Chronic Heart Failure Medications Quiz

Client Information

• A client with chronic heart failure is likely to be on a β-adrenergic blocking agent (β-blocker) and a vasodilator such as an angiotensin-converting enzyme inhibitor.
• Important to ask about medications, including dose, administration route, frequency, and time of day taken, as they may affect the exercise prescription.

Medical History

• A concise, relevant list of past medical problems, including dates, is essential.
• All conditions, injuries, etc., should be recorded, as one may influence another and the exercise prescription.
• For CHD, record severity of coronary lesions, types of conduits used if bypass was performed, target vessels, and most current assessment of LV function (EF).
• For lung disease, identify asthma or COPD, and explain why some medications are used when symptomatic and others as part of a long-term plan.

Meeting the Client

• Important components include informed consent, health screening, and CV risk factor analysis to identify at-risk individuals.
• Ability to predict exercise-related CV events is low due to high prevalence of CVD risk factors among adults and rarity of exercise-related sudden cardiac death and acute MI.

Interview

• Two main steps: general interview for subjective information and assessment/evaluation for objective measures.
• Used for the action plan (intervention exercise program).

Interview Environment

• Minimize interruptions, ensure quiet and secure environment, and use limited distractions.
• Use language that is understandable and appropriate, and start with general/open questions that become more specific.
• Ask for clarification when needed, and be mindful of non-verbal communication.

Reason for Referral

• Usually self-explanatory, but may require education to bridge the gap between the nature of the referral and the client's interpretation.
• Critical for a good working relationship with the client.

Demographics

• Age, sex, and ethnicity are related to risk of cardiovascular conditions and/or co-morbidities.
• Age is an independent predictor of survival in almost all cardiopulmonary conditions.
• Sex may affect exercise compliance and disease management, and ethnicity differences are often related to differences in SES and access to care.

History of Present Illness

• Record and convey primary information related to the condition that led to the referral.
• Include chief complaint, summary of manifestations, and information pertaining to date of onset, chronicity of symptoms, types of symptoms, exacerbating or alleviating factors, major interventions, and current disease status.

Medications and Allergies

• A current medication list is essential, considering how they align with the client's current and previous medical history.
• Ask about allergies, including nka (no known allergies).