Question

C. Anne is a retired registered nurse (RN)who has been glven the diagnoss of Stage B heart tature She knows from her RN education that she will "deinitely" be placed on digoxin as a therapy. She remembers something about halos as something to be auned to, As a mental heath nurse, she admits to not keeping up with medical types of medications and therapies 1. Describe the classification and treatment puideines for patients clagnosed with Stace 8 HF 2 Is Anne correct in her assumption that she will be piaced on digoxin? Explain R19AM If che is niacedt on this medication, does her mamev at aaioc anclu 6/17/2019

Answer 1

Ans) 1) Heart failure (HF) is a clinical syndrome characterized by symptoms of effort intolerance (eg, dyspnea and fatigue) and/or signs of fluid retention (eg, pulmonary congestion and peripheral edema) due to a variety of pathological processes that perturb normal cardiac function.

Stage B HF, as defined by the ACC/AHA guidelines, includes patients with structural heart disease but no current or prior symptoms of HF.

There are 4 stages of heart failure (Stage A, B, C and D).

These stages are different from the New York Heart Association (NYHA) clinical classifications of heart failure (Class I-II-III-IV) that reflect the severity of symptoms or functional limits due to heart failure.

Stage B treatment

The usual treatment plan for patients with Stage B heart failure includes:

• Treatments listed in Stage A
• Angiotensin converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) (if you aren't taking one as part of your Stage A treatment plan)
• Beta -blocker if you have had a heart attack and your EF is 40% or lower (if you aren't taking one as part of your Stage A treatment plan)
• Aldosterone antagonist if you have had a heart attack or if you have diabetes and an EF of 35% or less (to reduce the risk of your heart muscle getting bigger and pumping poorly)
• Possible surgery or intervention as treatment for coronary artery blockage, heart attack, valve disease (you may need valve repair or replacement surgery) or congenital heart disease

2) Digoxin has been considered a cornerstone in heart failure treatment. Before the advent of the neurohormonal hypothesis (a theory to explain the mechanisms of heart failure), routine use of digoxin was recommended to improve cardiac output.

- It is now known that only medications that blunt and modulate neurohormonal tone (i.e. angiotensin-converting enzyme [ACE] inhibitors, beta-adrenergic blockers, and aldosterone antagonists) improve long-term survival in patients with heart failure.