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APA
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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Topic:

Cardiorespiratory Complexities:Clinical Manifestations & Nursing Interventions

Case Study Instructions:

Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
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.
Subjective Data
Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is "running away."
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data
Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications administered through drug therapy control her symptoms:
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.'s situation. Include the following:
Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients' transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.'s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Case Study Sample Content Preview:

Cardiorespiratory Complexities
Student Full Name
Institutional Affiliation
Course Full Name
Professor Full Name
Due Date
Cardiorespiratory Complexities
Clinical Manifestations
Based on the information presented, it is clear that Mrs. J. was previously diagnosed with cardiovascular diseases, such as acute heart failure, hypertension, and chronic obstructive pulmonary disease (COPD). In this regard, there was a regular increase in her body temperature. Although the patient required 2L of oxygen and nasal cannula, she was a serial smoker for 40 years. There were also complaints related to productive coughs, nausea, and malaise. The cause also showed that she could never perform ADLs and needed assistance for walking over short distances. Another clinical manifestation reported is that Mrs. J. has never been able to take her medications to control or mitigate risks of heart failure for about three days (Guazzi & Naeije, 2017). The client is also very anxious and restless, which explains why she feels like she will die. Another aspect is that Mrs. J. denies pain. She feels like she cannot get sufficient air. The patient also reports that she feels exhausted and unable to drink or eat on her own.
Nursing Interventions
It was important for the nursing practitioners to undertake a comprehensive assessment of the patient. This was essential to establish the fundamental challenges experienced by the patient. On the other hand, it is also crucial to have a systematic assessment before the heart failure problems are addressed. The approach involved identifying the fundamental factors leading to heart failure as well as the potential risk factors. Moreover, the systematic assessment would reveal the patient's current status, aggravating factors, and the patient's lifestyle. In this regard, nurses must assess Mrs. J., plan and implement appropriate interventions, and undertake comprehensive patient education concerning the issues emerging (Rice et al., 2018). It is also vital to assess the heart rate and consider incentives to restore the speed to normal.
The evaluation may include noting the heart sounds, assessing the rhythm and vibrations. The nurses must also monitor the blood pressure and implement the medications as recommended. The Lasix medication is essential for maintaining diuresis, especially for patients with COPD. On the other hand, Vasotec is used to control high blood pressure, and lopressor effectively reduces blood flow and circulation. Since the patient is experiencing pain, using morphine was necessary to reduce the pain. The ProAir HFA effectively eliminated the breathing difficulties. Flovent HFA also controls symptoms such as wheezing and breathing complications (Rice, Say, & Betihavas, 2018). The oxygen also was important to assist the patient recover from the complications. These nursing interventions would assist in stabilizing the patient and addressing the complications.
Cardiovascular Conditions Leading to Heart Failure
High blood pressure leads to heart failure because it forces the heart to work harder to circulate blood. Persistence of the condition causes stiffness of muscles and inability to pump blood. Risks of high blood pressure can be minimized by regular exercise an...
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