On admission, immediate assessment and triage should be conducted to Mrs. J. The nurse present should prompt conduct an evaluation to recognize the case of shortness of breath. The nurse should carry out chest radiographs, haematologic, electrocardiograms liver blood and gas tests to verify the conditions. Management of the conditions including transfer to the appropriate environment and continued provision of care is recommended (Mebazaa et al., 2008). All questions from Mrs. J should be promptly answered and precise information provided to reduce anxiety. Continuous monitoring of changes in the present signs and symptoms.
Clinical examinations should be conducted for signs of congestion, laboratory tests, and measurement of anxiety levels, dyspnea severity, heart rhythm cardiac output and hemodynamic status (Mebazaa et al., 2008). The nurse should them administer diuretics to relieve dyspnea. The administration should be followed by close monitoring of urine output, renal function and the balance of fluids in the patient’s body. Constant evaluation of the hemodynamic status to determine volume and perfusions status. Results from the point of care assays are useful in establishing and guiding treatment.
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IV furosemide indicated by the volume overload through the elevated left and right ventricles is used as a foundation treatment for Acute Decompensated heart failure in patients with congestion symptoms. It reduces extracellular fluids which fill pressures and cardiac cavities improving performance and promotes high relief from congestion (Redfield et al., 2003). It is used to preserve renal function. Morphine is used for volume overload with adequate blood pressure after administration of nitroglycerin for treatment. It produces mild produce mild vasodilatation, induce respiratory relaxation and exert a calming effect on those with agitated dyspnea (Redfield et al., 2003). Enalapril is used as an ACE inhibitor useful in reducing the heart's workload. It is usually used to reduce mortality in patients with severe congestive heart failure. Vasopressors such as dopamine are used for the treatment of cardiogenic shock refractory.
Cardiovascular conditions include systolic, diastolic dysfunction, cardiovascular disease, and heart failure. Systolic and diastolic dysfunction are shown by impaired ventricular relaxation, fluid and sodium retention, cardiogenic shock. Severe hypervolemia hypo perfusion and acidosis. Diuretics and inotropic drugs should be administered to improve perfusions status. Drugs such as dobutamine or milrinone are used to stabilize the patients; they should, however, be combined with beta-blocker therapy after active perfusion as indicated by stabilized blood pressure and sufficient urine output (Redfield et al., 2003).
Multiple drug interaction problem can be solved by nurses. Identification of patients at risk and offering education on ways of risk reduction is a healthy step to risk reduction. Interventions by nurses include keeping a list of all medications dosages and frequency and outlining the reasons for taking the drug. Offering the patient a list of medical providers and their contacts will help them seek clarification to avoid mix-ups (Peacock et al., 2008). The older patients should be taught the purpose effects and interactions of different medications. The nurses should issue clear and precise instructions on drug storage, offer color-coded charts to help the elderly keep track of their medical routines.
To improve adherence to drugs, nurses should provide dosing schedules link to routine daily activities use of drug dispensers with voice activate messages for reminders or bells (Peacock et al., 2008). They should understand the need to contact healthcare providers in for their questions and concerns to be addressed rather than self-medicate. Patients should receive advice on proper medication habits like obtaining medicine form a specific pharmacy to help evaluate progress. They should seek help if any changes occur after drug introduction rather than stopping the drug before a consultation. Health care providers should embrace the new technology that warns of the effects of drug interactions before administration (Peacock et al., 2008). Outside solutions like dietary changes and exercises should be sought instead of relying on drugs only.
References
Mebazaa A, Gheorghiade M, Pina L, et al. (2008) Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes . Critical Care Medical Vol.36, pp.129–139.
Peacock W.F, Hollander J.E, Diercks D.B, et al. (2008) Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis . Emergency Medical Journal. Vol.25, 205–209
Redfield M.M, Jacobsen S.J, Burnett J.C, Mahoney D.W, Bailey K.R, Rodeheffer R.J. (2003). Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic . Journal of American Medical Association.Vol.289, pp.194–202.
