Paragraph 2

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

Looking at Mrs. J’s objective and subjective data a plan of care can be initiated for left sided heart failure. For the patient’s respiratory status, the patient’s sp02 is 82%, decreased breath sounds in the right lower lobe and coughing with frothy blood tinged sputum, oxygen therapy should be administered. Also, the patient’s crackles indicates congestion and fluid overload as well as the JVD. IV diuretics would treat this symptom. Placing a Foley catheter to ensure strict I&Os and possible fluid restriction will be considered. Daily weights would also be initiated to monitor the effectiveness of treatment and patient’s status. A chest x-ray would be performed to evaluate for any infection. Tylenol would be administered to treat the low grade temperature. The patient would be on 24hr telemetry monitoring. Medications would be administered to treat the AFIB to control the ventricular rate and for anticoagulation therapy.

Part B

  1. IV furosemide (Lasix) – Lasix is a loop diuretic. It is used to treat edema due to heart failure. It causes diuresis and mobilization of the excess fluid caused by heart failure. It also helps decrease blood pressure.
  2. Enalapril (Vasotec) – Enalapril is an ACE inhibitor. It is used to treat blood pressure. It is also used for CHF in conjunction with diuretics
  3. Metoprolol (Lopressor) – Lopressor is a beta-blocker that affects the heart and circulation. It can also help treat the patients Afib.
  4. IV morphine sulphate (Morphine) – IV morphine is a narcotic that is used many times in cardiac events such as chest pain. It helps open up the blood vessels and helps improve cardiac workload, reduce anxiety and pain.

Part C

1. Smoking- smoking is a major risk factor for the development of coronary heart disease (CAD). CAD is a major cause of heart failure. Nursing interventions to manage this are to educate patient on the importance of smoking cessation and the risk factors associated with not doing so. Getting respiratory therapy or other resources to help quit smoking. Get nicotine patches or other prescribed medication regimen to help quit smoking.

2. High blood pressure- Uncontrolled BP is a high risk factor for developing CHF. When pressure is blood vessels is too high the heart has to pump harder than normal to keep up and over time this causes the heart to get weaker. Nursing interventions to help manage this is ensuring all home medications are on the MAR. Check the BP per protocol and ensure that it is within the parameters set by the MD. Order PRN or adjust medication for BP per MD orders. Educate on taking BP medicine regardless if the BP is normal or the patient is not having any symptoms

3. Obesity- Being overweight can cause the heart to work harder than normal and can cause sleep apnea. Nursing interventions that can help manage obesity are ensuring proper diet is ordered in the hospital. Educating on the long term effects of obesity and some ways to help with weight loss. Encourage an exercise routine.

4. Sleep apnea- Pauses in breathing can contribute to fatigue and cause high blood pressure and heart failure, diabetes, stroke. Nursing interventions for sleep apnea are to ensure a sleep study is completed or ordered. Ensure all prescribed regimens are available such as CPAP at night. Educate on the importance of being compliant with CPAP and risks of failure to do so.

Part D

1. Help and educate the patient on keeping an accurate log and list of all medications and herbal medication that the patient is on. In order to reduce the chances of the physician ordering medications that may have drug interactions.

2. Educate the patient on the importance of choosing one primary care physician in order to reduce polypharmacy.

3. Help and educate the patient on ensuring proper dosage and frequency are followed by using a medication organizer.

4. Educate the patient on possible interactions of herbal medication and the need to inform the physician of all herbal medication.

5. Ensure the patient is educated on all new medications, indications, education, potential side effects and potential interactions.

References

American Nurses Association. (2010). Preventing polypharmacy in older adults. Retrieved from https://www.americannursetoday.com/preventing-poly…

 
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