Core Modules

module 3 | Activity 5: Symptom assessment

Case study

In Herbert’s story, he was introduced as a self-funded retiree with heart failure that had progressed and had been reclassified from Class II to Class lll Heart Failure. It has been six months since he was told that his heart failure was progressing.

His heart failure continues to worsen and he is upset that it is stopping him from spending time with his friends and doing what he enjoys.

He is particularly bothered by his fatigue and his breathing difficulties. As part of his assessment, Herbert is asked about his appetite. He states that he has a poor appetite and that although he tries to eat he feels that there “isn’t much pleasure in it anymore”.

As you watch the video, consider the physiological, psychological and environmental factors that may contribute to Herbert’s symptoms.

  1. What observations did you make from the video that indicate deterioration in Herbert’s illness?
  2. Consider Herbert’s experience with his illness over the past six months:
    • In what ways is this consistent, or not, with evidence-based literature about heart failure progression
    • What factors have influenced Herbert’s illness trajectory?
  3. What are the common symptoms or clinical concerns that he may now be experiencing with class III heart failure?
  4. What are Herbert’s psychosocial needs likely to be now that his illness is deteriorating?
  5. Consider Herbert’s illness and review the pathophysiology of two of the following:
    • Fatigue
    • Loss of appetite
    • Breathlessness.

Within your answer outline how these symptoms are impacting on his quality of life.