Nursing care for Congestive Heart Failure with post cardiac arrest with Hyperglycemic Crisis in Diabetes Patient: Case Study

Abstract

Objective: This case study aims to investigate the nursing care of patients with congestive heart failure with post cardiac arrest and hyperglycemic crisis.

Methodology: Selection of diabetic patients with complications to be admitted to Inpatient Department of Women's Medicine 2, Chaiyaphum Hospital between August 4 - 8, 2023. Collection data by observation, from patient’s medical records, analysis of pathology, signs and symptoms, treatment, FANCAS Critical Patient Assessment tool. Defines nursing diagnosis, nursing care and nursing outcomes in 3 phases: critical phase, semi-critical phase and rehabilitation phase

Result: A 43-year-old Thai patient with underlying diseases such as diabetes, hypertension and stage 3 chronic kidney disease to the hospital with shortness of breath, fatigue and swelling, patient has hyperglycemic crisis and acute cardiac arrest. Resuscitation for 13 minutes until return of spontaneous circulation (ROSC) and referral to Chaiyaphum Hospital for treatment. In the emergency department, alert E4VTM6, the initial diagnosis is Heart Failure with post cardiac arrest and Hyperglycemic Crisis and admitted to the Inpatient Department of Women's Medicine 2. The patient is able to remove the endotracheal tube within 2 days. In the treatment of critical patients according to the FANCAS principle, there are 3 phases of nursing care problems: critical, semi-critical, and rehabilitation phase. The patient is cared for according to the nursing process and discharged according to the D-METHOD.

Conclusion:  This patient received treatment and nursing care according to professional standards until the problems were resolved and could be discharged home, The care lasted total of 5 days, and an appointment was mas for a follow up visit to the cardiology clinic in 3 months.