The heart failure nurse identifies two priorities of care for Mina. These are to:
- reduce fluid retention and, thus, relieve Mina’s oedema and dyspnoea
- support Mina with personal care and food preparation
SIGN 147 – Management of chronic heart failure (2016) [.pdf] recommends that patients with heart failure and clinical signs or symptoms of fluid overload or congestion should be considered for diuretic therapy. The aim is to reduce fluid retention without overtreating and causing dehydration or renal dysfunction. Mina is already taking a loop diuretic and the heart failure nurse increases the dosage.
The nurse liaises with the local social work team and an emergency care team is organised to help both Mina and Joe with personal care and support Mina with meal preparation, for a limited period of time. This will allow time for the multidisciplinary care team to meet and consider Mina’s long term care options. The heart failure nurse agrees to visit Mina again in a couple of days, to assess her response to the diuretic therapy and to check how she is feeling now that she is getting some help in the home.
