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- W2435263559 abstract "A close acquaintance with the physiologic processes involved in the precipitation, avoidance, and correction of congestive failure must be achieved if the patient is to be treated properly. Rest, diet, digitalis, and diuretics are the basic components of therapeutic management. These may be prescribed singularly or collectively depending upon the patient's condition and needs at a given time. Congestive failure may be virtually undetected or may exhibit advanced symptoms. The adherence to the prescribed therapy may make the difference between control and recurrence of the episodes. Indeed, the prognosis of the disease is dependent upon the response to the prescribed regimens. The nurse plays a key role in helping the patient to better understand the purpose and the importance of the restrictions that should be maintained. An adequate cardiac output is the master key in the management of failure. A very considerable amount of noncirculating blood may be held in the lungs, systemic circulation, liver, and spleen. These reserve deposits may be called for by exercise or increased physiologic demands. The reserve supply of blood for the demands of the patient who has congestive failure is abnormally reduced and may even be nonexistent. For these reasons, nursing care must be given slowly with a minumum amount of patient effort being expended. Long tiring examinations and treatments must be considered in the light of conserving the reserve capacity. The older patient on a diuretic regimen is even more vulnerable than others to electrolyte imbalances. The alert nurse will be aware of the presenting symptoms of sodium and potassium alterations, and immediate steps should be taken to correct these changes as fully as possible, recognizing that prolonged electrolyte imbalances can be fatal. The many preparations of digitalis in use, with their varying stabilizing and maintenance programs, should have individual recognition. The actions of and adverse reactions to each preparation must be understood and observed by whoever is responsible for its administration. Variations in the radial pulse rate, arrhythmias, and bradycardia must, as symptoms, be recognized and considered for proper correction or management. Restricted sodium intake is perhaps the most difficult of all therapy to be accepted by the family and the patient. The dietitian, the nurse, and the doctor may explain the important role of controlled sodium intake in the diet to no avail. Many fine pamphlets and other guidance services are available through local heart associations and dietetic associations. From these sources pertinent, accurate information is obtainable. Suggestions for menu planning, buying, and seasoning of foods remove some of the obstacles that are ever present. The nurse can be of assistance to the doctor who is making an electrolyte profile of the patient by recognizing all the sources of fluid loss and making an accurate record readily available. These records should include all sources of fluid intake and output. A daily weight record is an important part of the management picture. The determination of “what is rest” for an individual patient is largely the responsibility of the nurse. A position that may be restful for one creates stress in another. Positioning should be individualized, and maximum relaxation with a minimum amount of sedation for the individual patient should be the desired goal. Rest is most important during acute episodes of failure. This does not mean that the everpresent threat of hypostatic pneumonia and thrombus formation is to be overlooked. Passive exercise may need to be instituted and it maintained if stasis of blood is to be avoided." @default.
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- W2435263559 date "1968-12-01" @default.
- W2435263559 modified "2023-09-27" @default.
- W2435263559 title "Heart Failure — The Geriatric Patient" @default.
- W2435263559 doi "https://doi.org/10.1016/s0029-6465(22)01026-x" @default.
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