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Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood adequately to meet the metabolic needs of the body. CHF is one of the most prevalent cardiovascular disorders globally, nationally, and locally, contributing to significant morbidity and mortality. This study aims to describe a comprehensive nursing care process applied to a patient (Mr. R) diagnosed with CHF at the Mawar 1 Ward of RSUD dr. Soeselo, Tegal Regency. This study used a descriptive case study design. Data were collected through interviews, physical examination, observation, and medical record documentation on February 9–11, 2026. Three nursing diagnoses were identified: ineffective airway clearance related to airway hypersecretion, fatigue related to physiological conditions (chronic disease), and knowledge deficit related to insufficient information exposure. Nursing interventions applied included airway management (semi-Fowler positioning, oxygen therapy, effective coughing technique), energy management (range-of-motion exercise, gradual activity), and health education about CHF. After 2×24 hours of nursing care, all three nursing diagnoses were resolved: airway clearance improved (SpO₂ increased from 91% to 95%, respiratory rate decreased from 28 to 23 times/minute), fatigue decreased, and patient knowledge about CHF improved. Systematic nursing care significantly improved the patient's condition in CHF management.

This study conceptually examines the influence of assurer type, assurance standards, and assurance level on the breadth of assurance statements in sustainability reports. Moving beyond prior literature that treats assurance as a binary variable (presence versus absence), this paper highlights disclosure breadth as a critical dimension of assurance quality and substance. Drawing on legitimacy theory and complemented by institutional theory, the study argues that the technical configuration of assurance shapes the quality of organizational legitimacy obtained by firms. Specifically, the type of assurer (public accounting firms versus non-accounting providers), the standards adopted (e.g., ISAE 3000 and/or AA1000AS), and the level of assurance (limited versus reasonable) influence the structure, systematic presentation, and comprehensiveness of assurance statements. Firms that engage reputable providers, apply globally institutionalized standards, and select reasonable assurance are more likely to issue broader and more detailed statements. In contrast, weaker institutional pressures may encourage symbolic assurance practices characterized by minimal disclosure. The study contributes theoretically by extending legitimacy theory to the technical dimensions of assurance and positioning disclosure breadth as a proxy for substantive legitimacy. Practically, it suggests that regulators and companies should emphasize transparency and comprehensiveness in assurance statements to enhance credibility and discourage symbolic sustainability reporting practices.