NRS 410 Case Study: Mrs. J.
Grand Canyon University NRS 410 Case Study: Mrs. J.-Step-By-Step Guide
This guide will demonstrate how to complete the NRS 410 Case Study: Mrs. J. assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRS 410 Case Study: Mrs. J.
Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 410 Case Study: Mrs. J. depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRS 410 Case Study: Mrs. J.
The introduction for the Grand Canyon University NRS 410 Case Study: Mrs. J. is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRS 410 Case Study: Mrs. J.
After the introduction, move into the main part of the NRS 410 Case Study: Mrs. J. assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRS 410 Case Study: Mrs. J.
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRS 410 Case Study: Mrs. J.
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRS 410 Case Study: Mrs. J.
The case scenario discussed is of 63-year-old Mrs. J who has been in care for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) and is now admitted due to their exacerbations. She reports a history of cigarette smoking, hypertension, poor compliance to medication, and a recent upper airway tract infection. This discussion aims to describe how she was managed, the reasons for exacerbation, and patient management plans.
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.
Question 1
COPD that Mrs. J is characterized by an inflamed airway that impairs expiration of gases thus presenting with dyspnea. The limited expiration results in the accumulation of carbon (IV) oxide in the body which triggers anxiety (Choi & Rhee, 2020). On the other hand, CHF reduces the heart’s ability to pump blood thus irregular heartbeat occurs described as the heart running away (Schwinger, 2021). It also presents with fatigue due to impaired blood supply to the body tissues (Hajar, 2019).
Question 2
Medications that have been administered to manage Mrs. J can be justified due to their effects. Furosemide and enalapril work through a different mechanisms of action to reduce the decompensation of the heart in CHF (Hajar, 2019). Although furosemide encourages diuresis by inhibiting the reabsorption of sodium in kidney tubules whereas enalapril inhibits the renin-angiotensin-aldosterone system (RAAS), they both lead to a decrease in preload and afterload (Lee et al., 2019). This reduces pressure against the heart and also corrects the reported edema especially due to furosemide use.
Metoprolol that was prescribed regulates the sympathetic system activation in heart failure thereby reducing the cardiac contractility and heart rate (Hajar, 2019). As such, it corrects the reported palpitations. Further, the inhaled bronchodilators and corticosteroids correct the bronchoconstriction due to COPD thus promoting expiration whereas morphine helped in reducing anxiety symptoms (Lief & McSparron, 2020). Due to Mrs. J’s low oxygen saturation, oxygen supplementation was also necessary to reverse the hypercapnia and promote oxygen delivery to tissues (Choi & Rhee, 2020). The prescribed drugs were therefore justified and appropriate for managing the exacerbations.
Question 3
CHF results from most heart conditions whether they affect the valves, heart muscles, or the electrical conduction pathways. Some of these conditions include cardiomyopathy, valvular defects, coronary artery disease (CAD), and arrhythmias. Cardiomyopathy is where there is damage to the myocardium due to a myriad of factors including alcohol use and it consequently impairs the heart’s ability to pump blood (Hajar, 2019). Valvular defects whether resulting from infection of the valves, stenosis, or regurgitation are also implicated (Lee et al., 2019). CAD where there are narrowed coronary artery vessels with consequential cardiac ischemia as well as arrhythmias where the is uncoordinated heart beating such as atrial fibrillation are other risk factors for CHF (Schwinger, 2021). Most of these conditions can be prevented from resulting in CHF.
Different nursing interventions can help in preventing CHF from these cardiac conditions. Such measures include the adoption of physical exercise and dietary modification for CAD, reduced alcohol consumption for cardiomyopathy, and aggressive antibiotic therapy to prevent the advancement of valvular infection into CHF (Lee et al., 2019). Non-pharmacological vagal maneuvers may be applied to correct arrhythmias.
Question 4
Nurses play important roles in preventing adverse reactions to polypharmacy. They achieve this through education, instruction, information, and organization. Education involves highlighting the presentation of adverse reactions and warning the patient about drugs or food that possibly interact with their prescribed medications (Zabihi et al., 2018). By instruction, adherence to therapy is emphasized to prevent incidences of overdose which is an adverse reaction. During instruction, the nurse directs the patient to reliable sources of medicine to ensure continuity of therapy (Lief & McSparron, 2020). On the other hand, the organization is done by arranging the drug into daily pill packs that promote adherence and discourages overdose.
