Problem
Mr Harinder Kumar is a 60-year-old man referred by his GP to the cardiology clinic. Mr Kumar has known severe left ventricular systolic impairment secondary to ischaemic heart disease with extensive peripheral oedema diagnosed as decompensated heart failure.
His past medical history includes diabetes type 2 treated with insulin and diabetic peripheral neuropathy. On examination, Mr Kumar was generally well, with no shortness of breath at rest, orthopnoea, chest pain, palpitations or syncope. Mr Kumar works as a taxi driver and has limited physical activity, recently he is has been trying to walk at least 30 minutes each day but reports feeling fatigue and breathlessness with his ordinary physical activity. His vital signs were within the normal range: BP sitting 122/58mmHg and standing 112/55mmHg, HR 70bpm, Spo2 97% on RA, temperature 36.2ºC. Mr Kumar's GP noted a significant increase in his weight compared, his weight is now 87kg up from 75kg two months ago.
Pmhx:
1) Severe left ventricular systolic impairment
2) ischaemic heart disease
3) T2DM
4) Peripheral Neuropathy
His current medications includes:
1) bumetanide 1mgtwice daily
2) spironolactone25mg once daily
3) aspirin 75mgonce daily
4) metformin 1gtwice daily
5) NovoMix® 30
6) ramipril 5mgtwice daily
7) simvastatin40mg once daily
8) bisoprolol3.75mg once daily and
9) Bendroflumethiazide5mg twice weekly.
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or prevention of deterioration on discharge. Patient education and discharge planning starts on admission and you need to provide your patient with education during your shift in preparation for discharge home.
Explain two important points/topics you will need to include in the patient's preparation for discharge to aid healing and prevent further illness.
One strategy to assist the patient to implement the education into their daily routine.