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Critical Thinking Essay: Heart Failure and COPD


Timely medical interventions have always been considered one of the major pillars in terms of successful healthcare management. However, in order to secure the intervention’s quality, it is of crucial importance to properly evaluate both objective and subjective data regarding the patient’s health condition. Thus, according to the researchers, as far as nursing interventions are concerned, there is an increased need to look into the patient’s perception of the illness in order to identify a working intervention for the individual (Zwakman et al., 2019). The primary aim of the following critical thinking essay is to evaluate the health condition and provide information related to the quality medical intervention in acute decompensated heart failure and chronic obstructive pulmonary disease (COPD).

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Clinical Manifestations

COPD and heart failure obtain a variety of cardiac and non-cardiac signs and symptoms. Some of the most widespread signs include a feeling of fatigue, breathing shortness, and coughing (Centers for Disease Control and Prevention, 2019). Regarding the situation of Mrs. J., the following clinical manifestation may be outlined:

  • Feeling shortness of air and inability to breathe in properly.
  • Failure to perform physical activities such as daily chores or walking small distances.
  • Nausea and malaise.
  • Fever is frequently identified as one of the signs of congestive heart failure.
  • Frequent cough.

Nursing Intervention Evaluation

COPD exacerbation, along with acute heart failure, required immediate medical intervention considering the age of the patient. According to the researchers, COPD presupposes the administration of bronchodilators, and inhaled steroids, whereas an acute decompensated heart failure requires morphine, furosemide, and enalapril (Abdulsalim et al., 2018; Antohi et al., 2019). Thus, considering the nursing intervention described, it may be concluded that the medication prescription was appropriate and relevant to that particular issue.

Cardiovascular Conditions Leading to Failure

Heart failure as a health condition frequently presupposes that people have previously experienced other heart-related health issues that deteriorated the heart’s performance in the long term. According to Harjola et al. (2017), some of the most widespread conditions leading to heart failure include:

  • Coronary artery disease. The following disease is characterized by the poor blood supply to the coronary arteries caused by an excessive amount of cholesterol stored in the arteries’ walls. One of the major ways to avoid heart failure in patients with CAD is the administration of cardiovascular-protective medications.
  • Hypertension. This health condition stands for an estimated pattern of high blood pressure. Just like CAD, the prevention of heart failure may be performed through the prescription of protective medications. However, another significant prevention means in nursing intervention is the patient’s lifestyle, encouraging them to pursue diet, physical activity, and refusal from dangerous habits such as smoking.
  • Congenital heart disease. Being a disease that emerges when a person is born, there is no probability of avoiding the condition development entirely. Thus, people with heart defects present at birth have to follow a therapeutic lifestyle, including diet and exercise.
  • Heart attacks in the past. Unquestionably, such an experience plays a detrimental role in the overall health condition in the long term. Hence, the most appropriate intervention for the case would be consistent medical checkups and cardiovascular-protective medication intake.

Nursing Interventions in Multiple Drug Interactions

Older patients naturally require a higher number of medications either for the sake of disease prevention or for rehabilitation from previous health conditions. Hence, it is of crucial importance for the nurses to make sure that the medications prescribed are both necessary and compatible with each other. Thus, according to Accetta (2016), some of the major interventions for achieving this goal include:

  • Constant update on the medication reconciliation. This notion stands for the process of creating a meticulous list of medications used by a patient in order to compare them with the medications prescribed by physicians.
  • Refusing duplicate medications. Sometimes, prior to being admitted to the hospital, patients take medications similar to the ones prescribed yet have slight differences in dosage or frequency. Hence, one of the medications may be eliminated from the treatment plan.
  • Assessing drug compatibility. While some medications may be beneficial when taken separately, their combination may be detrimental to the overall health condition of older adults.
  • Reconsidering the dosage. When evaluating the overall patient’s progress, it is of crucial importance to define whether the dosage administered to the patient does not interfere with the effect of other medications.

Health Promotion and Restoration Plan

Considering the following case study, it may be outlined that the overall lifestyle of the patient prior to their admission to the ICU was not beneficial for Mrs. J.’s health history. Hence, the promotion plan for the patient may include:

  • Giving up smoking, as it one of the major determinants of heart failure.
  • Once the patient feels better, nurses should promote such restorative activities as walking and changing nutrition patterns.

Modifications in the treatment intervention mean assistance in terms of the medication intake and checking up on such health determinants as blood pressure, arterial pressure, and heart rate.

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Education Method

One of the best methods to educate elderly patients regarding medication use is to make sure that the patients are aware of the significance of every pill they take. That is, prior to being released from the hospital, nurses have to explicitly explain to the patients why the following treatment plan will be working only when all the requirements are met. Moreover, it Is important for the nurses to ask more about the patient’s nutrition and physical activity patterns.

COPD Triggers

Some of the major COPD triggers include smoking, abandoning medication intake, exposure to air pollution and allergens, and lung infections such as the flu. It is evident that the smoking patterns of Mrs. J. are absolutely incompatible with heart failure and COPD. For this reason, nicotine replacement therapy or non-nicotine therapy should be encouraged for smoking cessation and avoidance of heart-related disease development in the future.


Accetta, R. C. (2016). Polypharmacy: Strategies for reducing the consequences of multiple medications. Today’s Geriatric Medicine, 9(3), 24.

Abdulsalim, S., Unnikrishnan, M. K., Manu, M. K., Alrasheedy, A. A., Godman, B., & Morisky, D. E. (2018). Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: A randomized controlled study. Research in Social and Administrative Pharmacy, 14(10), 909-914. Web.

Antohi, E. L., Ambrosy, A. P., Collins, S. P., Ahmed, A., Iliescu, V. A., Cotter, G., Pang, P. S., Butler, J., & Chioncel, O. (2019). Therapeutic advances in the management of acute decompensated heart failure. American Journal of Therapeutics, 26(2), e222–e233. Web.

Centers of Disease Control and Prevention. (2019). Basics about COPD. CDC. Web.

Harjo, V. P., Mullens, W., Banaszewski, M., Bauersachs, J., Brunner‐La Rocca, H. P., Chioncel, O.,… & Mebazaa, A. (2017). Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Journal of Heart Failure, 19(7), 821-836. Web.

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Zwakman, M., Weldam, S. W., Vervoort, S. C., Lammers, J. W. J., & Schuurmans, M. J. (2019). Patients’ perspectives on the COPD-GRIP intervention, a new nursing care intervention for COPD. BMC FamilyPpractice, 20(1), 1-8. Web.

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