Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.
Congestive heart failure is inability of the heart to keep up with the demands on it, with failure of the heart to pump blood with normal efficiency(Medicine Net, 2018). From the case scenario, Mrs. J. has history of hypertension, CHF and sleep apnea with subjective data of shortness of breath, anxiety and weakness. Objective data shows low blood pressure of 90/58, SPO 82%, HR 118 irregular and pulmonary crackles and atrial fibrillation.
Nursing intervention appropriate for Mrs. J at the time of admission are as follows;
- Obtain patient vital signs, administer oxygen to increase oxygen saturation and blood supply to the body.
- Listen to breath sounds and place patient in upright position to decrease pulmonary congestion and enhance breathing.
- Restrict salt intake. (NRSNG) This is important because Sodium helps to retain fluid in the body there by increasing blood pressure. Retricting it will prevent fluid retension.
- Maintain strict intake and out put.
- Monitor heart rate rhythm with 12 lead ECG.
- Educate patient on diet, fluid restriction and compliance.
- Administer Lasix to help get rid of salt in the body
- Assist with feeding and activity of ADLs.
B. Rationals for administrating the following medication to Mrs J.
1. I/V Lasix. Furosemide is loop diuretic, Mrs. J. has pulmonary crackles secondary to congestion as a result of heart failure. Lasix administer to her will prevent the absorption of salt in the body and blocks the absorption of sodium, chloride and water resulting to increase urine output(MedicineNet).
2. Enalapril. Enalapril is angiotensin converting enzymes. It blocks the substances in the body that makes blood vessels to tighten thus relaxing blood vessels and promote blood and oxygen supply to the heart.
3. Metoprolol is a beta blocker. It work by relaxing blood vessels. slow heart rate, promote blood flow and lower blood pressure.
4. I/V Morphine. This is a narcotic. It helps to relax patient and reduce work load of the heart.
C. Four Cardiovascular conditions that may lead to heart failure.
According to American Heart Association, four cardiovascular condition that can lead to heart failure are;
- Coronary artery disease. ” when cholesterol and fatty deposits build up in the heart,s arteries, less blood can reach the the heart muscles(American Heart Association) The deposit of these fats overtime obstruct blood flow to the heart and the heart will be pumping hard that may result to heart failure. Nursing interventions includes includes health education to the public on smoking cessation, eating healthy diet and exercisers.
- High blood pressure. When blood pressure is not control, it may result to heart failure. “when pressure in the vessels is too high, the heart must pump harder than normal to keep the blood circulating” (American Hearth Association) This overtime weakens the heart chamber resulting to heart failure.
Nursing interventions includes;
1. Check blood pressure
2. Ensure low salt intake, good exercise and physical activities and smoke cessation to prevent constriction of blood vessels.
3. Reduce stress as much as possible.
4. Health education should be given to client on advantages of compliance in taking prescribed medications.
- Obesity. According to American Heart Association, can cause the heart to work harder resulting to heart failure.
- Sleep Apnea. This is a life threating sleep disorder.” pause breathing can contribute to severe fatigue during the day, can result to hypertension, heart failure(American Heart Association). Nursing intervention include include using CPAP at bedtime and also conducting to determine if patient needs other interventions.
Interventions that can help to prevent problems caused by multiple drug interactions in older patients.
Health education should be given to patients on the use of 7-day pill boxes and daily pill boxes to enhance compliance and to keep accurate list of medication taken.
Furthermore, older patient should be encourage to disclose supplementary medications they are taken to their primary care physician so as to prevent drug interactions and complications. Older patients should be reminded not to share drugs or take medications not given to them by their doctor.
Finally, proper and accurate list of medication and limiting the number of providers will help to prevent problem with drug interaction in older patients.
American Heart Association. Causes of heart failuree. Retrieved from.