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2 pages/β‰ˆ550 words
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3 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Coursework
Language:
English (U.S.)
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MS Word
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Topic:

Mandatory Discussion Question: Nursing Interventions

Coursework Instructions:

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.
Case Scenario
Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.
Subjective Data
Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is "running away."
Reports that she is so exhausted she cannot eat or drink by herself.
Objective Data
Height 175 cm; Weight 95.5 kg
Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin
Critical Thinking Questions
What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

Coursework Sample Content Preview:

Mandatory Discussion Question
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Date
Nursing Interventions are complex activities that are performed by medical professionals. These activities are limited to procedures that guide specifically old patients in managing their medications. Instilling knowledge in patients is a key component to eliminate polypharmacy. The patient needs to know the drug they are taking and its purpose. Knowledge guides them in adhering to their prescriptions. The old patients also need to be listened to and be understood by these professionals.
The immediate nurse intervention to counteract Mrs. J’s case is auscultated apical pulse. The intervention is necessary to compensate for the reduced ventricular contractility (Robyn, 2013). In this intervention, the heartbeat of the patient noted. The sound is restored from the diminished action of pulping. Monitoring and recording patient`s blood pressure is essential. This intervention aids to get complete picture involved in the valves. Skin color, temperature, and moisture observation is a necessary intervention. Observation helps in analyzing conditions exhibited by the patient. This also aids in checking the peripheral vasoconstriction.
Lasix, Vasotec, Lopressor, and Morphine are the most appropriate medications for hypertension, chronic heart failure and sleep apnea, (Kate, 2010). The IV furosemide (Lasix) should be given to heal renal impairment. These drugs are effective since they stop sodium and chloride resorption. Enalapril (Vasotec) is also given to decrease pulse rate as well as raising the cardiac output. Metoprolol (Lopressor) is helpful in blocking the chronic effects of cardiac and adrenergic stimulation. IV morphine sulfate (morphine) limits venous return and vascular resistance. The drugs also aid in restoring the patient`s consciousness.
Coronary artery disease, heart attack, cardiomyopathy and high blood pressure are conditions responsible for heart failure. C...
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