Question

Sixty-two-year -old James White is accompanied to the clinic today by his wife and son. James has had increasing problems with his memory for the past several months and has rapid mood swings for no apparent reason. His wife says that "he'll go outside in the garden without his clothes on, and his speech is difficult to understand." His son reports that at times James flaps his arms a lot and notices that he is unable to cut his food or tie his shoes. James was diagnosed with heart failure approximately 6 months ago.

      a. How would you explain to the White family what is occurring with James?

      b. What treatment modalities would be appropriate for James at this time?

Make sure you respond concerning the multi-system impact of this condition. How are his symptoms and history manifesting a textbook picture of the disorder? What are the systems involved? What are both immediate and long term treatment options? Are these appropriate for this client? Why do you make that determination?

Answer 1

a. The White family had to be explained the following

• The changes which can happen in the body after the heart failure
• Usually patient's with heart failure will have altered level of blood being pumped to the brain. This can cause confusion and mood swings as days goes on. Also patient tends to behave in an aggressive or depressive manner because of the disease condition .
• The system like cardiovascular system is affected from its functioning. This has an direct impact on the central nervous system .When this system is affected it can alter the endocrine system responsible for hormone production and causing various signs and symptoms of mood swings.

b. The treatment modalities which can be appropriate for this patient are

• Cognitive behavior therapy
• Medication to control the symptoms
• Family therapy

The immediate treatment option is to control the manifesting symptoms .

The long term treatment goal is to prevent future episode by ensuring the heart failure is managed efficiently .

The treatment options is appropriate for the patient .Medications along with this therapy can involve the patient and the family members to be a part in the plan of care .As a result a patient centered care can be provided .