Mr Silveria Heart failure 2 Case study
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages
Mr Silveria is a 47-year-old Brazilian man who was referred to the heart failure clinic by his consultant cardiologist for titration of his heart failure treatment. He has severe biventricular failure (NYHA III-1V) secondary to mitral valve disease. His current presenting symptoms are breathlessness on minimal exertion, paroxysmal nocturnal dyspnoea and poor appetite, and he experiences dizziness with quick movements. His past medical history includes septic arthritis with mitral endocarditis and septic emboli, mitral valve repair in 2012 and out of hospital ventricular fibrillation arrest in 2009. He has an implantable cardioverter defibrillator to manage recurrent ventricular tachycardia. Unfortunately his arrest in 2009 left him with profound short-term memory loss. His partner also stated that he often forgot to drink enough fluids. Sometimes he only drank 12 glasses of fluid per day whilst she was at work. Mr Silveria, however, has normal coronary arteries. His medication on the initial consultation is: lisinopril 2.5mg once daily, aspirin 75mg once daily, furosemide 40mg once daily and bisoprolol 1.25mg once daily.
On clinical examination, his observations were within the normal parameters, including a clear lung field on auscultation and no peripheral oedema. His jugular venous pressure (JVP) was not raised and his renal function and ECG were within normal limits. However, his systolic BP was relatively low, at 100/86mmHg.
In summary, his main problems were hypotension and memory loss and he was low in mood. The plan for Mr Silveria was to:
c) Increase his medication (up-titration of heart failure treatment) in order to reduce the deterioration in his current symptoms. On the first consultation, Mr Silverias lisinopril was increased from 2.5mg to 5mg.
d) Provide support to help him address how he felt about his condition and suggest strategies to help him cope with his memory loss.
On the second consultation, Mr Silveria returned to the clinic with paroxysmal nocturnal dyspnoea. During the assessment it was discovered that he had stopped taking his furosemide but neither he nor his partner knew who had instructed him to stop it. Furosemide was recommenced.
This situation illustrates the need for good communication and clear documentation by all involved in a patients care. The matter was investigated further, and the relevant individual was made aware of the results of their actions.
On his third visit to the clinic, Mr Silveria was generally well and more optimistic about his progress. However, his systolic BP was now 80mmHg, and although the dizziness was still present it had not worsened. No further changes were made to his medication and a follow- up appointment was made to see the consultant cardiologist. The consultant commenced Mr Silveria on spironolactone 25mg od because he was still symptomatic, (hypotension, dizziness) despite almost optimal treatment with an ACE-inhibitor and a beta-blocker.
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). 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APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. 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The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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