Nursing Case Studies Management of
acute exacerbation of chronic heart
failure
Management of acute exacerbation of chronic heart failure
Patient background
Mr. Johnson is a 65-year-old male with a history of chronic heart failure (CHF). He presents to the
emergency department with complaints of worsening shortness of breath, fatigue, and lower extremity
edema for the past two days. He reports non-compliance with his prescribed medications and dietary
restrictions.
Assessment findings
Vital signs: BP 160/90 mmHg, HR 110 bpm, RR 24 bpm, SpO2 88% on room air
Lung auscultation: Bilateral crackles heard in lung bases
Lower extremity assessment: 2+ pitting edema bilaterally
Lab results: Elevated BNP levels, hyponatremia, hypokalemia
Nursing diagnoses
1. Impaired Gas Exchange related to fluid overload and decreased oxygenation.
2. Activity Intolerance related to decreased cardiac output and dyspnea.
3. Noncompliance with Medications related to lack of understanding and socioeconomic factors.
Interventions
1. Administer oxygen therapy via nasal cannula at 2 L/min to improve oxygenation.
2. Monitor fluid intake and output, restrict sodium intake, and administer prescribed diuretics to reduce
fluid overload.
3. Educate the patient and family about the importance of medication adherence, dietary restrictions,
and daily weight monitoring.
4. Collaborate with the healthcare team to adjust medication regimen, including ACE inhibitors, beta
blockers, and diuretics.
Rationale for interventions
1. Oxygen therapy improves oxygenation and relieves dyspnea.
2. Diuretics help reduce fluid overload and alleviate symptoms of congestion.
3. Patient education promotes self-management and empowers the patient to participate in their care
Evaluation
Mr.source
This study Johnson's oxygen
was downloaded saturation from
by 100000897898521 improves to 94%
CourseHero.com on supplemental
on 05-27-2025 oxygen.
06:25:32 GMT -05:00
Crackles in lung bases diminish after diuretic therapy, and lower extremity edema decreases.
https://www.coursehero.com/file/249817626/nursing-case-studies-with-answers-2025-2026pdf/
acute exacerbation of chronic heart
failure
Management of acute exacerbation of chronic heart failure
Patient background
Mr. Johnson is a 65-year-old male with a history of chronic heart failure (CHF). He presents to the
emergency department with complaints of worsening shortness of breath, fatigue, and lower extremity
edema for the past two days. He reports non-compliance with his prescribed medications and dietary
restrictions.
Assessment findings
Vital signs: BP 160/90 mmHg, HR 110 bpm, RR 24 bpm, SpO2 88% on room air
Lung auscultation: Bilateral crackles heard in lung bases
Lower extremity assessment: 2+ pitting edema bilaterally
Lab results: Elevated BNP levels, hyponatremia, hypokalemia
Nursing diagnoses
1. Impaired Gas Exchange related to fluid overload and decreased oxygenation.
2. Activity Intolerance related to decreased cardiac output and dyspnea.
3. Noncompliance with Medications related to lack of understanding and socioeconomic factors.
Interventions
1. Administer oxygen therapy via nasal cannula at 2 L/min to improve oxygenation.
2. Monitor fluid intake and output, restrict sodium intake, and administer prescribed diuretics to reduce
fluid overload.
3. Educate the patient and family about the importance of medication adherence, dietary restrictions,
and daily weight monitoring.
4. Collaborate with the healthcare team to adjust medication regimen, including ACE inhibitors, beta
blockers, and diuretics.
Rationale for interventions
1. Oxygen therapy improves oxygenation and relieves dyspnea.
2. Diuretics help reduce fluid overload and alleviate symptoms of congestion.
3. Patient education promotes self-management and empowers the patient to participate in their care
Evaluation
Mr.source
This study Johnson's oxygen
was downloaded saturation from
by 100000897898521 improves to 94%
CourseHero.com on supplemental
on 05-27-2025 oxygen.
06:25:32 GMT -05:00
Crackles in lung bases diminish after diuretic therapy, and lower extremity edema decreases.
https://www.coursehero.com/file/249817626/nursing-case-studies-with-answers-2025-2026pdf/