Question 5
Health promotion in a patient with COPD and CHF will aim at reducing readmission rates and facilitating recovery. To reduce the readmissions, the risk factors of exacerbation such as unhealthy diet, cigarette smoking, and obesity should be addressed. Mrs. J will therefore be encouraged to reduce her weight, adopt the DASH diet, and also engage in physical activity (Hajar, 2019). She will also be advised against cigarette smoking which may worsen COPD. In the promotion of her recovery, the patient will benefit from a multidisciplinary team comprised of pulmonologists and cardiologists who will educate her on pulmonary physiotherapy, cardiac rehabilitation, and adherence to medication (Schwinger, 2021). Homebased care can also be adopted to promote her well-being at home. These measures will enhance recovery and reduce the risks of readmission.
Question 6
Mrs. J is a geriatric patient who will benefit from proper education on her condition. Given most geriatric patients have poor literacy that may enable the comprehension of complex medical information during education, an effective education would involve the use of diagrams and charts for illustrations (Lee et al., 2019). This not only promotes comprehension but also encourages memorability. Adoption of family education can also be encouraged to promote the involvement of family members in patient care (Toledano-Toledano & Luna, 2020).
Question 7
Some of the factors that may have exacerbated the COPD in this patient would include the history of cigarette smoking and the recent flu-like illness that is reported. These triggers cause airway hyperresponsive and worsen bronchoconstriction, especially in COPD and asthma patients (Lief & McSparron, 2020). Other possible causes of the exacerbation may include exposure to cold, air pollution, and non-adherence to medications. Smoke cessation would therefore be encouraged for patients with COPD who smoke a cigarette. The options to encourage cessation of smoking include nicotine replacement therapy, use of bupropion, as well as psychotherapy such as group therapy (Choi & Rhee, 2020). These methods help in reducing cravings for smoking thus promoting recovery.
Conclusion
Chronic illnesses such as COPD and CHF have underlying organ dysfunctions that are responsible for their presentation. Understanding these dysfunctions as well as their causes and triggers helps in the formulation of effective strategies for managing patients against these conditions. The use of medications should be aimed at addressing the dysfunction or patient symptoms. In the course of treatment, adherence to therapy should be encouraged as the incidences of adverse drug reactions are reduced. Further, the specific risk factors of the conditions should also be addressed by encouraging health promotion strategies such as a healthy diet, smoke cessation, and physical exercise. This would reduce incidences of readmission for these patients and promote patient recovery.
References
Choi, J. Y., & Rhee, C. K. (2020). Diagnosis and treatment of early chronic obstructive lung disease (COPD). Journal of Clinical Medicine, 9(11), 3426. https://doi.org/10.3390/jcm9113426
Hajar, R. (2019). Congestive heart failure: A history. Heart Views: The Official Journal of the Gulf Heart Association, 20(3), 129–132. https://doi.org/10.4103/HEARTVIEWS.HEARTVIEWS_77_19
Lee, J. H., Kim, M. S., Yoo, B. S., Park, S. J., Park, J. J., Shin, M. S., Youn, J. C., Lee, S. E., Jang, S. Y., Choi, S., Cho, H. J., Kang, S. M., & Choi, D. J. (2019). KSHF guidelines for the management of acute heart failure: Part II. Treatment of acute heart failure. Korean Circulation Journal, 49(1), 22–45. https://doi.org/10.4070/kcj.2018.0349
Lief, L., & McSparron, J. (2020). Acute Exacerbation of COPD. In Evidence-Based Critical Care (pp. 169–173). Springer International Publishing.
Schwinger, R. H. G. (2021). Pathophysiology of heart failure. Cardiovascular Diagnosis and Therapy, 11(1), 263–276. https://doi.org/10.21037/cdt-20-302
Toledano-Toledano, F., & Luna, D. (2020). The psychosocial profile of family caregivers of children with chronic diseases: a cross-sectional study. BioPsychoSocial Medicine, 14(1), 29. https://doi.org/10.1186/s13030-020-00201-y
Zabihi, A., Hosseini, S., Jafarian Amiri, S., & Bijani, A. (2018). Polypharmacy among the elderly. Journal of Mid-Life Health, 9(2), 97. https://doi.org/10.4103/jmh.jmh_87_17
Sample Answer 2 for NRS 410 Case Study: Mrs. J.
The case scenario concerns Mrs. J., a 63-year-old female with hypertension, chronic heart failure, and COPD. She usually uses 2L of oxygen at home during activity but has persisted in smoking cigarettes 2PPD for the last 40 years. The purpose of this paper is to analyze the patient’s condition.
