Introduction
Heart failure is among the most dangerous conditions, which stems from cardiovascular conditions, and additionally results from lifestyle and habits. Although heart failure can be deadly, there are still essential interventions that might not only protect the patient and sustain health but prolong their lives. In the given scenario, Mrs. J. is experiencing conditions that are similar to heart failure, which can be seen through her medical history and admission subjective and objective data.
Subjective and Objective Clinical Manifestations
When it comes to objective clinical manifestations, these involve low blood pressure of 90/58, a fast heartbeat of 118, and an increased temperature of 37.6C. As for cardiovascular signs, among the vital ones are the ventricular rate of 132 and atrial fibrillation. Respiratory vitals show signs of heart failure, such as decreased breath sounds right lower lobe and pulmonary crackles. The symptoms of infection can be seen through coughing frothy blood-tinged sputum. The subjective clinical manifestations can be observed through anxiety, intense heartbeat, exhaustion, and no evident pain. Moreover, the inability to eat and drink on their own, the feeling of the nearness of death, and decadent moods and lack of air can also be attributed to the context of subjective data.
Cardiovascular Conditions
Four cardiovascular conditions in which Mrs. J. is at risk and that may lead to heart failure. These include high blood pressure, cardiomyopathy, coronary heart disease, and heart inflammation (Prasad et al., 2018). The interventions for high blood pressure involve diuretics and angiotensin II receptor blockers to relax the arteries and help eliminate sodium and liquid from the system (Adams & Khan, 2020). Cardiomyopathy interventions might involve the previous medications in order to control the sodium level in the body and lower the blood pressure of the patient. Additionally, coronary heart disease interventions should be aimed at lower blood pressure, which can be achieved with beta-blockers, ACEs, and ARBs (Umashankar & Kumar, 2020). Finally, interventions for heart inflammation should include anticoagulants to ensure blood thinness. With these interventions, the risk of heart failure will decrease due to the maintenance of symptoms.
Admission Intervention
The interventions at the time of admission were beneficial for Mrs. J and should not be changed. Medications administered to the patient help bring more oxygen to the system, relieve blood vessel tension, lower blood pressure, increase blood flow, and ease heart stress. Therefore, the intervention must be effective with the given list of medications. However, in order to ensure patient independence and prevent readmission, I would recommend switching the patient’s position every two hours and looking for edema, and I would additionally promote resting and a calm atmosphere.
Medications
Regarding the medications, the first one is IV furosemide (Lasix). Loop diuretics are a class of medications that includes furosemide. It primarily functions by promoting the body’s elimination of water (Guy, 2019). The rationale is that injections of furosemide are used to relieve inflammation and liquid accumulation brought on by heart failure. The next one, enalapril (Vasotec), belongs to a group of drugs known as angiotensin-converting enzyme inhibitors (Guy, 2019). It functions by lowering specific molecules that restrict blood vessels, allowing blood to flow more freely and enhancing the heart’s ability to pump blood more effectively (Guy, 2019). As a result, the rationale is that the heart receives more blood and oxygen, and hypertension is decreased.
However, there are additionally other vital medications for heart failure. Metoprolol (Lopressor) belongs to the group of drugs known as beta-blockers (Guy, 2019). It enhances blood circulation and lowers blood pressure by relaxing veins and arteries and lowering heartbeat. The heart beats more slowly as a response, thereby reducing blood pressure. The following drug, morphine sulfate, belongs to the group of drugs known as opiate analgesics (Guy, 2019). Morphine sulfate lowers resistance to blood flow and venous return, which lessens the stress on the heart. Inhaled short-acting bronchodilators (ProAir HFA) are classified as Beta2 Agonists (Guy, 2019). They function by loosening the tissues that surround the airways, allowing them to dilate and facilitating easier breathing. Flovent HFA, an inhaled corticosteroid, is a member of the Corticosteroids, Inhalants medication category. In order to facilitate respiration, it reduces inflammation of the airways, which is the reason it is used (Guy, 2019). Finally, if SpO2 is between 85 and 91%, oxygen can be administered first at 2-4 L/min using nasal cannulae (Guy, 2019). Patients can benefit from oxygen treatment by feeling less short of breath.
Medication exposure should be managed by nurses through interventions. First, they must track not only the health targets for treating the disease, but also other potential symptoms, especially those reported as side effects of the medication. Secondly, it is necessary to introduce an appropriate diet, which will allow certain drugs to work better, while also energizing the mechanism of the old person for stable digestion and stool. Third, taking into account the risk assessment, nurses should always consider non-pharmacological alternatives to medical treatment and choose the latter, where it is sufficient and possible. Finally, an effective way is to introduce an iterative control with a specialist who can adjust the individual dose, the period of administration after each administration of the drug to the body.
Health Promotion and Restoration Teaching Plan
Patient education must be incorporated into nursing care plans for patients. Mrs. J. might be given information and direction on how to monitor her symptoms at home, take her medications as prescribed, monitor her weight each day, limit her intake of sodium to 2 to 3 grams per day, and drink no more than 2 liters of liquid per day for at least two or three weeks (Malik et al., 2021). Risk factors that can be changed comprise diabetes, hypertension, overweight, smoking, and alcohol use disorders. Rehabilitation resources and modifications will assist the patients’ transition to independence and prevent readmission through additional knowledge of the risk factors. This can be achieved through health education activities, free dissemination of information through accessible channels, the allocation of a specific line of advice on rehabilitation resources or a collection of reliable Internet resources.
Tobacco Use
The final step is to ensure that tobacco use is eliminated. This can be done through nicotine replacement therapy, which involves many alternatives to tobacco. For example, Mrs. J. might prefer a transdermal patch for nicotine or nicotine replacement medication with rapid action. Among the additional substitutes for smoking are nicotine gum or lozenges. With a variety of options, the patient will be able to pick the one in accordance with their preferences. COPD triggers, such as tobacco smoke, allergic things, fumes from cleaning supplies or wood home heaters can increase deterioration and result in return visits.
Conclusion
Hence, Mrs. J. has conditions that reflect heart failure, as evidenced by her medical history and admission statistics. High blood pressure, cardiomyopathy, coronary heart disease, and cardiac inflammation are four cardiovascular disorders that Mrs. J is at risk for, and that can cause heart failure. Mrs. J will benefit from the interventions made at the time of admission, and they should not be changed. Patients need instructions on how to take their medications as directed and information on how to monitor their symptoms at home.
References
Adams, J., & Khan, E. (2020). Medications used for the cardiovascular system. In E. Khan & P. Hood (Eds.). Understanding pharmacology in nursing practice (pp. 167-217). Springer, Cham.
Guy, J. S. (2019). Pharmacology for the prehospital professional. Jones & Bartlett Learning, LLC.
Malik, A., Brito, D., Vaqar, S., Chhabra, L., & Doerr, C. (2021). Congestive heart failure (Nursing). StatPearls Publishing. Web.
Prasad, B. V., Akbar, S., & Ashwini, R. (2018). Cardiovascular disease in elderly an early care: Biopsychosocial perspective. In C. Delles & R. M. Touyz (Eds.). Handbook of research on geriatric health, treatment, and care (pp. 175-193). IGI Global.
Umashankar, M. S., & Kumar, A. B. (2020). Pharmacotherapeutic management of cardiovascular disease complications: A textbook for medical students. Bentham Science Publishers.