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Re:Topic 3 Mandatory Discussion Question
What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?
The patient has many complications. The ABC rule is recommended, and, therefore, it is important to control respiratory problem first. The symptoms are indicative of a patient suffering acute heart failure. She needs immediate hospitalization and monitoring. Telemetry monitoring is necessary for 24-48 hours. Additionally, there is need for diuretics, vasodilators, and inotropic support to perfuse the patient (Joseph et al., 2009). Important vital that should be taken and monitored closely include weight, serum creatinine levels, fluid balance, electrolyte levels, and signs of congestion. Tests of BNP, D-dimer, CBC, and liver function are also important (Joseph et al., 2009).
- IV furosemide (Lasix) cause prompt diuretic effect which results in a decrease in ventricular filling pressures. It improves symptoms in patients suffering ADHF.
- Enalapril (Vasotec) inhibits angiotensin converting enzyme to widen blood vessels and reduce water quantity in the blood, and, therefore, reduced blood pressure (Goons, McGraw, & Murali, 2011).
- Metoprolol (Lopressor) is a beta1-blocker and helps in the management of hypertension, heart failure, and angina pectoris.
- IV morphine sulphate (Morphine) is effective in reducing preload, heart rate, and afterload, and eventually reducing the myocardial oxygen demand (Goons, McGraw, & Murali, 2011).
Describe 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.
Four possible cardiovascular conditions that may lead to heart failure include coronary heart disease, hypertension, myocarditis, and arrhythmias (Anderson, 2016). Coronary heart disease is managed through lifestyle changes, medication, and surgery, in certain cases. Hypertension is manageable through medication, lifestyle changes, healthy diets, reducing alcohol, and quitting smoking (Anderson, 2016). Myocarditis is managed through medication, proper rest, and low salt diets. Finally, arrhythmia is managed through medication, pulse monitoring, and managing the risk factors (Anderson, 2016).
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.
Nurses prevent problems resulting from multiple drug interactions by creating an accurate list of all medications of the patients. The list outlines the generic drugs, brand names, doses, time for dosages, and rationale for taking each drug. The list improves accuracy of taking drugs and helps patients take the right drug at the right time. The second intervention involves warning patients against sharing drugs. Third, nurses should warn patients against using old prescriptions/medications. Lastly, nurses should educate patients on how to take medications correctly, according to instructions.