The clinical manifestation for Mrs. J includes anxiousness, exhaustion, and pain, even though she denies it. She also presents a high heart rate with an inability to eat or drink by herself. The primary role of nurses in the management of such cases mainly focuses on monitoring and follow up of the patients on admission or readmission. Previous studies indicate an improvement in outcome in patients who were under a multidisciplinary care team involving a nurse ( Mosterd, & Hoes,2017). Nurses' role in the management heart failure became prominence in the early 1990s. Since they had already proven their role in the management of patients with chronic illness, they quickly confirmed their role with heart failure patients.
Upon diagnosis of Mrs. J, several drugs were administered.IV Furosemide treats edema and edema related renal failure and heart failure when used alongside other medications for the treatment of acute volume overload that is associated with heart failure. (Garcia-Aymerich, Farrero, Felez, Izquierdo, Marrades & Anto,2019). There is limited research indicating that the drug is used in relieving patients with acute breath shortness. In as much as professionals still use the drug in the treatment of acute heart failure, it is slowly falling out of favor for several reasons. The main reason is that heart failure patients do not have uniform volume overload. Also, it does not relieve the symptoms in very sick patients, as previously thought.
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Furthermore, studies have indicated that patients who are not on IV Furosemide report fewer deaths and shorter times of hospital stay( Garcia –Aymerich et al.,2019 .).Enalapril is an angiotensin-converting enzyme inhibitor. Specialists use in the treatment of hypertension in both adults and children who are not younger that one month old (Garcia –Aymerich, et al., 2019). Researchers have proven that the drug can also treat patients with congestive heart failure. Morphine administration is dependent on the products. Its administration is through the injection into a muscle, vein, or under the skin. Patients who stop the medications have reported withdrawal cases. To prevent such instances, doctors may lower the dosage slowly. An inhaled short-acting bronchodilator in the prevents and treats shortness of breath caused by breathing problems. It serves as a quick-reliever. It opens the breathing pathways and relaxes the muscles. Inhaled corticosteroid controls symptoms such as shortness of breath and wheezing associated with asthma ( Garcia –Aymerich, et al.,2019 ). It reduces the swelling in the airways, thus making breathing easier.
High blood pressure is a contributor to heart failure. Increased pressure in the valves increases the pumping rate of the heart, thus overworking the lungs, making them larger and weaker. Specialists suggest treatment of the condition to avoid further complications severe lung disease makes the lung unable to work correctly, thus forcing the heart to work harder to supply oxygen to the body (Felker, Lee, Bull, Redfield, Stevenson, Goldsmith & Anstrom, 2018 ). One can avoid smoking or stop smoking altogether to prevent the development of lung disease. When the fatty deposits and cholesterol accumulate in the arteries, the blood supply to the heat becomes complicated, which may eventually result in a heart attack. Regular exercising and proper dieting help reduce the case of arteriosclerosis, thus reducing the chances of heart failure(Felker at.al,2018 ). Finally, a disease in the heart muscles such as myocarditis increases the risk of heart failure. Treating the underlying heart muscle disease helps to prevent cases of heart failure.
Polypharmacy is a term used to refer to the effects caused by multiple drug interactions to manage coexisting health conditions. (Mosterd & Hoes, 2017). Nurses have the responsibility of helping the patients at risk of Polypharmacy and educating families and patients about ways of reduction. Nurses have the duty of providing the necessary information to the patient at risk. They should talk to them about the need to keep an accurate list of the medications: including the name, doses, and reason for taking the drug. They should also have a record of the medical providers at reach. Nurses should also teach the patients on the instructions associated with each prescription. They can tell them about the side effects of the medications and drug-related problems that warranty emergency care. They can also help the patient manage their medications by cautioning them against the sharing of drugs, proper disposal of old prescriptions, and refrigeration of medicines if necessary.
Considering her state, Mrs. J requires an immediate cardiac rehab response. Cardiac rehab programs often involve counseling sessions on the use of medication and modification of risk factors through nutrition and diet. Also, rehab team members provide the patient with a medical evaluation to determine their needs and limitations. Most importantly, they counsel and educate the patient to help them understand tier conditions, possible sand ways of management. Rehabilitation resources and modifications help patients in the transitioning towards independence since they now have full control over their health
When a patient with COPD fails to cease smoking cigarettes, they increase exacerbation risk (Felker et al.,2018 ). As a long term smoker, Mrs. J should stop the habit while offering her the best solutions. According to the FDA, medications such as bupropion and nicotine replacement therapy can help such patients cases from using tobacco (Garcia -Aymerich,2019 ). Smokers who receive a combination of cessation medications and behavioral treatment have a higher chance of quitting smoking than their counterparts.
References
Felker, G. M., Lee, K. L., Bull, D. A., Redfield, M. M., Stevenson, L. W., Goldsmith, S. R., ... & Anstrom, K. J. (2018). Diuretic strategies in patients with acute decompensated heart failure. New England Journal of Medicine , 364 (9), 797-805.
Garcia-Aymerich, J., Farrero, E., Felez, M. A., Izquierdo, J., Marrades, R. M., & Anto, J. M. (2019). Risk factors of readmission to hospital for a COPD exacerbation: a prospective study. Thorax , 58 (2), 100-105.
Mosterd, A., & Hoes, A. W. (2017). Clinical epidemiology of heart failure. Heart , 93 (9), 1137-1146.