Clinical Manifestations of Patient
The patient’s subjective findings include fever, nausea, productive cough, malaise, inability to perform ADLs, anxiety, palpitations, dyspnea, and fatigue. Objective findings include obesity (BMI-31.2), mild fever, low blood pressure, tachypnea, and tachycardia with irregular heart rhythm. In addition, the patient has jugular vein distention, distant heart sounds, S gallop, faint PMI at sixth ICS, and atrial fibrillation. Respiratory findings include frothy blood-tinged sputum, reduced breath sounds, pulmonary crackles, and SpO2 82%. GI findings include hepatomegaly.
Cardiovascular Conditions in Which Mrs. J Is At Risk
The patient’s obesity increases the risk of Coronary Artery Disease (CAD), which causes heart failure (HF) when cholesterol and fat deposits accumulate along the arteries obstructing myocardial blood flow. HF can be prevented in patients with CAD by administering lipid-lowering agents and lifestyle modification to lower cholesterol levels. Atrial fibrillation (AF) causes increased resting heart rate and an exaggerated heart rate response to exercise, causing a reduced diastolic filling time and eventually reduced cardiac output that causes HF (Schwinger, 2021). Lifestyle modification and maintaining optimal blood pressure can prevent the progression of AF to HF. Stroke induces cardiac damage like ventricular wall motion defects that increase the risk of HF. Cardiac damage can be prevented by controlling BP through antihypertensives and lifestyle modification. Myocardial infarction (MI) causes myocardial damage, stunning, and necrosis that impairs the heart’s contractility resulting in heart failure (Schwinger, 2021). HF in patients with MI can be mitigated by administering ACE inhibitors to decrease cardiac output and avoiding high-intense activities that increase oxygen demand.
Evaluation of Nursing Interventions at Admissions
The interventions during the admission of Mrs. J. included the administration of IV Lasix, Vasotec, Lopressor, IV Morphine, inhaled ProAir HFA, Flovent HFA, and oxygen via nasal cannula. The appropriate interventions included IV Lasix, ProAir HFA, and oxygen therapy. Lasix was appropriate because it alleviates symptoms of pulmonary congestion like cough, frothy sputum, palpitations, pulmonary crackles, and jugular vein distention (Oparil et al., 2019). ProAir HFA was also appropriate because it relieves COPD exacerbations, which would increase perfusion and alleviate dyspnea.
Oxygen therapy was ideal for improving the oxygen saturation levels to above 95%. Vasotec and Lopressor were inappropriate because they lower BP, which would worsen the patient’s low BP (Oparil et al., 2019). Furthermore, Morphine was unsuitable because it causes respiratory depression, which would worsen the patient’s breathing difficulties. Flovent HFA was inappropriate during admission since it is indicated for long-term COP maintenance to prevent exacerbations.
Nursing Interventions for Older Patients to Prevent Problems Caused by Multiple Drug Interactions
Lasix is a loop diuretic that facilitates water and sodium excretion by interfering with the chloride-binding cotransport system. This hinders the reabsorption of sodium and chloride in the ascending loop of Henle, and distal renal tubule, and lower preload in CHF (Oparil et al., 2019). Vasotec hinders the conversion of angiotensin I to angiotensin II, causing elevated plasma renin levels and reduced aldosterone secretion. This lowers blood pressure and improves HF symptoms. Lopressor is a selective beta-1-adrenergic blocker that competitively blocks beta1-receptors at low doses and blocks beta2-receptors at higher doses (Oparil et al., 2019). It is used in HF because it lowers cardiac output through negative inotropic and chronotropic effects.
Morphine is an opioid analgesic that blocks the ascending pain pathways altering pain response. It produces analgesia, sedation, and respiratory depression. ProAir HFA is a Beta 2 Agonist that relaxes bronchial smooth muscles and is indicated to alleviate acute bronchospasms (Nici et al., 2020). Flovent HFA is an inhalant corticosteroid with an anti-inflammatory effect on eosinophils, neutrophils, macrophages, lymphocytes, mast cells, and mediators
Older adults are significantly affected by multiple drug interactions due to polypharmacy since they have comorbid health conditions. Nursing interventions to prevent drug interactions include medication reconciliation, which entails identifying and documenting all drugs a patient takes and comparing the list with the physician’s orders (Kurczewska-Michalak et al., 2021). The nurse can also note a patient’s coexisting conditions and medications and assess the possibility of resulting in adverse drug effects. In addition, the nurse should educate the patient on how to take the medications, including the medications, generic and brand names, indications, and potential side effects, and explain how long the medication will likely be taken (Kurczewska-Michalak et al., 2021). Furthermore, the nurse can regularly reevaluate the patient for the need to continue prescribed medications and inform the physician to stop those that are no longer necessary or medications with higher possible risks than benefits.
