Question Description

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

Immediate nursing interventions for the patient include monitoring the patient’s airway, administering oxygen and calling a respiratory therapist to ensure the best oxygen delivery for the patient. This may also alleviate her anxiety, since oxygen deprivation increases anxiety. (Copstead & Banasik, 2013). The next interventions should include calming the patient and providing a quiet environment. This may help her to slow her breathing and improve oxygen exchange. Ensuring the patient is in an upright position allows blood to pool in the extremities, reducing pulmonary hydrostatic pressure and congestion (Copstead & Banasik, 2013). Monitor vital signs and lab results. Continue to assess heart sounds and lung sounds, as well as peripheral pulses and mental status. Measure input and output to monitor the patient’s kidney function. Educate patient on prescribed medications and treatments. Weigh patient daily. (Gulanick & Myers, 2007).

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Medications and rationale:

IV furosemide (Lasix)- This medication is used to reduce overall fluid volume and enhance sodium and water excretion. This will help her to get fluid off of her lungs and increase breathing ability.

Enalapril (Vasotec) – This medication is an ACE inhibitor. This medication will relax the blood vessels and increase the blood supply to the heart and other vital organs.

Metoprolol (Lopressor)- This medication is a beta-blocker and it will slow the heart rate while allowing it to pump more efficiently.

IV Morphine Sulfate (Morphine)- This medication will treat pain, induce respiratory relaxation and assist with dyspnea by providing a calming effect.

(Gulanick & Myers, 2007)

Four conditions that may lead to heart failure include coronary artery disease, hypertension, hyperthyroidism and cardiomyopathy.

In coronary artery disease, plaque grows on the inside of arterial walls until blood flow to the heart is restricted. Interventions to prevent HF from developing would be to educate patients on working to eliminate risk factors such as living a healthy lifestyle, taking prescribed medications, cease smoking, and weight management (American Heart Association, 2019).

In hypertension, elevated blood pressure puts pressure on your blood vessels and damages your circulatory system. Similar to CAD, a healthy lifestyle and prescribed medications can help manage hypertension (American Heart Association, 2019).

Hyperthyroidism is a disease of the thyroid and can cause atrial fibrillation. A-fib can lead to heart failure, blood clots, and stroke. Taking medication to manage hyperthyroidism or having a thyroidectomy can help eliminate risks of developing heart failure (American Heart Association, 2019).

In cardiomyopathy, the heart muscle is enlarged and unable to pump blood adequately to the body. Treatments include lifestyle changes, medications, surgery, and implanted devices to control dysrhythmias (American Heart Association, 2019.)

Preventing multiple drug interactions:

Nurses can identify patients who might be at increased risk for drug interactions due to polypharmacy such as the elderly. For the elderly, nurses can teach them how to keep an up-to-date list of all of their medications and dosages and call their pharmacist if they have a question. Other interventions include educating all patients on medications and their expected side effects and the importance of taking them exactly as directed. It is important they let their doctor know about any over the counter medication they take such as aspirin, ibuprofen, or tylenol as these may interact with their prescriptions. (Woodruff, 2010).

References:

American Heart Association. (2019). Congestive Heart Failure. Retrieved from

https://www.heart.org/en/health-topics/heart-failure
 
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