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preload and afterload through vasodilatation. Side effects include chest pain, angina, headache, thrombocytopenia and lowered potassium levels. It is important to monitor labs, vitals, and dailyweights while receiving this medication. Heart failure is reported to contribute to every one in nine deaths (AHA, 2018). Heart disease remains the leading cause of death in the United States (CDC, 2016). A community health assessment was complete for Tri-County area finding an increase in number of patient diagnosed with heart failure, we are above the national average for mortality rates being one in every six deaths have been contributed with a diagnosis of heart failure. This shows an opportunity to better educate our patients on heart failure to achieve early diagnosis with pharmacological treatment being initiated in the earlier stages of heart failure to optimize overall quality of health in our community. Inquiry of evidence-based medical treatment in the state was reviewed through an acute care hospital setting. The results of the inquire prove evidence-based medical treatment for phases a-d of heart failure is the same as the evidence-based medicaltreatment guidelines put forth by the AHA 2017 Heart Failure Guidelines (AHA, 2017). Clinical GuidelinesClinical practice guidelines are published by a national organization, and focus on medical practice in the United States. The intent of clinical practice guidelines is to improve the patient quality of care and improve health outcome through up to date evidence and data for prevention, assessment, treatment, and education of disease process. Several national organizations have come together to guide clinician in the assessment, diagnosis and treatment of heart failure. American Heart Association, American College of Cardiology and Heart Failure Society of America have published Guidelines for management of heart failure.
Pathopharmacological Foundation 9Assessment: According to the ACCF/AHA the assessment should be comprehensive and include an extensive history and physical, this is pivotal in diagnosis of heart failure. The historyshould identify any pre-existing conditions that place patients at higher risk for development of heart failure, such as hypertension, coronary artery disease, valvular disease, myocarditis and familial history of heart disease (2013). History would also include questions about life style such as smoking, alcohol consumption and activity. Physical symptoms of heart failure include,dyspnea with exertion or at night, unusual fatigue, poor appetite, elevated heart rate, report a rapid weight gain, or signs of congestion. Upon the physical exam the practitioner should evaluate vital signs and volume status by a series of weights, jugular vein pressure, presence of peripheral edema, and orthopnea. Auscultation of heart and lungs would anticipate hearing a 3rdheart tone known as a gallop and or pulmonary rales. This will aid in the identification of risk to help guide therapeutic treatment.