week Specifics might be distinctive for various individuals (check with specialist about what sort and the amount) Always need to begin moderate and develop progressively/www.fi.edu/biosci2/solid/inline/options.gif

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Nutrition Low salt Low fat www.bkmarcus.com www.gothamist.com

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Sodium-Enters the body as salt Necessary mineral in the body Consumed in arranged nourishments or added to sustenances when cooking Can make liquid be held and circulatory strain to rise Recommended 2,000-2,300 mg/day Reference: one teaspoon= 2,000 mg sodium

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Salt – Case Study Question: Which do you think has more salt, pretzel or Fritos?

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Case Study – Which has more Salt?

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Salt Question: Which do you think has more salt? Rundown of regular sustenances with measure of salt

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Fat Should speak to 30% of calories Fats are isolated into 3 sorts: Unsaturated Saturated fat Trans fats

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Unsaturated fats Polyunsaturated (corn/sunflower/soybean oil) Monounsaturated (canola/olive oil) Fat - Healthy fats

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Saturated fat Limit sums (7-10% of calories) Animal items (drain/margarine/meat) Trans fats Avoid, no medical advantage Solid at room temperature Shortening, grease Fat – Unhealthy fats

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Fat – Case Study Question: Which do you think has more fat and soaked fat?

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Case Study – Which has more Fat?

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Fat Question: Which do you think has more fat? Rundown of regular nourishments with measure of fat

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Case Study What would you be able to do to find a low sodium and low fat nibble?

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Cholesterol Fat-like substance in the body Important uses in the body (however an excessive amount of can "obstruct" veins") Comes from body–produced in the liver and from sustenances Healthy eating routine: restrain cholesterol in eating regimen 200-300 mg of cholesterol/day

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Lose weight Body weight is an aftereffect of the harmony between: The calories in the nourishment eaten (Energy In) and The calories copied to keep up the body and amid physical action (Energy Out) SO… if a man takes in less calories than are utilized, the individual WILL get more fit Energy Out Energy In

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Lose weight Basic rules Go gradually Eating an assortment of sound sustenances Avoid inclining or restricting eating methodologies Two methodologies that work best when utilized together Reduce number of calories taken in (eat sustenances low in included sugar and fat and high in supplements) Burn more calories by turning out to be physically more dynamic

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Smoking More than 400,000 passings in the United States every year identified with smoking There are ~ 4000 chemicals in cigarettes Many of the chemicals are lethal and many are referred to advance plaque development and additionally cause tumor Smokers' danger of coronary illness is 2-4 times higher than nonsmokers' http://dccps.nci.nih.gov/tcrb/Smoking_Facts/about.html www.cdc.gov

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Smoking Stresses the heart – causes expanded pulse and heart rate. Decreases the oxygen in the blood. Harms veins, making clumps more conceivable. Stopping smoking is the best way of life change for decreasing demise from lung tumor and coronary illness http://dccps.nci.nih.gov/tcrb/Smoking_Facts/about.html www.cdc.gov

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Smoking Cigarette smoking is the greatest preventable reason for sudden passing in the U.S. Urge patients to stop smoking Each year more than 1.3 million smokers quit. With great projects to help, 20% to 40% of the individuals who attempt, remain off cigarettes for no less than a year. Social insurance suppliers can recommend quit smoking arrangements… But stopping is truly up to the person! http://dccps.nci.nih.gov/tcrb/Smoking_Facts/about.html www.cdc.gov

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Alcohol Limit allow At most one drink for each day for ladies and two beverages for each day for men One drink = 12 oz brew = 5 oz wine = 1.5 oz spirits

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Modify liquid admission Different individuals may have distinctive limitations Accurate records can help suppliers see what amount the individual can oversee

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TREATMENT: Monitor for change Daily weights Swelling Medications Change in signs and manifestations

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Daily weights Weight pick up can show the body is holding liquid, which is unsafe for a man with heart disappointment makes the heart work harder may mean the individual needs an adjustment in treatment

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Monitoring weight for liquid put on Weight pick up can demonstrate the body is holding liquid, which is risky for a man with heart disappointment makes the heart work harder may mean the individual needs an adjustment in treatment Each individual ought to have a built up pattern weight and a set up weight territory (when to call)

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Tips for exact day by day weights Weigh each day in the meantime on a similar scale in a similar kind of attire Record weights Notify if weight out of range www.euroscales.com

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Monitoring for swelling Check the body: Legs and feet Hips and posterior (if sitting a great deal) Stomach and back (if in the bed a ton) Check their garments and shoes Tight (denoting the skin) Modified (cut) Ask the individual

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Monitoring medicines Take ALL prescriptions as coordinated Even when the individual feels alright The meds may be the reason he/she feels alright www.swivel.com

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Warning side effects Increasing shortness of breath Increasing hacking Chest torment Leg swelling/shoes tight Weight increase Increased pads around evening time Fatigue, shortcoming

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Warning signs Decreased oxygen level Increased heart rate (beat) Increased respiratory rate Edema in the furthest points Weight pick up of more than three pounds more than three days Not taking pharmaceuticals *ALL key parameters are dictated by RN manager and are quiet particular

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Standard of look after the Nurse Aide is: Observing Recording perceptions Reporting to attendant chief as per the tend to the patient Observation of the patient with CHF

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TREATMENT - Medications help to enhance dissemination of blood by reinforcing the heart muscle's pumping activity or extending the veins Medications can likewise lessen the measure of water and sodium in the body, which thusly diminishes the heart's workload

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Medications Take ALL drugs as coordinated Take meds notwithstanding when the individual feels OK The solutions may be the motivation behind why he/she feels OK

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Classes of Medications Diuretics help the kidneys sift more water through of the body, prompting to less swelling and less work for the heart Digoxin strengthens the heart's capacity to pump

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Medications (proceeded with) Beta blockers slow the heart rate and decline blood weight Ace inhibitors lower circulatory strain

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Treatment - Surgery Angioplasty Coronary course sidestep join Heart pump Transplant

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Summary Points What is heart disappointment? What causes heart disappointment? What are signs and side effects of heart disappointment? What ar