| Course | NUR-3380 Applying the Nursing Process to Alteration in Health |
|---|---|
| Module | Module 4 |
| Paper type | Nursing process paper: heart failure self-care |
| Length | About 1,048 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | B.S.N., Accelerated Second Degree |
| Updated | October 2026 |
Free sample paper for NUR 3380 Module 4
Three Admissions in a Year: Heart Failure Self-Care Teaching for a Hackettstown Patient
Student Name
B.S.N., Accelerated Second Degree, Thomas Edison State University
NUR-3380: Applying the Nursing Process to Alteration in Health
Mentor Name
Month Day, Year
Three Admissions in a Year: Heart Failure Self-Care Teaching for a Hackettstown Patient
The Patient
Mrs. Bianchi and her Hackettstown hospital are fictional. Mrs. Bianchi, 66, has heart failure with reduced ejection fraction after a heart attack five years ago. She lives alone in Hackettstown, is a retired school secretary and manages her own medicines. Each of her three admissions this year followed several days of weight gain and swelling that she noticed but did not report, because she thought it would pass and did not want to bother her doctor. She owns a bathroom scale but weighs herself only occasionally. She enjoys cooking traditional dishes and uses canned tomatoes and cured meats often.
Assessment
The student assessed Mrs. Bianchi's symptoms, fluid status, medications and understanding. She knew the names of her medicines but not why each mattered. She did not know that weight gain could signal fluid. She said she felt confident caring for herself but did not know when to call. Her score on a brief cognitive screen was normal. Her daughter lives nearby and visits on weekends.
Self-Care Theory
Riegel et al. (2016) described a theory, built for heart failure specifically, of how patients care for themselves, in three parts. Self-care maintenance includes the daily behaviors that keep patients stable, such as taking medicines, limiting sodium and staying active. Symptom perception includes monitoring the body and recognizing and interpreting changes, such as weight gain or swelling. Self-care management is the response to symptoms, such as taking an extra diuretic dose as directed or calling the clinician, and then evaluating whether the response worked. The theory holds that knowledge, experience, skill and values shape each part.
Mrs. Bianchi's maintenance was partly adequate, but her symptom perception and management were weak: she noticed changes but did not interpret them as warning signs or act on them.
Promoting Self-Care
Riegel et al. (2009), in an American Heart Association scientific statement, reviewed evidence on promoting self-care in heart failure. They described self-care as a naturalistic decision-making process and identified barriers such as limited knowledge, poor symptom recognition, depression, cognitive impairment and lack of social support. They recommended teaching that builds skill in recognizing and responding to symptoms, not only knowledge, and that involves family members.
A Trial of Discharge Teaching
Koelling et al. (2005) randomly assigned patients hospitalized with heart failure to an hour alone with a nurse educator before discharge or to standard discharge information. The teaching covered heart failure, daily weights, diet, medicines and what to do when symptoms worsened. Over six months, patients who received the session had fewer readmissions or deaths, spent fewer days in the hospital and had lower costs of care.
| Source | Key idea | Plan element |
|---|---|---|
| Riegel et al. (2016) | Maintenance, symptom perception and management | Teach daily weights and what changes mean |
| Riegel et al. (2009) | Build skills and decision making; involve family | Practice decisions; include her daughter |
| Koelling et al. (2005) | One hour of nurse teaching reduced readmission or death | Protected hour of teaching before discharge |
Nursing Diagnoses
Her care plan centered on ineffective health self-management related to limited recognition of symptoms, risk for excess fluid volume related to sodium intake and delayed response to weight gain and readiness for enhanced knowledge.
Planning
Before discharge, Mrs. Bianchi will explain why daily weights matter and state her weight thresholds for calling the clinic, choose three lower-sodium substitutions for dishes she cooks often and describe what she will do in each zone of a heart failure action plan. Within one week, she will be weighing herself every morning and recording the result.
Implementation
The student arranged a protected hour on the day before discharge, with her daughter present by phone. She explained heart failure in plain terms and linked each medicine to its purpose. Using Mrs. Bianchi's own history, she showed how each admission had followed weight gain. Together they set her dry weight and the thresholds on the action plan: she phones the clinic if the scale shows two or three pounds more than the day before, or five pounds more than a week ago. They practiced decisions: what would she do if she gained three pounds overnight and her ankles were swollen? She answered correctly on the second scenario.
For diet, the student and Mrs. Bianchi went through her favorite recipes and found substitutions, such as no-salt-added tomatoes and smaller amounts of cured meat, rather than asking her to give up her cooking. She was given a log sheet and asked to keep it by the scale.
Medications and Their Purpose
The student reviewed each of Mrs. Bianchi's medicines with her, connecting each to a symptom or risk she understood. The diuretic removes extra fluid, which is why her weight matters. The beta blocker and the other heart medicines help her heart pump better over time, even though she may not feel a difference. She learned not to stop them because she feels well. The student also checked that she could get her prescriptions filled the day she went home and arranged a follow-up appointment with the heart failure clinic within a week, since early follow-up after discharge is part of reducing readmissions.
