Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Health
History
Mrs. J. is a 63-year-old
married woman who has a history of hypertension, chronic heart failure, and
chronic obstructive pulmonary disease (COPD). Despite requiring 2L of
oxygen/nasal cannula at home during activity, she continues to smoke two packs
of cigarettes a day and has done so for 40 years. Three days ago, she had
sudden onset of flu-like symptoms including fever, productive cough, nausea,
and malaise. Over the past 3 days, she has been unable to perform ADLs and has
required assistance in walking short distances. She has not taken her
antihypertensive medications or medications to control her heart failure for 3
days. Today, she has been admitted to the hospital ICU with acute decompensated
heart failure and acute exacerbation of COPD.
Subjective
Data
1. Is very
anxious and asks whether she is going to die.
2. Denies
pain but says she feels like she cannot get enough air.
3. Says her
heart feels like it is “running away.”
4. Reports
that she is exhausted and cannot eat or drink by herself.
Objective
Data
1. Height
175 cm; Weight 95.5kg.
2. Vital
signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular:
Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses
are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates
a ventricular rate of 132 and atrial fibrillation.
4. Respiratory:
Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy
blood-tinged sputum; SpO2 82%.
5. Gastrointestinal:
BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications
administered through drug therapy control her symptoms:
1. IV
furosemide (Lasix)
2. Enalapril
(Vasotec)
3. Metoprolol
(Lopressor)
4. IV
morphine sulphate (Morphine)
5. Inhaled
short-acting bronchodilator (ProAir HFA)
6. Inhaled
corticosteroid (Flovent HFA)
7. Oxygen
delivered at 2L/ NC
Critical
Thinking Essay
In 750-1,000 words,
critically evaluate Mrs. J.’s situation. Include the following:
1. Describe
the clinical manifestations present in Mrs. J.
2. Discuss
whether the nursing interventions at the time of her admissions were
appropriate for Mrs. J. and explain the rationale for each of the medications
listed.
3. Describe
four cardiovascular conditions that may lead to heart failure and what can be
done in the form of medical/nursing interventions to prevent the development of
heart failure in each condition.
4. Taking into
consideration the fact that most mature adults take at least six prescription
medications, discuss four nursing interventions that can help prevent problems
caused by multiple drug interactions in older patients. Provide a rationale for
each of the interventions you recommend.
5. Provide a
health promotion and restoration teaching plan for Mrs. J., including
multidisciplinary resources for rehabilitation and any modifications that may
be needed. Explain how the rehabilitation resources and modifications will
assist the patients’ transition to independence.
6. Describe
a method for providing education for Mrs. J. regarding medications that need to
be maintained to prevent future hospital admission. Provide rationale.
7. Outline
COPD triggers that can increase exacerbation frequency, resulting in return
visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what
options for smoking cessation should be offered.
You are required to cite to
a minimum of two sources to complete this assignment. Sources must be published
within the last 5 years and appropriate for the assignment criteria and
relevant to nursing practice.
Prepare this assignment
according to the guidelines found in the APA Style Guide,

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