Mandatory Discussion Question
Mandatory Discussion Question
Nursing interventions are important in addressing the aggravating factors, which may influence the status, quality of life or the survival of the patient (Story, 2018). The nursing inventions appropriate for Mrs. J. at the time of her admission include addressing her respiratory problems, which need to be controlled. The patient’s oxygen saturation levels are 82%, which is below the normal levels (Story, 2018). This can be addressed by administering oxygen, which will help in delivering oxygen to the patient to increase oxygen circulation.
The patient can also be placed on a low stimuli environment to calm her anxiety (Levy ; Bellou, 2013). Anxiety can also be addressed by the use of relaxation techniques or with the use of anti-anxiety medications. The patient’s blood pressure is also low which needs to be addressed (Story, 2018). This can be done using medications to increase her blood pressure. The patient should also be placed on telemetry and monitored continuously to prevent further increase of the underlying symptoms, which may worsen the situation (Levy & Bellou, 2013).
Rationale for the Administration of Each of the Following Medications?
The reason for the administration of the IV furosemide (Lasix) medication is to address the pulmonary edema, which is due to heart failure, which is also one of the health issues affecting the patient. This medication will also help the patient since she has a congestive heart failure to treat fluid retention (Rahko, 2014). Enalapril (Vasotec) is also a medication used to treat heart failure as well as hypertension. This medication may be used in emergencies as its effect kick in quickly if administered through an injection into a vein. Metoprolol (Lopressor) is also a drug used to treat hypertension as well as congestive heart failure. This medication is administered to the patient to address the abnormal heart rate aggravating the symptoms of heart failure and ease the effects that are associated with heart problems (Rahko, 2014). Morphine medication is used to control severe pain in patients with chronic illnesses. This medication has been administered to the patient to relieve the pain associated with heart failure. Morphine acts as receptor blocker, which addresses stress, which contributes to hypertension (Rahko, 2014).
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
High Blood Pressure
When the blood pressure is uncontrolled, it may lead to heart problems. When the blood pressure is too high, the heart pumps the blood harder than normally to ensure that the blood is circulated as is required (Peacock, 2017). This causes the heart to weaken over time leading to heart failure. A medical intervention to prevent the development of heart failure involves ensuring that patients with hypertension take their medication as required. Patients should be able to monitor their blood pressure levels and take the necessary measures to manage the condition if it is not in the required level (Peacock, 2017).
Coronary Artery Disease
Coronary heart disease is caused by damage in the coronary arteries, which are responsible for supplying oxygenated blood to the heart. The building up of plaque may cause this damage, which is a waxy substance, which forms in the coronary arteries (Peacock, 2017). With time, the plague may rupture causing a blood clot in the artery, which may block blood flow to the heart (Peacock, 2017). This may lead to heart attack due to lack of oxygenated blood to the heart. If this is not addressed early in advance, the heart begins to die which can lead to other health problems including death. Medical interventions to prevent this cardiovascular condition include controlling the risk factors, which contribute to the development of the condition. This can include controlling the blood cholesterol, blood pressure, and obesity (Peacock, 2017). Stroke
Stroke occurs when blood supply to the brain is reduced or interrupted affecting the required amount of oxygen, which goes to the heart (Rahko, 2014). This will deprive the brain tissue of oxygen and other nutrients, which are important in the normal operation of the heart and other body organs, which will result in brain cells beginning to die. This condition should be addressed immediately as it may lead to brain damage and other serious complications (Rahko, 2014). Medical interventions to prevent this condition include addressing the risk factors, which include controlling high blood pressure, properly managing diabetes, and lowering the cholesterol level for obese individuals. This can also be achieved by adopting a healthy lifestyle (Rahko, 2014).
Congenital heart disease
This cardiovascular condition is attributed to an abnormality in the heart that may develop before birth. This defect affects the structure of the heart, which can affect the walls of the heart, the arteries, or veins, which may affect the normal blood flow to the heart (Rahko, 2014). This can lead to the blood flowing to the wrong place or the blood may be blocked from reaching the heart leading to heart failure. This cardiovascular condition can be prevented by medications, which help the heart to work more efficiently and prevent the formation of blood clots (Rahko, 2014). Pacemakers can also be implanted to regulate an abnormal heart rate. Surgery can also be performed to repair the defect, which may include closing holes inside the heart and repairing any damaged heart values (Rahko, 2014).
Nursing Interventions That Can Help Prevent Problems Caused By Multiple Drug Interactions in Older Patients
One of the ways to manage polypharmacy, which is the effect of taking multiple medications to address coexisting health problems, involves educating the patients and family members on the risk factors surrounding this aspect (Golchin et al., 2015). Healthcare providers have the responsibility of determining the risk factors and implement strategies to minimize the risks. Patients should take advantage of medication reconciliations, which can help in identifying duplicate medications, which may be used to treat a common health condition (Golchin et al., 2015). This will help the patient in choosing one of the medications, which will prevent problems caused by multiple drug interactions in older patients. Another nursing intervention to help prevent problems caused by multiple drug interactions in older patients involves patients undertaking medical reviews, which is important in ensuring the safety of polypharmacy for elderly patients (Golchin et al., 2015).
This can include a monthly review, which can be undertaken by a pharmacist. The pharmacist is able to identify any unnecessary medications, which have no benefit to the patient (Golchin et al., 2015). The third nursing intervention which can help prevent problems caused by multiple drug interactions in older patients is by healthcare providers addressing any health issues arising due to the use of certain type of medications (Golchin et al., 2015). This will help in preventing any serious health issues, which may result from polypharmacy. The last nursing intervention involves using alternatives to medications, which may include diet changes and behavior changes, which may be used to address certain types of health conditions instead of using medications (Golchin et al., 2015).
Golchin, N., Frank, S. H., Vince, A., Isham, L., Meropol, S. B. (2015). Polypharmacy in the elderly. Journal of Research in Pharmacy Practice, 4(2), 85-88.
Levy, P. D., & Bellou, A. (2013). Acute Heart Failure Treatment. Current Emergency and Hospital Medicine Reports, 1(2).
Peacock, W. F. (2017). Short Stay Management of Acute Heart Failure. Cham: Springer International Publishing.
Rahko, P. S. (2014). Heart failure: A case-based approach. New York: Demos Medical.
Story, L. (2018). Pathophysiology: A practical approach. Burlington, MA: Jones & Bartlett Learning.