Health Promotion and Restoration Teaching Plan
The health promotion and restoration education plan for Mrs. J will focus on lifestyle modification to control BP, maintain a healthy weight, delay COPD progression, and prevent COPD exacerbations. Regarding COPD, Mrs. J will be educated on the benefits of smoking cessation and avoiding environmental pollutants to delay disease progression and prevent exacerbations. Physical exercises will further be emphasized to improve lung function (Burge et al., 2020). Health education to control BP will include engaging in moderate aerobic exercises at least 40 minutes daily to improve cardiovascular functioning, lower BP, and promote weight loss. In addition, she will be educated on a healthy diet and reducing caloric intake for weight loss and to lower BP.
A multidisciplinary approach will be needed for rehabilitation and will include pulmonary rehabilitation, nutritional counseling, education, and self-management. Pulmonary rehabilitation is a multidisciplinary intervention for COPD established to improve exercise tolerance, dyspnea, and health-related QoL (Young et al., 2021). Nutritional counseling by a dietitian is vital for COPD patients who are underweight or overweight. Education and self-management are vital aspects of the multidisciplinary approach. They involve educational sessions educating patients on the nature and course of COPD and how to live with the impact of the disease.
COPD Triggers and Options for Smoking Cessation
Mrs. J can be provided individual psychotherapy to help with smoking cessation and group-based behavioral counseling. Pharmacotherapy intervention for smoking cessation includes Nicotine replacement therapy (NRT). The patient can be administered nicotine transdermal patches, gum, lozenges, inhalers, or nasal spray (Krist et al., 2021). COPD triggers that can cause exacerbations and readmission include tobacco smoke, exposure to dust, and environmental pollutants like carbon monoxide, which cause bronchoconstriction.
Conclusion
Mrs. J has a risk of cardiovascular conditions like Coronary Artery Disease, Atrial fibrillation, Stroke, and Myocardial infarction. IV Lasix, ProAir HFA, and oxygen therapy were appropriate since they improve symptoms of pulmonary congestion and COPD exacerbations. However, Vasotec and Lopressor lower BP, which is unsuitable for the patient due to the low BP. Morphine would have caused respiratory depression, while Flovent HFA is indicated for long-term COPD maintenance and thus was inappropriate. The health education plan for Mrs. J focuses on lifestyle modification to control BP, promote weight loss, delay COPD progression, and prevent COPD exacerbations.
References
Burge, A. T., Cox, N. S., Abramson, M. J., & Holland, A. E. (2020). Interventions for promoting physical activity in people with chronic obstructive pulmonary disease (COPD). The Cochrane database of systematic reviews, 4(4), CD012626. https://doi.org/10.1002/14651858.CD012626.pub2
Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., … & US Preventive Services Task Force. (2021). Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. Jama, 325(3), 265-279. doi:10.1001/jama.2020.25019
Kurczewska-Michalak, M., Lewek, P., Jankowska-Polańska, B., Giardini, A., Granata, N., Maffoni, M., Costa, E., Midão, L., & Kardas, P. (2021). Polypharmacy Management in the Older Adults: A Scoping Review of Available Interventions. Frontiers in pharmacology, 12, 734045. https://doi.org/10.3389/fphar.2021.734045
Nici, L., Mammen, M. J., Charbek, E., Alexander, P. E., Au, D. H., Boyd, C. M., … & Aaron, S. D. (2020). Pharmacologic management of chronic obstructive pulmonary disease. An official American Thoracic Society clinical practice guideline. American journal of respiratory and critical care medicine, 201(9), e56-e69. DOI: 10.1164/rccm.202003-0625ST
Oparil, S., Acelajado, M. C., Bakris, G. L., Berlowitz, D. R., Cífková, R., Dominiczak, A. F., Grassi, G., Jordan, J., Poulter, N. R., Rodgers, A., & Whelton, P. K. (2019). Hypertension. Nature reviews. Disease primers, p. 4, 18014. https://doi.org/10.1038/nrdp.2018.14
Schwinger, R. H. G. (2021). Pathophysiology of heart failure. Cardiovascular diagnosis and therapy, 11(1), 263–276. https://doi.org/10.21037/cdt-20-302
Young, M., Villgran, V., Ledgerwood, C., Schmetzer, A., & Cheema, T. (2021). Developing a Multidisciplinary Approach to the COPD Care Pathway. Critical care nursing quarterly, 44(1), 121–127. https://doi.org/10.1097/CNQ.0000000000000345
Sample Answer 3 for NRS 410 Case Study: Mrs. J.
