Case Study revision

Table of Contents

Case Study: Mrs. J. NameInstitutionInstructorCourseDate Case Study: Mrs. J.Clinical Manifestations Present In Mrs. JOne clinical manifestation is fever occurs when the body temperature goes above the normal range of 36–37° Centigrade and is a common medical sign to indicate underlying medical problems. Another present symptom is productive cough which is a cough that produces mucus and is a symptom common for people who smoke (Grand Canyon University, 2018). The patient also reports requiring assistance in walking short distances, decompensated heart failure, and acute exacerbation of COPD. These are worse signs of heart failure and potentially a respiratory problem. Subjective data from the patient indicate that the patient has difficulty in getting enough air and is exhausted that she cannot eat or drink by herself. Trouble breathing may indicate chest congestion, heart, and lung problems (Grand Canyon University, 2018). Nursing Interventions at the Time of Her AdmissionsAt the time of her admission, the doctor administered IV furosemide, Enalapril, Metoprolol, IV morphine sulphate, Inhaled short-acting bronchodilator, Inhaled corticosteroid, and Oxygen delivered at 2L/ NC to address the present symptoms affecting Mrs. J.). This nursing intervention is appropriate as it aims at addressing and stabilizing Mrs. J. respiratory problems (Peacock, 2017). The administration of IV Furosemide medication is meant to address pulmonary edema affecting Mrs. J. that is caused by heart failure. This medication is also meant to treat congestive heart failure by addressing fluid retention. The other medication that is administered to Mrs. J. is Enalapril which is meant to treat hypertension and congestive heart failure (Trevor & Chipps, 2018). This medication is an ACE inhibitor and should be used continuously for individuals with high blood pressure to help in maintaining a normal level. Enalapril is mostly used in emergencies due to its quick effect if administered through an injection into the vein (Trevor & Chipps, 2018). The patient is also administered Metoprolol which is a beta-blocker to address congestive heart failure and hypertension. Since the patient has an abnormal heart rate, this medication lowers the risk of death or the need to be hospitalized for heart failure (Trevor & Chipps, 2018). The physician also administers Morphine to the patient which is aimed at minimizing pain associated with congestive heart failure. This medication acts on the central nervous system to minimize pain for individuals with chronic illnesses (Trevor & Chipps, 2018). Inhaled short-acting bronchodilator is a quick-acting reliever to address asthma attacks by opening the airways. This is helpful as the patient reports continuing to smoke on daily occasions and feels like she cannot get enough air (Trevor & Chipps, 2018). The patient is also issued with inhaled corticosteroid which is aimed at preventing asthma attacks and improving the functioning of the lungs which prevents asthma attacks. The last nursing intervention involves the administration of oxygen which is delivered at 2L/ NC. This is meant to improve the flow of oxygen to the lungs for patients with acute exacerbation of COPD (Trevor & Chipps, 2018). Four Cardiovascular Conditions That May Lead To Heart Failure and Nursing Interventions to Prevent the Development of Heart Failure in Each ConditionCoronary Artery DiseaseCoronary artery disease is characterized by narrowing or blocking the coronary arteries that may be caused by obesity since cholesterol may build up on the inner walls of the arteries affecting the flow of blood to the heart and other body parts (Hruby et al., 2016). The fat deposits in the inner walls of the arteries may form a plaque that may rupture leading to a blood clot in the artery. This clot may cause blockage preventing the flow of blood to the heart which may deprive the heart and other body parts of adequate oxygen supply. Medical interventions to prevent coronary artery disease include addressing the risk factors associated with this disease such as obesity (Hruby et al., 2016). This includes eating a healthy diet, quit smoking, be physically active, and keeping blood pressure under control. High Blood PressureHigh blood pressure is a condition where the force of the blood against the artery walls is too high. If this is not controlled, it may lead to heart problems in the long-term. Medical interventions to prevent high blood pressure involve taking medications to lower high blood pressure above the normal rate (Hruby et al., 2016). High-risk individuals should also exercise regularly, reduce stress, quit smoking, and reduce salt intake as this triggers high blood pressure. StrokeStroke is a condition caused by a limited supply of blood to the brain that affects the supply of oxygen in the brain causing brain damage (Rahko, 2014). If there is a lack of these nutrients, brain cells will begin to die and the brain may fail to function optimally affecting other body functions as the brain is responsible for controlling diverse body functions. Medical interventions to prevent stroke is addressing and controlling risk factors that may lead to stroke (Rahko, 2014). These include lowering high blood pressure, quit smoking, and addressing obesity that can be managed by adopting a healthy lifestyle. Congenital Heart DiseaseCongenital heart disease is a condition characterized by a problem with the structure of the heart. A person may be born with a heart defect that can affect the walls of the heart, heart valves, arteries, or veins near the heart affecting the normal flow of blood (Rahko, 2014). This defect may block the flow of blood or cause blood to flow to the wrong place failing to reach the heart. This condition can be prevented by using medications that improve the functioning of the heart and the flow of blood to the heart (Rahko, 2014). Pacemakers can also be used to regulate an abnormal heart