Comprehensive Nursing Care of a Patient with Congestive Heart Failure: A Case Report
Keywords:
congestive heart failure, nursing process, nursing care, case report, patient educationAbstract
Background: Congestive heart failure (CHF) is a clinical syndrome in which structural or functional abnormalities of the heart impair ventricular filling or ejection, leading to symptoms and signs of congestion and reduced exercise capacity. Careful assessment, appropriate medical treatment and comprehensive nursing care are essential to relieve symptoms, prevent complications and improve quality of life. Case presentation: This report describes a 62-year-old man admitted to the medical ward of a tertiary care hospital with congestive heart failure, who presented with breathlessness, orthopnoea, fatigue, bilateral pedal oedema, reduced activity tolerance and an oxygen saturation (SpO2) of 89%. Assessment comprised history-taking, physical examination, laboratory investigations and cardiac diagnostic evaluation. Care was planned and delivered using the nursing process alongside the prescribed medical treatment. Nursing management: The priority nursing diagnoses were decreased cardiac output, impaired gas exchange, excess fluid volume, activity intolerance and deficient knowledge about the disease and its management. Interventions included monitoring of vital signs and cardiorespiratory status, positioning and oxygen therapy, monitoring of fluid balance and body weight, graded activity and rest, administration of prescribed medications, and education on medication adherence, prescribed sodium and fluid restriction, daily weight monitoring, warning symptoms and follow-up. Outcome: During hospitalisation, the pulse rate fell from 108 to 84 beats/min, the respiratory rate from 28 to 20 breaths/min and the blood pressure from 150/90 to 130/80 mmHg. SpO2 rose from 89% to 96%, body weight decreased by 3 kg, pedal oedema regressed from +++ to +, orthopnoea resolved, and activity tolerance improved from poor to moderate. Conclusion: This case illustrates how systematic assessment, continuous monitoring, individualised nursing interventions and patient education, delivered alongside medical treatment, can support symptom control, prevention of complications and recovery of functional status in congestive heart failure.
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