The registered nurse must demonstrate an understanding of the pathophysiology of different diseases, including the patient’s clinical presentation and the appropriate treatment approaches. This paper analyzes Mrs. J’s case scenario, describing her clinical manifestations and nursing interventions. It also discusses cardiovascular conditions that may cause heart failure, nursing interventions that prevent health problems caused by interactions of using multiple drugs, a health education plan for the client, and options for smoking cessation provided to the client.
Clinical Manifestations
Mrs. J has a history of chronic heart failure, hypertension, and chronic obstructive pulmonary disease (COPD). She has also been smoking for forty years despite requiring 2L oxygen supplementation through a nasal cannula. In the last three days, Mrs. J has developed flu-like symptoms such as productive cough, fever, nausea, and malaise. Over the same period, Mrs. J has been unable to perform activities of daily living (requiring help to walk over a short distance). She has not been taking her medications for hypertension or cardiac failure. She is currently diagnosed with acute decompensated heart failure and exacerbation of COPD and has been admitted to the intensive care unit.
Mrs. J is anxious and enquires whether she will die, reports an irregular and increased heartbeat, feelings of exhaustion, and inability to get enough air which renders her unable to feed or drink by herself. Objective assessment yields audible S3 heart sound, cough with blood-tinged sputum, hepatomegaly (4cm below her costal margin), and pulmonary crackles on auscultation. She also has decreased breath sounds, distant S1 and S2, bilateral jugular vein distension, and atrial fibrillation during initial cardiac monitoring. Vital signs are HR of 118, irregular, RR 34, T 37.6C, BP 90/58 mmHg, and an SPO2 of 82%.
Nursing Interventions and Rationale for Medications
The nursing interventions at the time of Mrs. J’s admission were appropriate and timely, including supplemental oxygen at a flow rate of 2L/minute and administration of medications. These were called for to address her vital signs that were not within the normal ranges (RR 34, HR 118 and irregular, SPO2 82%). Intravenous furosemide (Lasix) is a loop diuretic. Lasix prevents the reabsorption of chloride and sodium ions from the loop of Henle and the distal convoluted tubule (DCT) (Adams et al., 2018). Subsequently, the renal excretion of sodium, water, and other electrolytes increases, mobilizing excess body fluid and reducing the blood pressure (Khan et al., 2022). These effects will enable the enhancement of the patient’s irregular heart rate.
Angiotensin 2 is a potent vasoconstrictor. Enalapril, an angiotensin-converting enzyme (ACE), hinders the conversion of angiotensin 1 to angiotensin 2 (Smith & Pacitti, 2020). Therefore, enalapril is valid for Mrs. J as it will help reduce hypertension and heart failure symptoms. Metoprolol is a beta-blocker agent that blocks beta 1 (myocardial) adrenergic receptors, reducing the heart rate and blood pressure. Therefore, the drug is also essential in the patient’s regimen.
Morphine sulfate is an opioid analgesic. Morphine attaches to the opiate receptors in the central nervous system, altering pain perception and response (Adams et al., 2018). Adequate pain management is vital for optimal effects. Therefore, morphine is a credible component of the regimen. Albuterol (ProAir HFA) is a short-acting bronchodilator. It blocks beta-2 adrenergic receptors in the smooth muscles of the airways, causing bronchodilation and relaxation. Bronchodilation is therapeutic for the Mrs. J experiencing low SPO2, elevated respiration rate, and breathing difficulties.
Inhaled Flovent HFA is a corticosteroid. Adams et al. (2018) assert that the drug is an immune modifier and long-acting anti-inflammatory agent. Therefore, it prevents airway inflammation, easing breathing and improving Mrs. J’s condition. Oxygen supplementation was also an essential intervention to assist the patient meet the oxygen requirements for her body. The patient was experiencing low SPO2, tachypnea, and breathlessness, meaning she did not have an adequate respiratory exchange.
Cardiovascular Conditions Leading to Heart Failure
Valvular disease, chronic hypertension, cardiomyopathies, and coronary artery disease (CAD) are cardiovascular conditions that can cause heart failure. In CAD, plaque builds up on coronary arteries, reducing perfusion to the myocytes. Consequently, there is hypoxic tissue injury and myocyte death, causing heart failure. Managing CAD includes weight reduction, lipid-lowering agents such as statins, and appropriate dietary changes (Hinkle & Cheever, 2018).
