As people grow older, their immunity diminishes, and they become vulnerable to various conditions. They are prone to diseases such as Chronic Obstructive Pulmonary y (COPD) and Heart failure. With reduced immunity and increased vulnerability, aging people require careful and personalized attention in the healthcare facilities. Because of this, the current case study, based on Mrs. J’s condition, elaborates on chronic health issues, the risk factors associated with them, their management, treatment, knowledge, and ways to reduce their incidence.
Mrs. J’s Clinical Manifestations
From the case study, Mrs. J has had Chronic COPD and Heart failure alongside hypertensive conditions in the past. At the moment, she has high fever besides malaise, nausea, and a stubborn cough. Additionally, she finds it hard to support her-self when walking, and she is unable to perform Activities of Daily Living ( ADLs). When she came to the hospital, she showed signs of restlessness as she was scared that she would die. Even though she never complained of any specific pain, she highlighted her difficulty in breathing. Her appetite had significantly changed as compared to the past when she used to enjoy her meals. Even her favorite meals do not interest her at the moment. Based on this data, she may be prone to related symptoms like dizziness, body swelling, and fatigue.
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Evaluation of Mrs. J’s nursing interventions
Upon admission, careful analysis of Mrs. J’s condition should be embraced to diagnose her carefully. Here, the risk factors are identified to minimize the chances of making mistakes that will worsen her condition. After that, the proper planning and development of her treatment procedure should be commenced. Besides, she should be educated to keep her informed and vigilant about her conditions and methods to manage it under different conditions.
Markedly, to handle her breathing problems, the patient is put under a non-rebreathe mask to develop the SpO2 level, and this should take several hours to regulate the SpO2 level. The rate of oxygen is to be increased progressively. Also, IV furosemide (Lasix) should be offered to Mrs. J to decrease fluid retention. Besides, furosemide (Lasix) should be administered alongside Enalapril (Vasotec) to regularize the heart pressure.
To handle her restlessness, she should be administered with Metoprolol (Lopressor). It plays a significant role in enhancing the calming effect and normalizing her heartbeats. Additionally, Metoprolol (Lopressor) enhances proper blood flow by narrowing her blood vessels. Morphine sulphate (Morphine) is also vital in pain reduction. Thus, these should be among the first actions that should be done to enhance her welfare and to ease her malaise pain.
Equally, to diminish her shortness of breath, she should be subjected to inhaled short-acting bronchodilator (ProAir HFA) to increase the rate and amount of oxygen that reaches her lungs. These remedies and actions are directed towards enhancing the possible comfort as she commences her recovery journey. Judging from her manifestations, she is asthmatic, and inhaled corticosteroid (Flovent HFA) is crucial. For it to be effective, it should not be depended upon as a rescue inhaler.
Cardiovascular conditions responsible for heart failure and their interventions
Coronary heart disease can result in heart failure. It is as a result of continuous smoking (Yeh et al., 2017). It requires nursing management and education of the vulnerable parties on the adverse effects of smoking. High blood pressure also causes heart failure. It leads to the overworking of the heart. To intervene in these conditions, nurses have to emphasize on the need for the patients to stick to the administered medications at the speculated time strictly.
Furthermore, sleep apnoea is a primary causative agent of heart failure as it ignites the overall blood pressure. To intervene in this condition, the vulnerable patients should be thought about the need to adhere to CPAP regimen. Finally, obesity is known to lead to heart failure eventually. The fact that the heart struggles to meet the needs of the overweight body makes it to overwork, and as such, the nurses should educate such individuals on lifestyle interventions to reduce their overall weight.
Nursing interventions on adverse effects on several drugs
Older patients lose track of their medication, and as a result, they may end up facing the effects of the interaction of their drugs. Nurses can offer the required help by embarking on their overall education. For instance, they should be prohibited from relying on non-prescribed over the counter opioids. Also, the nurses should organize and make follow-ups on these patients to ensure that they take the right medicines promptly (Bernocchi et al., 2018). The prescription should be done after a careful analysis of the past reactions of the patients in questions. Lastly, the nurses must remind and record the medical schedules of these patients continuously.
Health promotion and restoration plan
Mrs. J’s condition is severe and she can only be healed on the long-term basis if she avoids the disease causative actions and agents like smoking. On her own, she may not manage to embark on smoking cessation. The best way to enhance this is to sensitize her about rehabilitation and its positive effects on her health (Bernocchi et al., 2018). The knowledge, coupled with the programs, will promote her welfare in both the short and long-term phases.
Education techniques
Mrs. J’s chronic situation is attributed to her unwillingness to quit smoking. With the right information, she can gradually embark on smoking cessation. Face to face and persistent teaching is a great way to enhance her knowledge about the whole issue (Bernocchi et al., 2018). Markedly, to positively impact her health, she should be kept close and educated on the mechanisms to change her path.
COPD triggers and alternatives of Smoking Cessation
Apart from smoking cessation programs, the patient can embrace other mechanisms to impact on COPD positively. The fact that it is mainly caused by smoking means that it should be eradicated by all means. To enhance this process, the patient should be sensitized to embrace relaxation and continuous engagement to minimize idle moments. Also, nicotine replacement therapy is crucial (Stead et al., 2016). Ultimately, smoking cessation will become a reality.
References
Bernocchi, P., Vitacca, M., La Rovere, M. T., Volterrani, M., Galli, T., Baratti, D., ... & Scalvini, S. (2018). Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial. Age and ageing , 47 (1), 82-88.
Stead, L. F., Koilpillai, P., Fanshawe, T. R., & Lancaster, T. (2016). Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database of Systematic Reviews , (3).
Yeh, J. J., Wei, Y. F., Lin, C. L., & Hsu, W. H. (2017). Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia, and heart failure: a population-based retrospective cohort study. BMJ Open , 7 (10), e017657.
