Chronic Heart Failure and Cognitive Impairment
Discuss about the Nursing for Syndrome Developmental Medicine.
Chronic heart failure is a chronic condition that affects the normal functioning of the heart and may lead to severe to moderate cognitive impairment. The essay is about the analysis of a patient with chronic heart failure and hypoxic brain injury. It will analyze the impact of intellectual disability and chronic illness in the patients. Based on the identification of chronicity in cognitive impairment in the patient in the case study, the essay will describe how nurse plays a role in the ability to improve their health and quality of life. The patient has severe exacerbation due to his heart failure, and it will be necessary for the nurse to manage his symptoms. It will discuss the health challenges that the patient may face due to his intellectual disability and type 2 diabetes across his lifespan. Using the ICF model, the essay will explain how patients activity and social participation in life is affected by disability and diabetes. It will also identify one intervention strategy that nurses can use to manage type 2 diabetes.
Chronic heart failure is a costly and devastating disease that is the cause of mortality in the world. It has escalated health-care cost, and it is a severe burden on public and private health care system. There is a need for early recognition of disease and enhancing functional capacity in children to improve their health and overall being (Santulli, 2013). The case study is about Mr. John Davies, a 56-year-old man who has suffered anterior myocardial infarction and sustained hypoxic brain injury due to 16 minutes downtime of cardiac arrest. This has left John with both chronic heart failure as well as cognitive impairment. The patient has manifestations of Downs syndrome associated with moderate intellectual disability and type 2 diabetes. Down’s syndrome is a common chromosomal disorder causing intellectual disorder resulting in high risk of other conditions in life. Patients with Down’s syndrome have increased the prevalence of autoimmune disorder that affects endocrine and non-endocrine organs (Breslin et al., 2014). It is necessary that patient with Down’s syndrome be screened for Type 2 diabetes. Throughout such person lifespan, they manifest higher risk for infectious, oral health, cardiac and musculoskeletal disorders. Cognitive impairment may become challenging for patients to manage due to physical, psychological and environmental factors. In patients like Mr. John, cognitive deterioration takes place leading aggressive behavior and mood disorder. It affects person’s functional and learning skills and takes away independence in daily life activities. Behavioral problem and cognitive disorder are aggravated by conditions like chronic heart disease and type 2 diabetes. Chronic heart failure is a major risk factor for cognitive impairment because reduced cardiac output reduces cerebral blood flow. People with Down’s syndrome is at increased risk for other health problems like indigestion, hearing problems, visual impairment, increased risk of infection and dementia (Reijnders et al., 2013). Therefore exacerbations of heart failure together with the complications and morbidities associated with Down’s syndrome makes it very difficult to manage patient’s condition and lead a healthy life (Petersen et al., 2014). To manage poor health outcome due to the condition, proper interventions and self-management are important.
International Classification of Functioning, Disability and Health (ICF)
The International Classification of Functioning, Disability and Health also known as ICF is a framework for the description of health issues. In the context of intellectual disability, it enables the classification of health-related domains and determines their impact and interactions on daily life activities and social participation. It helps health practitioners to assess what a person can do in a standard environment in the presence of their disability and how it affects their normal life. ICF explains the environmental factors that interact with different components of disability and limits patient’s activity and participation in life activities (Carr et al., 2016). In the case of John, his conditions have worsened because of chronic heart failure and cognitive impairment. John has lost his independence in life due to activity restrictions and impairment of physical and intellectual capacity. John is extremely vulnerable to stressful social interaction because of his intellectual disability. It will have a significant impact on Mr. John’s social relationship (Dawes et al., 2015). People with this disability are more likely to discontinue education and getting deprived of necessities of life. Due to cognitive impairment, they may not get proper jobs as it limits their intellectual capability. Such people are at greater risk of social isolation which may further have an impact on their health. They face difficulty in the home and accessing public venues and moving in outside area. Mr. John is most likely to face difficulty in performing everyday activities. They cannot participate in sports or physical exercise. Social exclusion is also compounded by the attitude of people in the society. They stereotype such people as they do not have an idea what people with Down’s syndrome go through both physically and emotionally (Carroll & Payne, 2014). A person cannot cope with daily environmental demands and loses motivation in life. Impairment of memory and learning skills make it difficult for such person to communicate their views to people and such patients may develop frustration due to this disability. The outcome will be that they will exclude themselves from social participation in case of severe cognitive impairment. Thus, in the event of social exclusion, it is essential to plan effective intervention and teach patients coping strategies to manage life situations and fight with the health challenges (Hammel et al., 2015).
