Evaluating a Health History and Medical Information

Evaluate the Health History and Medical Information for MRS.J
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Evaluate the Health History and Medical Information for MRS.J
Clinical Manifestations present in Mrs.J
Mrs.J has a spectrum of symptoms, including fever, nausea, malaise, shortness of breath and productive cough. These symptoms reflect COPD exacerbation. The symptoms associated with COPD exacerbations are increased breathlessness, sputum volume, and sputum purulence (Agustí et al.,2014). She has unable to perform activities of daily living which illustrates impaired cardiorespiratory respiratory functioning. The symptomatology, in this case, denotes exacerbated COPD and decompensated heart failure. In addition, she has irregular tachycardia, tachypnoea and hypotension, as evidenced by a pulse rate of 118, respiratory rate of 34 and BP of 90/58mmg.S1, S2 and S3 are presents, though distant. The point of maximal impulse ( PMI) is a sixth intercostal space (ICS) while noting the location of PMI is usually fifth (ICS), which may suggest ventricular enlargement. Clinically, her jugular vein is distended, and cardiac ventricular monitoring shows a ventricular rate of 132 and atrial fibrillation. The jugular distention may suggest right heart failure.
She has pulmonary crackles, diminished breath sound, bloody sputum, and hypoxia shown by SPO2 82%. Crackles (rales), excessive fluid or secretions in the airways, and a decreased breath sounds can suggest increased fluid buildup in the lungs resulting from pneumonia, heart failure, and pleural effusion. In addition, the presence of hypoxia illustrates already deteriorating tissue perfusion and oxygenation.
Discuss whether the nursing interventions at the time of her admission were appropriate for Mr.s J and explain the rationale of each listed medication
Iv Furosemide:
IV furosemide is a loop diuretic for managing fluid overload or edema. Furosemide is approved for treating conditions associated with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure (Khan, Patel & Siddiqui, 2021). Therefore, this drug is appropriate in treating Mrs.J, who has fluid overload occasioned by heart failure. In patients having acute decompensated heart failure (ADHF) with volume overload who haven’t received diuretics previously, the initial dose of furosemide should be 20 to 40 mg intravenously can be administered (Khan, Patel & Siddiqui, 2021).
Enalapril:
Enalapril can treat heart failure and asymptomatic left ventricular dysfunction through its dilatory effects. Inhibition of the renin-angiotensin system (RAS) by angiotensin-converting enzyme (ACE)-inhibitors such as enalapril is one of the primary treatment approaches to heart failure (Sun,2016). However, enalapril might be the best option for increased ejection fraction, stroke volume, and decreased mean arterial pressure when considered, but it may lead to cough, gastrointestinal discomfort (Sun,2016).
Metoprolol (Lopressor):
Metoprolol is a beta-blocker. It is often used rate control in patients with atrial fibrillation (AF) and heart failure (HF), showing improved mortality benefits (Pandher et al.,2017).
IV Morphine Sulphate:
Morphine sulphate relieves moderate to severe pain that is not responsive to nonopioid analgesics. Acute pulmonary edema has considerable mortality. Morphine has been in use for a long time in treating patients with acute pulmonary edema. Morphine sulphates have anxiolytic and vasodilatory properties, which can control pulmonary edema (Agewall,2017). Thus, this drug is necessary.
Inhaled short-acting bronchodilator and Inhaled Corticosteroid:
An inhaled short-acting bronchodilator is a necessary medication because it will help open the airway and relieve symptoms of difficulty in breathing or shortness of breath. In addition, inhaled corticosteroids will help manage inflammatory cascades during COPD exacerbation.
Oxygen Delivered at 2L/NC
Mrs.J has hypoxia, as evidenced by low SPO2 levels. Thus, supplemental oxygen is appropriate.
Description of four cardiovascular disorders leading to heart failure and prevention methods of heart failure
High blood pressure:
High BP can lead to heart failure. High blood pressures destroy cardiac muscle due to the increased need to pump more due to increased peripheral vascular resistance. Heart failure caused by hypertension can be prevented by controlling or managing property blood pressures.
Emphysema/lung disease such as COPD;
In severe cases of COPD can cause right-sided heart failure because COPD can occasion low oxygen levels, which leads to a rise in blood pressure in the arteries of the lungs, which is referred to as pulmonary hypertension. Pulmonary hypertension is one of the critical precursors to heart f...