Living with Cardiac Illness

Question 1

Types of Cardiac Illness:

Answer 1

Ischemic disease
Arrhythmia
Cardiomyopathy
Valve disease
Congenital heart disease
Pulmonary hypertension

Question 2

Heart failure is:

Answer 2

• Chronic illness

- Progressive and life-limiting illness.

Question 3

Understand the trajectory:

Answer 3

• Ups and downs are a natural part of the whole decline
• Sudden death event can happen
• With supportive care (eg. Transplant or ventricular assist device) the functional status is considerably improved.
• Frailty (higher risk of negative health outcome and death) due to falls, hospitalization.

Question 4

Cardiac illness: Effect on the person

Answer 4

Physical
Social
Emotional
Spiritual

Question 5

Cardiac illness: Disrupture with the ‘‘normal’’ course of life

Answer 5

• Role loss/change
• Social changes (eg. isolation)
• Expectation regarding self-care and lifestyle changes
• Managing one more comorbidity

Question 6

Total dyspnea, the interconnection of symptoms:

Answer 6

• Nausea, vomiting, and constipation
• Fatigue
• Pain
• Anxiety. cognitive impairment.

Question 7

Anxiety and depression is found in 20% of HF patients, what contributes to symptoms?

Answer 7

• loss of control
• loss of function
• loss of social support, financial burden
• worsening physical burden
• Sense of personhood threatened
• Worries about ICD

Question 8

DEPRESSION is related to:

Answer 8

• Increased re-hospitalizations and mortality
• Greater health services utilization
• Poorer self-care behaviors

Question 9

Patient experience about spirituality and role of the nurses:

Answer 9

• Therapeutic relationship
• Taking time to understand the meaning people ascribe to their illness and functional changes
• Encouraging hope for the best and planning for the worst
• Exploring religious/spiritual beliefs of the patient
• Life review and Legacy work
• Spiritual care/chaplain available?

Question 10

Advance HF: the needs of older patients

Answer 10

• Needs to understand that is it chronic, progressive and life-limiting illness. (not only acute events/ change due to age)
• Needs to be prepare about advancing care planning and dying (ACP, decision about care)

Question 11

Nurse’s Role in ACP:

Answer 11

1. Explore (focus on values of the person, their fear and concerns, their future, their understanding of their illness and perception of quality of life)
2. Educate (Answer question, clarify myth and misunderstanding or repeat what the physician said)
3. Support (Dignity, compassion, presence, empathic communication)
4. Advocate (share patients concerns with the team and advocate the importance of spending time in psychosocial intervention)

Question 12

Palliative approach (philosophy of care):

Answer 12

• Dignity & personhood, compassion and communication
• Quality of life as priority of care
• Combined with Good medical health failure care and self-care by patient/family.