Congestive Cardiac Failure 
Mr Ward is a 71 year old male who is admitted to your ward after reporting to his local GP that he has been feeling a non-radiating, -heavy- discomfort in the lower retrosternal and epigastric region particularly when he bends over or walks short distances. During your assessment Mr Ward also reported that for the past 7 days he has been feeling short of breath during his gardening and had difficulty walking around the block with his wife, something he does every day 
On examination his blood pressure was 165/95 mm HG, pulse 90 -100 bpm, respiratory rate of 24 with inspiratory crackles at both lung bases and his Sp02 at 92%. His fingers are cool to touch with a capillary refill of 1-2 seconds. Mr Ward states that this is normal and he always has to wear bed socks as Mrs Ward complains about his cold feet. 
The following blood tests where ordered: a full blood count (FBC), Urea Electrolytes and Creatinine (UEC), Liver Function Tests (LFT), CK and Troponin. All results were within normal limits. 
An Arterial Blood Gas was also collected resulting in: pH 7.410, pCO2 38.7mmHg, PO2 69.8mmHg, HCO3 24.0mmol/L, BE -0.7mmol/L and O2 SAT 89.3% 
Mr Ward also has an ECG that showed normal sinus rhythm, and a chest x-ray showing cardiac enlargement and lower-lobe infiltrates, suggesting the presence of acute exacerbation of congestive cardiac failure. 
The following questions relates to the patient within the first 24 hours. 
1. Outline the causes, incidence and risk factors of the identified disease and how it can impact on the patient and family (450 words) 
2. List five (5) common signs and symptoms of the identified disease; for each provide a link to the underlying pathophysiology (300 words) 
a. this can be done in the form of a table - each point needs to be appropriately referenced 
3. Describe two (2) common classes of drugs used for patients with the identified disease including physiological effect of each class on the body (250 words) 
a. this does not mean specific drugs but rather the class that these drugs belong to. 
4. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours post admission for this patient. (500)