IndexClient Narrative and Therapeutic Treatment Plan Activities: ExamplePathophysiology of Congestive Heart FailureDrug Care Plan and Drug ProfilesConclusionIn developing a narrative therapeutic treatment plan , an example would be to explore and reframe the client's personal narrative to empower them to overcome challenges and shape a more resilient and positive future. Illnesses, illnesses, chronic conditions, all of these inflictions can be contracted or expressed in a variety of people through similar symptoms determined by the individual diagnosis. While each individual condition may express itself in similar ways, the steps taken to establish an effective treatment plan can vary dramatically depending on several biological, chemical, and psychological factors. To understand a treatment plan developed in an individual patient, several factors must be analyzed, including: a thorough description of the client to understand their needs and reason for hospitalization, the current pathophysiology of the condition, and management of the condition. the use of pharmacological reactions. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay Narrative of Client and Therapeutic Treatment Plan Activities: Example Descriptive data was researched and acquired on a hospitalized patient through a nursing student doing their clinical internship at their local hospital. The patient sought is an elderly woman who is currently married, not affiliated with any religion and from her home address. The patient presented to the hospital due to symptoms of fatigue and shortness of breath (SOB) leading to the diagnosis of congestive heart failure (CHF) along with a coded status for full resuscitation. The selected patient has a long history of previous health problems and diagnoses with the highest prevalence of: type 2 diabetes, endometrial cancer, hypertension, metabolic syndrome, renal cell carcinoma and high cholesterol. Previous attempts to treat the previously indicated diagnoses have uncovered a large list of allergies that can be harmful to the patient's health, such as allergies to: beta blockers, Ativan, calcium channel blockers, gentamicin, clindamycin, nitrofurantoin and many others . This understanding of basic information regarding the patient can be detrimental to creating a specialized care plan specifically for the patient that attempts to avoid unwanted reactions or unnecessary stress on the patient's body and mind. Further research was conducted on the patient's current plan of care regarding: his or her activities of daily living in the hospital, including his or her nutritional status, his or her hygiene and clothing skills, his or her elimination needs, and the outpatient needs that would normally are satisfied at home through the patient himself or assistance from the husband. The patient's nutritional care plan revolves around a low carbohydrate diet with only minimal assistance required to prepare food for direct consumption as the patient needs time to eat due to tiredness. The patient's hygiene and dressing skills vary from day to day depending on their current levels of fatigue and SOB as they may be independent with only preparation required or may need minimal assistance for harder to reach areas. The patient's eliminating needs are generally managed independently by the patient with only occasional assistanceneeded in the form of a bedpan or urinal due to symptoms. The patient's outpatient needs are minimal and the patient is able to get out of bed and reach the chair independently. The patient also has a four-wheel walker that can be used to walk additional distances with only supervision required for signs of weakness due to fatigue and SOB. Understanding the patient's care plan as it relates to their activities of daily living is important to the patient's comfort and health in order to meet their needs and routines in a semblance of normality that prevents any unnecessary risk on the part of the patient. patient in attempting to realize their needs on their own. Pathophysiology of Congestive Heart Failure Upon admission to the hospital, the patient was diagnosed with congestive heart failure. The condition known as CHF occurs when damage or weakness begins to affect the heart, inhibiting the strength needed to pump blood around the body. This inhibition of heart strength allows for the possibility of fluid buildup due to blood backing up from the lungs to the heart due to lack of muscle relaxation which can increase during activity or stressful events. Congestion caused by blood pooling can lead to exhaustion, hiccups, and edema that build up in the patient's ankles, legs, arms, hands, or torso. CHF has several possible underlying factors that could have started the condition; the two main underlying factors are damage or weakness of the heart due to: a myocardial infarction or long periods of high blood pressure. CHF can manifest itself through multiple symptoms with varying degrees of severity such as: SOB, edema at the periphery and occasionally at the center, increased levels of fatigue during activities or at rest, increased urination occurring mainly at night, along with pain, discomfort or pressure in the chest or heart. Since the heart is considered one of the most vital organs that supports the function of many others, severe cases of CHF can lead to the collapse of other organs such as the kidneys, lungs, peripheral nervous system, and in extreme cases, lead to complete organ collapse. due to lack of oxygenated blood leading to necrosis. Several tests can be done to detect congestive heart failure before end-stage symptoms appear, as long as the patient sees a healthcare provider as soon as symptoms appear. These tests may include an electrocardiogram to evaluate the size, rhythm, and strength of the heart as it pumps blood, a chest x-ray to examine any fluid buildup in the lungs, and a complete blood count to evaluate for any bleeding, electrolyte loss, and kidney function. Once congestive heart failure is diagnosed, the main treatment is mainly pharmacological with drugs such as diuretics, beta blockers and ACE inhibitors to reduce fluid volume, increase cardiac output and decrease systemic resistance. The patient, once admitted and evaluated by the student nurse, showed several signs and symptoms that would suggest the presence of CHF. Symptoms assessed included an irregular heart rate where occasional beats were not felt, swelling with pitting of the lower peripheral parts, mainly around the ankles suggesting fluid accumulation, increased fatigue with prolonged periods of rest, and SOB with little activity such as get out of bed. Other signs that would suggest a problem were seen in the blood results with almost triple the normal values ​​for creatine and blood urea nitrogen, suggesting areduced blood flow to the kidneys and low levels of