Hypertension is elevated blood pressure and is managed through pharmacotherapy and lifestyle changes. These include reducing weight, physical activities, and reducing dietary sodium intake. Pharmacotherapy entails using different classes of drugs. These include beta-blockers (such as atenolol), vasodilators (such as calcium channel blockers such as nifedipine), diuretics (such as furosemide or hydrochlorothiazide), and ACE blockers (such as enalapril) (Khalil & Zeltser, 2020). Rational polypharmacy is used to inform drug combinations to minimize toxicities.
Valvular disease results from congenital causes or infections. Failure of the valves to close or open completely increases the workload on the heart muscles, which, if overwhelmed by the workload, myocardial infarction ensues, and the subsequent heart failure. Management includes surgical replacement of valves, healthy lifestyles, and medications that treat symptoms and delay further heart problems. For cardiomyopathies, combining Lasix, enalapril, and metoprolol is an ideal intervention that lowers blood pressure, prevents water retention, and maintains a regular heartbeat, ensuring the heart is not overwhelmed.
Interventions to Prevent Multiple Drug Interactions
Nursing interventions to assist patients prevent drug interactions include teaching and helping patients to maintain a record of all the drugs they are using (including herbal agents), instructing patients to take medications as prescribed, teaching them the side effects to expect and watch out for, and encouraging patients to have one primary caretaker (Rankin et al., 2018). Maintaining a drug log ensures clinicians do not prescribe medications that could cause interactions. Having a primary physician ensures the provider is well acquainted with the client’s condition.
Rehabilitation Resources and Modifications
The health promotion and restoration teaching plan for Mrs. J will focus on physical exercises, weight management, and dietary changes. It should also comprise an adherence and compliance plan to implement the health education given. Additionally, using a team of experts and specialists promotes quality of care, optimal outcomes, and the well-being of patients. Therefore, an integrated team of experts would collaborate to improve different components of the patients. The team should have a nurse, physician, social worker, counselor, and dietitian.
Teaching Method
Through patient education, nurses assist patients in taking a more active role and responsibility for their health. I would first assess what the patient knows regarding her health condition and management plan to demystify any misconceptions or misinformation. I would also use teaching posters to stimulate more memory. I would use the posters and teaching aids to demonstrate correct drug usage. Teaching would also focus on the symptoms she ought to watch out for. Lastly, I would request the client to give a recap of the components of health education. This would assist in identifying gaps and addressing them.
Smoking Cessation
Tobacco smoking is the single most significant factor in COPD development. Optimal management of COPD includes smoking cessation, pharmacotherapy, and lifestyle modifications. Smoking cessation options include using medications such as bupropion and nicotine replacement therapies such as nicotine patches (Sealock & Sharma, 2022). Additionally, the healthcare provider should encourage patients to delay their desires and avoid triggers. Encouraging the patient to engage in relaxation techniques and physical activities helps them avert their desire to smoke. Motivate the patients by regularly reminding them of the health benefits of resisting urges to smoke and smoking cessation.
Conclusion
Through the analysis of the provided case study, the paper offers more in-depth insights into managing cardiopulmonary complexities. The nurse plays a vital role in educating and teaching patients about all components of their conditions. The nurse should strive to improve their knowledge of the pathophysiology and management of different health conditions. This would enhance their professionality and ability to provide safe and high-quality patient care to attain their clients’ optimal health outcomes.
References
Adams, M., Carol Quam Urban, El-Hussein, M., Osuji, J., & King, S. (2018). Pharmacology for nurses: a pathophysiological approach. Pearson.
Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing. Lippincott Williams & Wilkins.
Khalil, H., & Zeltser, R. (2020). Antihypertensive Medications. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554579/
Khan, T. M., Patel, R., & Siddiqui, A. H. (2022). Furosemide. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499921/
Rankin, A., Cadogan, C. A., Patterson, S. M., Kerse, N., Cardwell, C. R., Bradley, M. C., Ryan, C., & Hughes, C. (2018). Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews, 9(9). https://doi.org/10.1002/14651858.cd008165.pub4
Sealock, T., & Sharma, S. (2022). Smoking Cessation. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482442/
Smith, B. T., & Pacitti, D. (2020). Pharmacology for nurses. Jones & Bartlett Learning.