Mr. John is also suffering from Type 2 Diabetes. It is metabolic disorder characterized by high blood sugar, insulin resistance and deficiency of insulin in the body. To reduce the blood sugar level in Mr. John, it is essential that nurses plan an effective intervention that focuses on physical activity and diet of patients. One study highlighted the importance of diabetes self-management education as a critical element of care of people with diabetes. It provides evidence-based education and self-management support (Powers et al., 2015). The primary focus of nurse will be to emphasize on lifestyle interventions like changing diet and level of diet in patients with Type 2 diabetes. In the patient with Type 2 diabetes, weight loss and dietary management will be essential control blood glucose levels. The role of nurse will be to teach Mr. John lifestyle interventions and recommend the appropriate diet to control diabetes. The primary strategy for the nurse will be giving patient self-management education and improve nutrition, psychosocial care, and physical activity. About modification of diet, it will be necessary for the nurse to calibrate macronutrient composition in food to control sugar levels. Calorie restriction will be a priority for nurses, and they will advise patients to restrict saturated fats and simple sugars. Dietary counseling is also necessary for such patients to make them aware about correct food for maintaining good health. The nurse also has a role in monitoring the weight of Mr. John as weight gains act risk factors cardiovascular diseases. Eating well helps to manage blood glucose levels and maintain body weights (Evert et al., 2014). Activity modification will also be necessary to manage complications associated with diabetes. Exercise and physical activity modification help in making insulin work more effectively, lowering blood pressure and reducing the risk of cardiovascular complication in patients. The patient should be taught aerobic exercises to improve insulin sensitivity and improve glycemia. In patients with diabetes, structured exercise training with more than 150 minutes per week will be essential to reduce blood glucose level (Connelly et al., 2013). The patient should choose an activity that they can easily perform such daily walking for at least one hour. Physical activity combined with dietary modification lowers the blood glucose level considerably and provide better health outcome. Sedentary patients should be asked to start physical exercise slowly. It is also essential for Mr. John to learn self-management skills so that they can successfully manage their complications on time. Effective coping skills and self-management skills facilitate day-to-living in patients with the disease. The nurse can also utilize technology effectively to promote physical activity in patients with type 2 diabetes. Computer learning based technology like the video demonstration of appropriate exercise and physical activity make it easier for the client to learn skills (Negarandeh et al., 2013). Creating a menu plan wth low sodium diet and selecting venues with healthy food is necessary for Mr. John. Thus balancing of physical activity and diet modification will bring better health outcome for John and improve his quality of life.
Type 2 Diabetes and Intervention Strategies
Thus from the essay on the understanding chronicity of cognitive disability and type 2 diabetes in Mr. John, one can conclude that understanding of the interaction between chronicity and illness is necessary to plan an appropriate intervention for patients. Mr. Joh was suffering from chronic heart failure and cognitive disability due to brain injury. Analysis of factors that influences patient health and wellbeing due to the conditions reveals what kind of health challenges patient can face in life. Secondly, utilization of ICF model helped to know hoe normal activity and social activity is influenced by intellectual disability. It also gave detail on the strategies that nurse can take to manage symptoms of diabetes and highlighted the importance of physical activity and diet modification in such patients.
Reference
Breslin, J., Spanò, G., Bootzin, R., Anand, P., Nadel, L., & Edgin, J. (2014). Obstructive sleep apnea syndrome and cognition in Down syndrome.Developmental Medicine & Child Neurology, 56(7), 657-664.
Carr, A., Linehan, C., O’Reilly, G., Walsh, P. N., & McEvoy, J. (Eds.). (2016).The handbook of intellectual disability and clinical psychology practice. Routledge.
Carroll, J. S., & Payne, J. W. (2014). Cognition and social behavior. Psychology Press.
Connelly, J., Kirk, A., Masthoff, J., & MacRury, S. (2013). The use of technology to promote physical activity in Type 2 diabetes management: a systematic review. Diabetic Medicine, 30(12), 1420-1432.
Dawes, P., Emsley, R., Cruickshanks, K. J., Moore, D. R., Fortnum, H., Edmondson-Jones, M., … & Munro, K. J. (2015). Hearing loss and cognition: the role of hearing AIDS, social isolation and depression. PloS one, 10(3), e0119616.
Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., … & Yancy, W. S. (2014). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care, 37(Supplement 1), S120-S143.
Hammel, J., Jones, R., Gossett, A., & Morgan, E. (2015). Examining barriers and supports to community living and participation after a stroke from a participatory action research approach. Topics in Stroke Rehabilitation.
Negarandeh, R., Mahmoodi, H., Noktehdan, H., Heshmat, R., & Shakibazadeh, E. (2013). Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Primary care diabetes, 7(2), 111-118.
Petersen, R. C., Caracciolo, B., Brayne, C., Gauthier, S., Jelic, V., & Fratiglioni, L. (2014). Mild cognitive impairment: a concept in evolution.Journal of internal medicine, 275(3), 214-228.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … & Vivian, E. (2015). Diabetes self-management education and support in type 2 diabetes a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 41(4), 417-430.
Reijnders, J., van Heugten, C., & van Boxtel, M. (2013). Cognitive interventions in healthy older adults and people with mild cognitive impairment: a systematic review. Ageing research reviews, 12(1), 263-275.
Santulli, G. (2013). Epidemiology of cardiovascular disease in the 21st century: updated numbers and updated facts. JCvD, 1(1), 1-2.
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