Topic 3 DQ 1

Please respond with a paragraph to the following post, add citations and references:

1. Nursing interventions appropriate for Mrs. J at the time of her admission is to be elevated at Fowler’s position to facilitate breathing caused by her shortness of breath. Calm Ms. J and create a quiet atmosphere so she can get maximum oxygen and not hyperventilate. Administer MD orders to give medications like oxygen and diuretics since her O2 stat is 82% and she has fluid overload. Vital signs to be taken continuously for cardiac and respiratory status since they are abnormal.

1. The rationale for giving Lasix is because she is in fluid overload as evidenced by her pulmonary crackle, decreased breath sounds, faint peripheral pulses, and bilateral jugular distention. Lasix IV will help to take out the fluid overload from her lungs, heart, and other organs like her enlarged liver (Pellicori, Kaur, and Clark, 2015).
2. The rationale for giving Enalapril is because she is in cardiac failure, and in conjunction with a diuretic will treat her CHF (Davies, Gibbs, and Lip, 2000).
3. Metoprolol is a beta-blocker to treat her heart failure and left ventricular failure as evidenced by her blood-tinged sputum and inability to breath. It will also regulate her tachycardia (Cardio Smart, 2012).
4. IV Morphine would be used to treat her anxiety so she can regulate her breathing (Get Palliative Care, 2013).

2. Four heart conditions that could lead to heart failure are hypertension, myocardial infarction, coronary artery disease, and cardiac valve dysfunction (American Heart Association, 2017). For patients with hypertension to prevent heart failure, patients should control their blood pressure by taking their medications. Low sodium diet should be lifestyle modification should be encouraged like no smoking, daily exercise, and proper follow up with primary care provider. Also, patient’s labs should be monitored as per MD. For patients with myocardial infarction, diet modification should be done like low sodium and less red meat along with daily exercise (American Heart Association, 2015). Medications should be taken as per MD like low dose aspirin or hyperlipidemia medication. For patients with coronary artery disease, patients should follow up with their cardiologist or PCP. Diet should be changed to low sodium, low fat, encourage vegetables, fruits, and fiber. Exercise should be encouraged as tolerated. For patients with cardiac valve dysfunction, patients should follow up with their cardiologist and adhere to proper medication schedules and dosages. Lifestyle and diet modification are to be encouraged in the patient like low sodium, low fat.

3. Some nursing interventions that can help prevent problems caused by multiple drug reactions in older patients are to put their medications in a pill container separately with readable labels stating the time and dosage to be taken. This is to prevent medication mix-up and overdose. Another intervention is to educate on continuous medication adherence and the side effects of stopping medication abruptly. Many elderly have poor medication adherence because of poor understanding or confusion so education is vital to stress the importance of continuous medication adherence. A third intervention is to educate the elderly of negative consequences of taking herbal medication alongside their prescribed medication with MD guidance. The elderly must be aware of multiple drug reactions can occur if all supplements they are taking are not vetted. The fourth intervention is to telling the elderly to bring a list of prescribed and over the counter medications that they take to their PCP. They must be educated on each medication use, interaction, dosage, and side effects so they won’t make a mistake in overdosing.

Reference

American Heart Association. (2017). Causes and Risks for Heart Failure. Retrieved March 11, 2019, from https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure

American Heart Association. (2015). The American Heart Association’s Diet and Lifestyle Recommendations. Retrieved March 11, 2019, from https://www.heart.org/en/healthy-living/healthy-ea…

Cardio Smart. (2012). Sections. Retrieved March 11, 2019, from https://www.cardiosmart.org/Healthwise/hw30/568/hw…

Davies, M. K., Gibbs, C. R., & Lip, G. Y. (2000). ABC of heart failure. Management: diuretics, ACE inhibitors, and nitrates. BMJ (Clinical research ed.), 320(7232), 428-31.

Get Palliative Care. (2013). Shortness-of-Breath. Retrieved March 11, 2019, from https://getpalliativecare.org/shortness-of-breath/

Pellicori, P., Kaur, K., & Clark, A. L. (2015). Fluid Management in Patients with Chronic Heart Failure. Cardiac failure review, 1(2), 90-95.

 

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