Nursing Interventions
Three crucial interventions to be considered when admitting Mrs. J include assessment of current state, management of the condition, and educating the patient on what is expected of her. Considering that the patient presents with decreased breadth, and SpO2 of 82%, the best approach is to administer oxygen using a nonrebreather mask, this will assist in increasing the SpO2 level by providing the patient with high oxygen concentration (Ganiev et al. 2017). The patient should be kept at a sitting position of 45 degrees. Diuretics will also assist the patient to relieve pulmonary edema and crackles. The pharmacological measures that can assist include the use of Angiotensin-converting enzyme inhibitors, digitalis, and spironolactone (McKenzie & Cowley, 2003). Besides these, the patient should be closely monitored. Since she has anxiety, the best approach is to use relaxation techniques and provide anti-anxiety medications; this will be administered on a need basis.
The patient should be assisted to carry out basic things such as eating and going to the bathroom, this will assist the patient to conserve energy. The patient should also be educated on the importance of adhering to prescribed medications; this will enable the patient to understand the effects of failing to use or skipping the use of drugs.
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Rationale for Administering Medications
The rationale for administering IV furosemide (Lasix) is that it will help to remove excess fluid; increased extracellular fluid overloads the circulatory system leading to amplified contractions of the heart, increase pressure, and elevates hydrostatic pressure. This causes fluids to shift, leading to edema. Lasix reduces workload leading to the decreased filing of the ventricles. Enalapril (Vasotec) inhibits ACE, and assists blood vessels to dilate, hence blood flow to the heart and other parts of the body will be improved. ACE inhibitors improve the functionalities of kidney, heart, and eyes (Nagel et al. 2017). Metoprolol (Lopressor) metropolol blocks beta, and reduces heart rate and functions to inhibit induced tachycardia. IV morphine sulfate (Morphine) is an analgesic that is used to treat pain. It improves vasodilation and assists in relaxing the respiratory system (Reagan et al., 2013).
Cardiovascular Conditions
Some of the common cardiovascular conditions that may lead to heart failure include coronary artery disease, which can be controlled through drug therapy and cardiac rehabilitation, myocardial infarction, which can be prevented by administering anti-hypertensives and lifestyle change, and hypertension, which can be controlled through medication adherence and dietary approaches. Abnormal heart valves disease can be controlled by treating symptoms.
Interventions to Prevent Drug Interaction Problems
One of the ways to prevent issues caused by using multiple drugs is to have open communication with the patient. The patient should be advised to get their medications at the recommended pharmacies and have a complete list of medications, providers, and their contacts (Woodruff, 2010). This will ensure that the patient is provided with the appropriate dosage and reduce the risk of patients getting adverse effects based on the interactions of medicine. Moreover, the nurse should ask the patient if the drugs were prescribed by a doctor or whether the prescription was done over the counter. Getting to understand the kind of drugs that the patient is using will assist the nurse to eliminate possible problems that may arise based on drug interactions among elderly patients.
Asking the patient to report any changes they witness in their health, especially when they are starting new medications is also essential in minimizing complications (Woodruff, 2010). Older patients must be made to understand that it is important to inform their provider of the kind of medications they may choose to use. Keeping their medication in a safe place is also crucial. The location should be dry and away from direct sun. It is advisable to use recommended daily doses contained in packaging that can last for a specific time; this will allow the patient to stay disciplined and observe recommended dosage per day.
References
Ganiev, R., Reviznikov, D., Rogoza, A., Slastushenskiy, Y., & Ukrainskiy, L. (2017). Wave
Processes in the human cardiovascular system: The measuring complex, computing models, and diagnostic analysis. Doklady Physics, 62 (3), 154–157. https://doi.org/10.1134/S1028335817030107
McKenzie, D., & Cowley, A. (2003). Drug therapy in chronic heart failure. Postgraduate Medical Journal, 79 , 634-642.
Nagel, C., Trenk, L., Wulf, M., Ille, N., Aurich, J., & Aurich, C. (2017). Oxytocin treatment
does not change cardiovascular parameters, hematology and plasma electrolytes in parturient horse mares. Theriogenology, 91 , 69–76. https://doi.org/10.1016/j.theriogenology.2016.12.028
Reagan, W. J., York, M., Berridge, B., Schultze, E., Walker, D., & Pettit, S. (2013).
Comparison of cardiac troponin I and T, including the evaluation of an ultrasensitive assay, as indicators of doxorubicin-induced cardiotoxicity. Toxicologic Pathology, 41 (8), 1146–1158. https://doi.org/10.1177/0192623313482056
Woodruff, K. (2010). Preventing polypharmacy in older adults. American Nurse Today, 5 (10)
