Nursing intervention
On admission of the patient to the hospital, several interventions will be conducted to help analyze the client's conditions. First, I will review Mrs. J conditions by comparing with other set factors and conditions that stress the heart. If Mrs. J has acute and chronic diseases, the circulation of the blood in the heart may be compromised due to the excessive demand on the heart. Secondly, I will check the client's laboratory data such as cardiac markers, complete blood cell count, creatinine, ABG's. Through monitoring these elements, a clear identification of contributing factors to the client's condition will be noted. The next step involves monitoring and recording BP levels. This process will include measuring both arms and legs of the patient while at rest, then sitting and finally while standing over an interval of four minutes between tests. This process will give a clear picture of vascular involvement and the scope of Mrs. J problem. Severe hypertension is realized when diastolic pressure elevates to 110mmHg. Lastly monitoring of auscultate heart tones and breathing sound of Mrs. J is crucial. This process will help in monitoring the severity of the patient's condition. The presence of crackles and wheezes in Mrs. J breath indicates congestion in the pulmonary which may result in a series of diseases including chronic heart failure. It also helps in determination of S3 and S4 sounds which assist in determining the level of severity of the patient's condition. Another intervention involves observing the Mrs. J skin color, moisture, and temperature that may indicate cardiac decompensation or decreased output.
IV Furosemide (Lasix)
Lasix comes in a variety of forms including; tablets (20, 40 and 80mg), oral solution (10mg/ml, 40mg/5ml) and injection (10mg/ml). For hypertension client like Mrs. J 40mg bid PO will be administered. Additional ant hypersensitive agents may be added during the administration of the drug. Lasix is administered to patients having heart failure. It helps remove excess fluid out of the system. High fluid levels in the system increase the heart workload and resistance. Removal of excess fluids will help reduce hypertension condition.
Enalapril (Vasotec)
Enalapril comes in a variety of tablets ranging from 2.5mg, 5mg, 10mg and 20mg. These tablets are used for oral administration. Vasotec helps reduce hypertension or prevent heart failure. This drug inhibits the creation of angiotensin 2. This is achieved by blocking angiotensin-converting enzyme. Through inhibiting the enzymes, the blood vessels are widened and as a result, reduce the amount of water put back in your blood from the kidney. It is usable with other drugs such as hydrochlorothiazide. The reduction of fluid in the body helps reduce heart-related complications.
Metoprolol (Lopressor)
Metoprolol is used alongside other drugs to treat high blood pressure. However, the drug can be used independently without the need of other drugs. This drug lowers the blood pressure, as a result, prevents kidney problems and heart attack. Also, the drug can treat chest pains and improve conditions after a heart attack. The drug blocks the action of epinephrine on heart and blood vessels. The inhibition of natural chemical results in lowering of heart rate, blood pressure and strain on the heart.
Morphine
Morphine is used to treat severe pain in the body. It is administered under the skin or into a blood vein. It acts on a given portion of the brain to offer pain relief for the patient. Morphine is a narcotic pain reliever. In some cases, the drug injection occurs around the spinal cord or the fluid space that encompass the spinal code.
Cardiovascular conditions that may lead to heart failure
Heart valve problem
This issue occurs when the valves do not open wide enough to allow blood to flow through the valve. This condition is known as stenosis. Regurgitation is a condition where the valves do not close well resulting in leakages. This condition leads to straining of the heart to pump blood resulting in heart failure.
Arrhythmia
This condition leads to the abnormal rhythm of the heart. This condition interferes with the heart beat making it slow, fast or irregular. The irregular heart rhythms affect how the heart functions. The patient that suffers from this condition may not pump enough blood required by the body resulting in heart failure. It involves measuring the heart's beats per minute.
Heart attack
A heart attack occurs when a section of the heart does not get sufficient oxygen. Coronary artery diseases are the primary cause of heart attack. Coronary heart disease results in the formation of wax like the structure of the arteries supplying blood to the heart which lead to blockage of the artery hence the insufficient supply of oxygen to the heart.
Stroke
A stroke occurs through interruption of blood flow to the brain. Blood clots in blood vessels prevent them from supplying blood to the brain and as a result cause stroke.
Prevention of the cardiovascular conditions
Heart valve problem can be corrected by repairing the blood tissues through surgery. Tissues are added to the arteries or removed and replaced. Also, doctors may prescribe medication that lowers blood pressure and cholesterol levels. Arrhythmia can be prevented by living a healthy life through the use of vitamin rich foods that will help develop the heart. Also, the patient suffering from Arrhythmia should avoid smoking, unnecessary stress, and caffeine intake. Medications are also available that stabilize the heartbeat. Heart attack and stroke are preventable through maintaining a good diet therapy, monitoring of an individual's weight, blood sugar level and cholesterol. Statin therapy is recommended for patients having these conditions.
Drug interactions
Several drugs react adversely when used with other drugs. It is always important to understand the various drugs and their interactions when used with others. It is, therefore, vital for a nurse to prevent polypharmacy among the elderly patients. Prevention of drug interactions is preventable through three core steps which include; instruction, information, and organization. Information involves discussing the patient the need to keep a list of all his medication both prescription and over the counter drugs. The patient should be advised to record medication name, dosage and dosing frequency. Patients should be taught about the medications prescribed and their adverse effects. Besides, each patient should be educated on the importance of visiting a health provider, and the need of taking the drugs on time as directed by the physician. On organization, the patient should be advised of the need to restrain from sharing drugs, storage of drugs in a cool location away from sunlight. These initiatives will help sensitize the patient on drug use preventing irresponsible use of medications that might cause severe interactions.
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