Heart Matters: Detecting decompensated heart failure
Teresa Seright PhD, RN, CCRN

$3.95 		Nursing Made Incredibly Easy!
June 2013 
Volume 11  Number 3
Pages 12 - 16
 
  PDF Version Available!

ABSTRACT
Mrs. L opens the door in answer to my knocking, welcoming me into her sunlit home. Big band music subtly floats into the room via the adjacent kitchen. I'm immediately struck by Mrs. L's glow: her skin is beautiful, belying her 80-plus years. She smiles easily and engages me eagerly. She appears fit and moves about gracefully.At first, I'm not sure this patient referral was appropriate. You see, I'm at Mrs. L's home today because I'm conducting a pilot study on readiness for discharge in patients with chronic obstructive pulmonary disease and heart failure. But Mrs. L seems so healthy, I wonder to myself if she's really chronically ill with heart failure. As it turns out, I'm not the only person in Mrs. L's life who has been fooled by her vitality and strength.Mrs. L and her husband shared more than 50 years together, which she describes as "the best." They enjoyed their large family and after years of hard work, entertained and relaxed with friends and family at their lake home. After her husband's death 12 years ago, Mrs. L immersed herself in her children and grandchildren's lives. She was active with gardening, sewing, and socializing with friends. In fact, Mrs. L's progression to heart failure started soon after her husband's death as she was planning a weekend craft fair excursion with one of her daughters.Mrs. L awoke to nausea and abdominal pain the morning she was to depart for her daughter's home. She decided to take it easy that day, and when her symptoms didn't resolve, she called her daughter and cancelled their plans. Thinking she must have the flu, Mrs. L retired early in hopes of sleeping off her symptoms. She awoke the next morning feeling better, not entirely, but well enough to make the drive and renew her plans. However, as she neared her daughter's home, the abdominal pain came back with a vengeance. She began sweating profusely and became very nauseous.Upon arrival to her destination, Mrs. L informed her son-in-law, "I think I'm having a heart

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