Clinical Manifestation present in Mrs. J
Mrs. J. suffers from acute exacerbation of chronic obstructive pulmonary disease (COPD) as well as acute decompensated heart failure. Her smoking habit must have interfered with her heart function, causing exhaustion or possible collapse of vital heart functions. Smoking is the leading cause of COPD, and therefore, her continued smoking must have led to heart complications.
Nursing Interventions Appropriateness
The administration of IV furosemide was essential because the drug assists in instances that cardiac, pulmonary, hepatic, and renal edema and is performed when oral therapy is precluded. The administration of Enalapril was essential to ease her blood pressure and help her regain composure and control of her cardiovascular balance. The administration of Oxygen delivered at 2L/ NC was imperative to assist her with her breath and help avert possible suffocation due to lack of enough oxygen to the brain. However, the administration of Morphine was uncalled for as it is highly reactive with the other two agents already mentioned.
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Cardiovascular Conditions that May Lead to Heart Failure
According to Sinnenberga & Givertzb, (2019), some of the common cardiovascular conditions that lead to heart failure include valve defects, rhythm disorders, heart muscle defects, coronary heart diseases and other heart diseases like coronary artery disease, high blood pressure, faulty heart valves, damage to the heart muscle or cardiomyopathy, myocarditis, congenital heart defects, and abnormal heart rhythms or arrhythmias. Moreover, other chronic heart diseases like protein build-up or amyloidosis, iron builds up or hemochromatosis, hypothyroidism, hyperthyroidism, hypertension, and HIV.
According to Snipelisky, Chaudhry, & Stewart, (2019), coronary artery diseases is the most common cause of heart failure among all the cardiovascular conditions that may lead to heart disease. The situation involves typically the build-up of fatty tissue along the arteries, which clock the smooth movement of blood to and from the heart, thereby suffocating the heart muscle. High blood pressure forces the heart to work harder to sustain the pressure in the blood and at the same time, maintain the normal heart functions (Snipelisky et al., 2019). Moreover, whenever there is a damaged valve in the heart, this forces the heart to work harder than it should and hence causing severe fatigue, which can lead to heart failure.
According to Jorsal, Wiggers, & John, (2018), patients can develop damage to the heart muscles due to many other causes including infections, several diseases, toxic effects of drugs like cocaine and the consequences of alcohol. Additionally, people exposed to prolonged periods of chemotherapy are likely to develop such conditions. Nonetheless, patients are at times born with conditions such as the improper formation of the heart chambers. The heart may have abnormal rhythms which force it to pump blood faster than usual, and this may cause fatigue, leading to heart failure.
Interventions for Heart Failure
According to Carlisle et al., (2019) various strategies can be used to help prevent or treat conditions that may lead to heart failure in adults, and these include cessation of intake of drugs in instances that involve alcohol abuse like cardiomyopathy. Additionally, patients in need of chemotherapy can opt for alternative options for cancer sure as opposed to the procedure, which increases the chances of heart fatigue due to the demand for the heart to work harder. A change in lifestyle, as well as some drugs to ease the pressure of the blood, can help to avert or cure hypertension whereas maintaining a healthy lifestyle can help to reduce the presence of fats in the valves of the heart thereby decreasing the chances of muscle fatigue.
Interventions for Multiple Drug interaction in Older Patients
Aspirin, ibuprofen, and acetaminophen form some of the most common drugs older patients take that leads to Polypharmacy or the effect of taking multiple drugs over extended periods of time. According to Greg & Rosen, (2019), nurses can assist patients in averting such complications by keeping a comprehensive list of all the drugs the patient takes, and these include the generic and brand names, the reason for taking the drugs, dosage, and frequency. Additionally, nurses must sensitize patients concerning the uses and effects of each medication, interactions of each medication and adverse effects, and the significance of using one pharmacy to obtain drugs for consistency.
Health care professionals must seek nonpharmacologic alternatives to drugs, and this includes the use of therapy and natural alternative medicines which have less adverse effects compared to processed drugs. Moreover, healthcare practitioners must explore other means of accessing healthcare for the patient, and these include living a healthy lifestyle and change of diet. Therefore, healthcare providers must minimize the number of drugs prescribed to older adults as a way of averting possible drugs reactions.
Health Promotion and Restoration Teaching Plan
The health restoration and promotion teaching plan entail sensitizing Mrs. J about not only the dangers smoking poses to her lifestyle but also on her diet and the dangers multiple intakes of drugs poses to her health. The use of the modifications and rehabilitation resources will assist the patients' transition to independence by allowing the patient to exercise more and eat a healthy diet. Mrs. J. can best learn by developing reminders around her life and home, and this will help to prevent future admissions. Some of the COPD triggers that can increase exacerbation frequency include smoking and air pollution, several limitations to airflow, prior exacerbation, and comorbidities. Considering Mrs. J.'s current and long-term tobacco use, she should find lozenges, patch, gum, and nasal spray as aids to help her quit her habit.
References
Carlisle, M., Fudim, M., DeVore, A., & Jonathan. (2019). Heart Failure and Atrial Fibrillation, Like Fire and Fury. JACC: Heart Failure, 7 (6), 447-456. doi: 10.1016/j.jchf.2019.03.005.
Greg, T., & Rosen, R. (2019). Psychotropic polypharmacy reconsidered: Between-class polypharmacy in the context of multimorbidity in the treatment of depressive disorders. Journal of Affective Disorders, 252 (1), 450-457. doi: 10.1016/j.jad.2019.04.018
Jorsal, A., Wiggers, H., & John, S. (2018). Heart Failure: Epidemiology, Pathophysiology, and Management of Heart Failure in Diabetes Mellitus. Endocrinology and Metabolism Clinics of North America, 47 (1), 117-135. doi: 10.1016/j.ecl.2017.10.007.
Sinnenberga, L., & Givertzb, M. (2019). Acute heart failure. Trends in Cardiovascular Medicine, 1 (1), 121-132. doi:10.1016/j.ejheart.2008.08.005
Snipelisky, D., Chaudhry, S.-P., & Stewart, G. (2019). The Many Faces of Heart Failure. Cardiac Electrophysiology Clinics, 11 (1), 11-20. doi: 10.1016/j.ccep.2018.11.001.
