COPD and Cardiovascular Conditions: Rationale for Medications - Essay Example

Mrs. J Case Study

Clinical manifestation of Mrs. J

As perceived in the case of Mrs. J has a merge of life-threatening diseases that involves congestive pulmonary disease (COPD), chronic heart failure, and hypertension. She is experiencing problems with high fever, productive cough, malaise, and nausea. She has been having difficulty performing ADLs for the past three days, and on walking short distances, she asked for help (fatigue). On examination, the vital signs were not within the normal range. On review of system, cardiovascular system, there is jugular vein distention because of high blood pressure, weak peripheral pulses, cardiac monitoring shows the signs of atrial fibrillation and ventricular rate of 132 hence shows the patient had heart failure. SPO2 of 82 % due to oxygen deprivation due to COPD and heart failure. Pulmonary crackles decreased breath sounds and coughing blood with blood-stained are as a result of COPD.

Nursing interventions administered at the time admission and rationale the medication

Throughout entry and before planning patient care, it is necessary to carry out a patient assessment, especially for the hospital admitted with life-threatening conditions like that of Mrs. J's case. Therefore, it is crucial to identify the aggravating factors, the causes, and the possible risk factors that may impact a person's living patterns and quality life. Having done an assessment from head to toe to note any abnormalities that include the review of systems. The presence of pulmonary crackles decreased breath sounds, and SPO2 of 82 % guide the nurse during admission to administer oxygen via nasal canular to increase the supply oxygen in the body because there was a high demand for oxygen less than body requirement. Weighing the patient's weight was necessary because the nurse will be able to monitor the patient's fluid overload daily. Taking the patient's vital signs was appropriate as it is used to track the abnormal patterns as it acts as a baseline record. Admitting the patient to ICU help to conserve patient energy as the nurses will help the patient to do her daily activities.

Rationale for medications

IV furosemide (Lasix)

It is loop diuretic drugs administered to patients with hypertension and heart failure to reduce pulmonary edema. This drug's rationale is to improve sodium excretion, water, chloride, and minerals such as calcium. It is used to treat heart failure in Mrs. J's case, thus treating pulmonary edema.

Enalapril (Vasotec)

This medication is used to treat hypertension and heart failure. its mechanism of action reduces afterload resistance due to vasodilation of peripheral vessels, hence lowering blood pressure, increasing cardiac output, and exercise tolerance. It is administered to treat heart failure in Mrs. J's case.

Metoprolol (Lopressor)

It is a beta-blocker medication used in treatment in hypertension and heart failure. It reduces cardiac output and increased peripheral resistance. It is administered to control hypertension and heart failure. It is used to control heart failure due to clinical manifestations of heart failure seen in Mrs. J.

Iv morphine sulfate (Morphine)

Opioids used in the management of severe pain that the patient cannot tolerate are used to numb the pain. Although the patients deny pain, she is restless, and of course, morphine is administered due to heart failure and COPD.

Inhaled short-acting corticosteroids (ProAir HFA)

It is used to treat COPD by reducing the inflammation, swelling, and reducing mucous productions of the lining. It is used in the treatment of COPD in Mrs. case due to inflammation of the airway lining.

Inhaled corticosteroid (Flovent HFA)

It is used in the treatment of COPD by reducing the inflammation, swelling, and reducing mucous productions of the lining (Müllerova et al.,2015). It is used in the treatment of COPD in Mrs. case due to inflammation of the airway lining.

Oxygen therapy supplementation

It is used to increase the oxygen saturation level for the patient who has low oxygen concentration. The patient has difficulty breathing hence oxygen supplementation.

Cardiovascular conditions that can lead to heart failure and its prevention

High blood pressure

Uncontrolled blood pressure will quickly lead to congestive heart failure since when the BP is high, and the heart needs to pump blood at harder to compensate, thus making the cardiac weaker (Mozaffarian et al.,2016). The nurse's intervention includes teaching the patients on the importance of treatment and taking encouraging them to take medications even if they show no symptoms. The nurse should also check the patient's BP to see whether they are within the normal range as per the protocol requirement.

Previous heart attack

It occurs as a result of the blockage of an artery that supplies blood to all body organs. Hear failure chip in when the heart muscles are weakened because the heart pumps blood at a higher rate than usual to compensate. The nursing intervention involves educating the patients on the impending signs of a heart attack so that they can visit the hospital as soon as possible.

Abnormal heart valves

Infection of heart valves as a result of endocarditis or a congenital disability can result in heart failure. The nursing intervention involves administering antibiotics to treat endocarditis and, observing hygiene and correcting congenital disabilities at birth.

Coronary artery disease

When there is a history of the previous blockage of an artery by a plague due to the accumulation of fatty and cholesterol substances can lead to heart failure. The nursing intervention involves encouraging the patients to exercise at least 30 minutes per day and compliance with the prescribed medication.

Nursing interventions that can be helpful for adults with multiple drugs interaction and their rationale

First, encouraging and aiding the patient to keep all the records concerning all the medications given, by doing so, will help reduce many drug ordering that might have drug interactions. Second, the nurse should educate the patient on the need to select primary physicians. Having one physician will help to reduce cases of polypharmacy (Fick et al.,2015). Third, educating the patients on the possible interactions of herbal drugs, the patient should be aware of the habit of not mixing herbal and clinical medication. Lastly, educating the patient on the patient on the importance of adhering to the prescribed dosage will ensure the patient is the appropriate dose hence proper drug interaction.

Health promotion and rehabilitation for Mrs. J

Mrs. J's conditions are acute and chronic conditions that affect older adults like her. Through health promotion and improvement, she will come out of the hardest situation with a multidisciplinary team and family support. Community based-care is the best technique for helping adult people who suffer from attacks from chronic disease. Therefore, enrolling Mrs. J in-home hospital care will aid in teaching her on the importance of quitting smoking and how it is harmful to her health with the help of other medical practitioners from a different department. The patient will participate in smoking therapy, where it helps one to stop smoking gradually.

Method of providing education to Mrs. regarding medications that need to be maintained

First, using visualizing aid when explaining the drugs to the patient will help increase knowledge and understanding of the proper treatment. Second is stimulating a patient's interest; this can be achieved by establishing patient rapport; hence the patient will be free to ask any question concerning the medication that has been prescribed, thus improving compliance. Third, involving the family, with the help of the family, the patient will be able to adhere to the treatment due to close supervision. Last but least, considering the patient's strengths and weaknesses for successful compliance, the nurse should have full knowledge of the patient's mental and physical abilities.

Outline triggers that can increase COPD resulting in frequent visits

If Mrs. Continues smoking and failure to comply with the prescribed medication will lead to regular visits due to COPD. Exposure to allergens such as air pollution and cold weather will lead to the development of the disease; hence the patient should keep warm (Müllerova et al.,2015). I can advise her to use nicotine replacement patches as this will help to quit smoking effectively and safer manner.