Activity
Mrs. Bianchi had been avoiding walking because she became tired. The student explained that regular activity, increased slowly, helps people with heart failure feel better, and they set a goal of a ten-minute walk each day at the mall, where she could rest on benches.
Evaluation
At discharge, Mrs. Bianchi explained her thresholds and walked through her action plan. A follow-up call at one week found her weighing daily and recording weights. At two weeks, she called the clinic about a three-pound overnight gain, her diuretic was adjusted and she avoided an admission.
Limits
A single successful call does not show long-term change. The trial studied a specific teaching program at one center. Self-care depends on factors such as mood and cognition that can change over time.
Conclusion
Mrs. Bianchi noticed her symptoms but did not interpret or act on them. Riegel's theory explained the gap, the scientific statement showed how to build decision-making skills and Koelling's trial showed that an hour of nurse teaching can reduce readmissions. Teaching built around her weights, her decisions and her cooking helped her act early and stay out of the hospital.
References
Koelling, T. M., Johnson, M. L., Cody, R. J., & Aaronson, K. D. (2005). Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation, 111(2), 179-185. https://doi.org/10.1161/01.CIR.0000151811.53450.B8
Riegel, B., Dickson, V. V., & Faulkner, K. M. (2016). The situation-specific theory of heart failure self-care: Revised and updated. Journal of Cardiovascular Nursing, 31(3), 226-235. https://doi.org/10.1097/JCN.0000000000000244
Riegel, B., Moser, D. K., Anker, S. D., Appel, L. J., Dunbar, S. B., Grady, K. L., Gurvitz, M. Z., Havranek, E. P., Lee, C. S., Lindenfeld, J., Peterson, P. N., Pressler, S. J., Schocken, D. D., & Whellan, D. J. (2009). State of the science: Promoting self-care in persons with heart failure: A scientific statement from the American Heart Association. Circulation, 120(12), 1141-1163. https://doi.org/10.1161/CIRCULATIONAHA.109.192628
What the NUR 3380 Module 4 instructions ask for
Disease management across the adult lifespan is part of TESU's catalog description of NUR-3380, and because no syllabus is posted, module four is planned as a heart failure self-care paper. A paper of this kind assesses self-care maintenance, symptom recognition and response, uses a self-care theory and evidence on teaching, writes goals the patient demonstrates, describes teaching that builds decision skills with the patient's own history and evaluates whether the patient acts on what was taught. Some sections ask for a discharge teaching plan in table form. Check whether the brief requires a validated self-care questionnaire and whether the action plan should be attached. Include a follow-up call or visit in the evaluation so readers can see whether the patient acted on the teaching.
Inside the NUR 3380 Module 4 example
An invented 66-year-old woman leaving a Hackettstown hospital after her third heart failure admission in a year opens the paper, with weight gains she noticed but did not report. Riegel's self-care theory, the AHA statement on promoting self-care and Koelling's trial of one hour of nurse teaching are explained and linked to the plan. A protected teaching hour uses her own history, practice scenarios and her recipes. Evaluation at discharge, one week and two weeks, when she calls about a weight gain and avoids admission, follows, with limits and conclusion. Annotations note teaching grounded in evidence and the patient acting on it. Sections on medications, follow-up and activity complete the self-care maintenance plan. The student also arranges a clinic visit within a week.
Where the marks sit in the NUR 3380 Module 4 rubric
Heart failure papers earn credit for an assessment of all parts of self-care, accurate use of a self-care theory and evidence, goals the patient demonstrates, teaching that builds decision skills and evaluation that shows the patient acting. Mentors notice when a student uses the patient's own admission history to teach. Adapting diet to the patient's cooking rather than forbidding it shows respect. Including a family member supports self-care. Scientific statements with many authors should be cited in full. Linking each medicine to its purpose and scheduling early follow-up show attention to readmission risk. Scheduling clinic follow-up within a week reflects evidence on transitions after discharge.
NUR 3380 Module 4 help: mistakes that cost marks
Heart failure teaching papers often list topics such as weights and diet without practicing decisions; give the patient scenarios to solve. Another frequent gap is teaching that ignores the patient's food culture. Use the patient's own history. Set clear thresholds for calling. Involve family. Follow up after discharge to see whether the patient acts. A free first draft about your own heart failure patient is available; send the brief. Connect each medicine to its purpose, and book a clinic appointment for the first week home. Set a realistic activity goal.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 3380 Module 4 questions, answered
Where can I find a free NUR 3380 Module 4 sample paper?
The heart failure self-care paper about an invented patient in Hackettstown, from her three admissions to the call that avoided a fourth, can be read here.
What are the parts of heart failure self-care?
Riegel's theory describes self-care maintenance, symptom perception and self-care management.
Does discharge teaching reduce heart failure readmissions?
In Koelling's trial, a one-hour nurse teaching session reduced readmission or death and lowered costs over six months.
When should a heart failure patient call about weight gain?
Most action plans ask for a call after an overnight gain of two to three pounds or a five-pound rise across one week.
How can heart failure teaching respect a patient's diet?
By finding lower-sodium substitutions in the patient's own recipes rather than asking them to give up their cooking.