hemoglobin, hematocrit and mean platelet volume, suggesting a decreased percentage of red blood cell volume in the blood and decreased oxygen transport in the blood. Therapeutic measures selected by the doctor included the use of beta-blockers to decrease the strength and rate of the heart which would lower the pressure of the blood in the arteries as it leaves the heart, immunosuppressants to lower the body's reaction to beta-blockers due to patient allergies to the drug, diuretics to decrease fluid volume and accumulate fluid to prevent increased edema and manage blood pressure levels, and a combination of bronchodilators and selective receptor agonists beta-adrenergics to facilitate the flow of oxygen through the airways and into the lungs. This treatment plan proved to be ineffective for the patient, as evidenced by observations on a weekly basis until the need for transfer for further therapeutic measures. In treating this patient, the nursing student noted that several considerations and interventions were needed, such as the patient requiring breaks between activities and rest from normal activities of daily living due to fatigue and SOB. Short, direct activities were needed to decrease the patient's fatigue level compared to long, slow activities, with moments of independence such as allowing them to perform pericare and eating at a slower pace to prevent exhaustion. Drug Plan of Care and Drug Profiles The patient over their lifetime has acquired multiple conditions that have required multiple drug treatment methods that have been transferred to the patient's current treatment plan for CHF. Medicines previously prescribed and used by the patient include: apixaban used to prevent serious blood clots due to atrial fibrillation, atorvastatin and ezetimibe used to manage high lipid levels, insulin aspart and insulin glargine used to manage diabetes, levofloxacin to prevent growth of bacteria in patient wounds, mometasone for psoriasis, pantoprazole for management of gastroesophageal reflux disease and tolterodine for overactive bladder. Understanding and recognizing the currently prescribed medications from previous diagnoses that the patient is using is vital to creating a medication care plan to prevent any chemical reactions between medications and avoid overdose. Occasionally, when creating a drug treatment plan, certain medications are needed for mild conditions or as secondary medications unrelated to the patient's diagnosis, such as: allopurinol for kidney stones, acetylcysteine ​​for management of acetaminophen poisoning, and prednisone to suppress the patient's immune system. These medications can be considered among the most important as they can prevent the development of further symptoms or assist with the function of the primary medications to improve the chances of recovery. Finally, the primary medications associated with a pharmacological treatment plan are those that work to manage or treat the condition for which the patient has been hospitalized, such as: bisoprolol, furosemide and nitroglycerin to manage hypertension and guaifenesin, ipratropium and salbutamol for management of the patient's airway and breathing. Further insight into the patient's medication plan of care can be explored through the prevalence of the five most significant medications in the patient's care plan. Prednisone, otherwise known as Winpred, is one of the most important medications in a patient's medication plan. treatment plan, not as a drugprimary used to manage the diagnosis, rather as a secondary drug that allows the adequate effects of bisoprolol due to its immunosuppressive effects. Prednisone falls into the class of corticosteroids due to its primary anti-inflammatory effects. The prescribed medication was administered daily in the morning via a 30 mg oral tablet. Prednisone was indicated to the patient to suppress the body's natural immune response as the patient has an allergy to beta blockers, one of the most effective medications for managing congestive heart failure. Prednisone works by binding to cytoplasmic receptors and inhibiting DNA synthesis to decrease the rate of white blood cell replication in the body to decrease the immunological and inflammatory response. Since no drug is perfect, some side effects appeared such as: dry skin that could be found on the feet where the gout would appear, increased bruising as seen from the bruises present from the injections and slow healing of wounds as seen from the marks of healing. rate of wounds on the patient's legs. For nursing considerations, it is important when administering the drug to evaluate for the development of peripheral edema or pulmonary congestion that may require a diuretic to resolve. Bisoprolol, otherwise known as Zebeta, is the most important drug for the treatment of congestive heart failure in the patient's pharmacological treatment plan due to its decreasing effects on rare heart contractions. Bisoprolol falls into the class of selective beta-adrenoceptor blocking agents for its effect in the management of high blood pressure. The prescribed medication was administered daily as a 2.5 mg oral tablet. Bisoprolol was given to the patient to allow the heart to relax while it replenishes the amount of incoming blood. Bisoprolol works by blocking the stimulation of adrenergic receptors in the heart muscles to slow conduction of the atrioventricular node. Bisoprolol side effects manifested as increased tiredness as the patient needed rest periods during the day and a slower heart rate observed during the patient's head-to-toe assessment. For nursing considerations, it is important to slowly decrease the amount administered rather than simply stopping it as serious adverse effects may occur. Furosemide, otherwise known as Lasix, can be valuable in managing the diagnosis as the drug can be used to lower the blood level. pressure and eliminate any excess fluid in the body. Furosemide falls into the class of drugs known as potassium-sparing diuretics for its effects of managing hypertension through fluid loss. The prescribed medication was administered twice daily as a 40 mg oral tablet. Furosemide was indicated for the patient to help manage blood pressure and expel any excess fluid that may accumulate and move into the interstitial tissues causing increased edema. Furosemide works by blocking the absorption of sodium, chlorine, and water in the kidneys. Side effects of furosemide manifested as constipation in the patient, evidenced by lack of bowel movement over a period of three days. For nursing considerations, it is important to monitor the patient's blood pressure prior to administration to prevent the risk of hypotension. Ipratropium, also known as Atrovent, is an important drug found in a patient's pharmacological treatment plan as the drug helps alleviate the connective side effects that CHF has on the lungs..