as well as prevent some of the problems associated with a defective heart. Four Nursing Interventions That Can Help Prevent Problems Caused By Multiple Drug Interactions in Older PatientsOne of the ways to prevent help prevent problems caused by multiple drug interactions in older patients is educating the patients and close family members to enable them to understand the effects of this process and effective ways of managing the effects (Golchin, Frank, Vince, Isham, Meropol, 2015). Patient education is important as this enhances decision-making to prevent some of the problems associated with multiple drug interactions. The second nursing intervention involves undertaking medical reviews where patients have regular appointments with doctors to determine the state of their health and determine effective interventions to implement based on the health status of the patient (Golchin et al., 2015). This will enable the doctor to determine some of the unnecessary medications that can be stopped. Another nursing intervention to prevent problems caused by multiple drug interactions in older patients is addressing any negative side effects affecting patients due to the use of multiple drugs (Golchin et al., 2015). Patients should seek medical help after detecting any changes in their health to prevent the adverse effects of using multiple drugs. Doctors will implement strategies to address these problems as well as advice on measures ti be taken to prevent a reoccurrence of such problems (Golchin et al., 2015). The last nursing intervention involves the use of other alternatives to medications. Alternative medicine will help in substituting medications used by individuals minimizing on the side effects and other negative problems associated with the use of multiple drugs. These may include behavior changes or changes in diet (Golchin et al., 2015). Health Promotion and Restoration Teaching Plan for Mrs. J.One effective way to ensure a stable health for Mrs. J. is adopting a healthy lifestyle due to the conditions affecting her health. This requires a good diet, exercise, and controlling the underlying conditions using appropriate medications (Baker & Fatoye, 2019). One way of achieving this is through patient education that will help the patient to understand her condition and how to effectively manage the condition to prevent some of the negative effects as witnessed by her current condition (Baker & Fatoye, 2019). Patient education will help the patient to understand the risk factors that have contributed to her current status and what effective strategies can be implemented at home to help her improve her health in diverse forms. The patient can seek rehabilitation services to help her with the addiction problem. One of this is the LFA community based maintenance exercise program to help individuals with COPD (Baker & Fatoye, 2019). Providing Education for Mrs. J.Patient education is important in helping the patient to adopt a healthy lifestyle as well as control the health conditions currently affecting her. This will also help her to become responsible for her health, as she will be able to take an active role in managing her care (Grand Canyon University, 2018). One way of providing patient education to Mrs. J. is taking advantage of technology as this makes education materials more accessible to patients. This is important in addressing individual patient needs as Mrs. J. can access adequate information regarding the risk factors associated with inadequate management of the underlying conditions well as effective measures to apply in improving her health (Grand Canyon University, 2018). Technology also enhances the relationship and communication between the physician and Mrs. J. where close monitoring can be done and continuous education to ensure that the patient is able to maintain and control the underlying health issues (Grand Canyon University, 2018). COPD Triggers That Can Increase Exacerbation Frequency, Resulting In Return VisitsOne COPD trigger that can increase exacerbation frequency is tobacco smoke which is the leading cause of COPD and increases the progression of the disease. Tobacco smoke can lead to difficulty in breathing, coughing, and wheezing as experienced by the patient who continues to smoke two packs of cigarettes a day regardless of her health condition (Baker & Fatoye, 2019). Another trigger is air pollution such as vehicle exhaust, fumes at the gas pump station, and pollution from factories as these may irritate the lungs triggering a COPD flare-up. High-risk individuals should avoid exposure to these chemicals while performing outside activities such as walking, shopping, or exercising (Baker & Fatoye, 2019). Considering Mrs. J. s current and long-term tobacco use, the doctor may administer Varenicline which a prescription medication that aims at reducing cravings for tobacco as well as controlling nicotine withdrawal symptoms by blocking nicotine receptors in the brain. The doctor may also use behavioral therapy to determine the triggers as well as develop a plan in collabiration with Mrs. J. to address the triggers (Baker & Fatoye, 2019). ReferencesBaker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: A systematic review of qualitative research. International Journal of Nursing Studies, 91, 22-34. doi: 10.1016/j.ijnurstu.2018.12.004. Epub 2018 Dec 31.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.Grand Canyon University. (2018). Pathophysiology: Clinical Applications for Client Health. Grand Canyon University.Hruby, A., Manson, J. E., Qi, L., Malik, V. S., Rimm, E. B., Sun, Q., Willett, W. C., & Hu, F. B. (2016). Determinants and Consequences of Obesity. American Journal of Public Health, 106(9), 1656-1662.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.Trevor, J. L., & Chipps, B. E. (2018). Severe Asthma in Primary Care: Identification and Management. The American Journal of Medicine, 131(5), 484-491. doi: 10.1016/j.amjmed.2017.12.034. Epub 2018 Mar 30