According to her medical history, Mrs. J. suffers from four diseases at once: smoking, hypertension, obesity, and heart rate disorders. Clinical manifestations of these diseases include rapid breathing and coughing with thick sputum and heavy bleeding. This is also confirmed by the bilateral expansion of the jugular vein, pulmonary cracks described in history.
Heart rate is expressed in 34 movements per minute, which exceeds the norm for a healthy older person. This is inextricably linked to panic and lack of oxygen, which are common symptoms for both heart failure (asthma) and COPD (Causes of Heart Failure, 2017).
In addition, irregular heart rate and elevated heart rate averages are a consequence of discontinuation of medication and continued smoking when heart failure occurs. The burden on the heart can be reduced through a nurse’s intervention that includes an artificial oxygen supply because the history shows O2 saturation only at 82%, but oxygen concentration can be increased gradually.
Intervention by medical personnel is necessary to monitor essential medical data. In heart failure, the body additionally retains salt and water, resulting in swelling and weight gain (Causes of Heart Failure, 2017). Sudden weight gain may mean that fluid is kept in the body due to worsening heart failure. The IV furosemide (Lasix) loopback diuretic (Canaan, 2017) can help reduce body weight to normal levels.
Due to the increase in sodium ions excretion, there is a secondary (mediated by osmotically bound water) enhanced water excretion and increased potassium ions secretion in the distal part of the renal tubule. Enalapril (Vasotec) is a vasoconstrictor. It helps to restore the damaged structure of blood and excretory vessels in the body, which is particularly important in heart failure, but there is currently no urgent need to take this drug (Medications Used to Treat Heart Failure, 2017). The use of Metoprolol (Lopressor) helps to reduce heart rate and has hypotensive effects (Medications Used to Treat Heart Failure, 2017).
As the patient enters the emergency department, the introduction of IV morphine sulfate (Morphine) will reduce the panic effect and inhibit conditioned reflexes, reducing the excitability of the cough center, but it should also be avoided because it changes the respiratory frequency. Inhaled short-acting bronchodilator relaxes the respiratory muscles, allowing more oxygen to be captured. Inhaled corticosteroid (Flovent HFA) helps to reduce hoarseness and whistling sounds while breathing, and oxygen delivered at 2L/ NC is necessary for sufficient oxygen supply. However, it should be remembered that the sharing of these drugs should be organized in a way that does not harm the patient’s health.
Here are the recommended actions that Mrs. J. should take to prevent the consequences of making the medicines together. First, she should monitor all the pills and foods she uses. Some medicines are not compatible with the ingredients in the supplements. It is also essential to follow the terms and conditions for storing herbs. It is necessary to prohibit the patient from taking medicines that are not approved by the doctor. If Mrs. J. wants to receive a new medication, she needs to talk to the doctor about it.
For the patient, J. There should be an appropriate nurse intervention that includes monitoring her blood pressure, body temperature, CRT, and skin tone. Also, nurses should measure the frequency of breathing exercises, heart rate, lower and upper blood pressure. It is essential to monitor the patient’s body position: it is advisable to move the patient from the horizontal to the vertical position so that she does not have too much water in her lungs.
The nurse carries out preventive and informational work for the patient to justify the use of each of the medicines and to remind the patient of the importance of a healthy and athletic lifestyle. The leading causes of COPD are exposure to environmental hazards, tobacco use, general ecological pollution, frequent respiratory tract infections, heredity, and α1-antitrypsin deficiency. Given the patient’s long-term dependence on cigarettes, there is no point in suggesting quitting smoking. Instead, it may be recommended to use non-nicotine drugs or artificial nicotine administration, which will significantly reduce the progression of the disease.
References
Canaan, K. (2017). Effects of Lasix on Congestive Heart Failure. Web.
Causes of Heart Failure (2017). American Heart Association. Web.
Medications Used to Treat Heart Failure (2017). American Heart Association. Web.