Treatment Guidelines Essay Discussion Paper

Posted: December 23rd, 2022

Treatment Guidelines Essay Discussion Paper

Treatment guidelines

Various aspects of healthcare are guided by treatment guidelines, which serve as a guide for making choices and establishing criteria for diagnosis, management, and treatment. Treatment guidelines provide nurses and other health-care professionals with the opportunity to have research content gathered, evaluated, and summarized into precise practice standards by experts. This paper seeks to delve into the treatment guidelines for congestive heart failure, pneumonia, and acute coronary syndrome.

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Congestive Heart Failure

Congestive heart failure (CHF) is a frequent clinical phenomenon caused by a number of different cardiac illnesses and conditions. Since heart failure is mostly a clinical diagnosis founded on a thorough history, physical examination, lab, and imaging information, there is no one noninvasive diagnostic test that qualifies as a benchmark for the disease (McDonagh et al., 2021). Although the majority of individuals with probable heart failure do not need invasive tests for diagnosis, the diagnostic standard for diagnosing heart failure is the detection of an increased pulmonary capillary wedge tension at rest or during activity when in an invasive hemodynamic exercise test (McDonagh et al., 2021. Treatment Guidelines Essay Discussion Paper

Providing symptom relief, improving health-related life quality and functional abilities, and decreasing the incidence of hospitalization are the primary goals of CHF treatment. Admission to the hospital is necessary for all patients. Oxygen, diuretics, ultrafiltration, vasodilators, inotropes, and vasopressors may all be used as treatment options (McDonagh et al., 2021.

It is important to evaluate patients who have acute CHF for possible triggering causes such as myocardial ischemia, arrhythmias, worsening of hypertension, and medication interactions. As soon as the patient has been stabilized, the patient should begin receiving definite medical treatment for heart failure. It is common practice, to begin with, an ACE inhibitor (or an angiotensin-II receptor antagonist if ACE inhibitors are not tolerated) and then add beta-blockers as tolerated. The provision of sufficient oxygenation is a component of supportive care, and the aim is to keep it between 95 percent and 98 percent. A relatively low sodium diet and limitation of daily fluid consumption, as well as the management of triggering causes like pain and restlessness, should all be implemented (Yancy et al. 2019).

Pneumonia

History of coughing, breathlessness, pleuritic discomfort, or rapid cognitive or functional impairment, along with abnormal vitals and lung exam results, suggests pneumonia diagnosis (Torres & Liapikou, 2016). Chest radiography or ultrasound should be used to substantiate the diagnosis.

Treatment recommendations for pneumonia suggest a variety of therapeutic interventions based on the care setting (hospitalization or outpatient) if the pneumonia is categorized as serious, and whether the patient has comorbidities or other risk indicators for drug-resistant pathogens (Torres & Liapikou, 2016). Those who have severe pneumonia or who are hospitalized in the ICU must be treated with a beta-lactam antibiotic in addition to azithromycin or a respiratory fluoroquinolone, as recommended by the American Lung Association. Treatment Guidelines Essay Discussion Paper

Acute Coronary Syndrome

Cardiac troponin (cTn) has solidly defined itself as the “gold standard” for diagnosing acute coronary syndromes (ACS) in recent years (Katus et al., 2017). Patients who report symptoms indicative of ACS should have their cTn assessed as part of their physical examination and electrocardiogram (ECG) as well. The electrocardiogram (ECG) may be used to detect acute coronary syndrome by monitoring the electrical activity of the heart. It is also essential to get a blood sample in order to demonstrate that cardiac cells are dying.

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Initial treatment for acute coronary syndromes (ACS) should be directed on stabilizing the condition of the patient, alleviating ischemic discomfort, and administering antithrombotic therapy to minimize myocardial damage and minimize future ischemia from occurring (Switaj et al., 2017). ACS individuals at moderate or high risk should be provided with an early invasive approach in conjunction with concurrent antithrombotic treatment, which may include aspirin, clopidogrel, and unfractionated or LMWH (Switaj et al., 2017). Patients with ACS who are taking antiplatelet and antithrombin treatment may benefit from the use of humidified oxygen to decrease the risk of nosebleeds. If a patient has a history of confirmed intolerance to antiplatelet drugs, current internal bleeding, or bleeding problems, antiplatelet or antithrombotic treatment should be avoided (Switaj et al., 2017)Treatment Guidelines Essay Discussion Paper.

References

Katus, H., Ziegler, A., Ekinci, O., Giannitsis, E., Stough, W. G., Achenbach, S., Blankenberg, S., Brueckmann, M., Collinson, P., Comaniciu, D., Crea, F., Dinh, W., Ducrocq, G., Flachskampf, F. A., Fox, K. A., Friedrich, M. G., Hebert, K. A., Himmelmann, A., Hlatky, M., … Semjonow, V. (2017). Early diagnosis of acute coronary syndrome. European Heart Journal, 38(41), 3049-3055. https://doi.org/10.1093/eurheartj/ehx492

McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., … & Kathrine Skibelund, A. (2021). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal, 42(36), 3599-3726. https://doi.org/10.1093/eurheartj/ehab368

Torres, A., & Liapikou, A. (2016). Diagnosis and management of community-acquired pneumonia. Oxford Medicine Online. https://doi.org/10.1093/med/9780199600830.003.0116

Switaj, T. L., Christensen, S., & Brewer, D. M. (2017). Acute coronary syndrome: current treatment. American family physician, 95(4), 232-240. https://www.aafp.org/afp/2017/0215/p232.html

Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Colvin, M. M., Drazner, M. H., Filippatos, G. S., Fonarow, G. C., Givertz, M. M., Hollenberg, S. M., Lindenfeld, J., Masoudi, F. A., McBride, P. E., Peterson, P. N., Stevenson, L. W., & Westlake, C. (2017). 2017 ACC/AHA/Hfsa focused update of the 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the heart failure society of America. Circulation, 136(6). https://doi.org/10.1161/cir.0000000000000509 Treatment Guidelines Essay Discussion Paper