NRS 410 Bowie State University Older Patients Health History Questions

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

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. 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.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. 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.

Expert Solution Preview

Introduction:
The case study presents the health history and medical information of Mrs. J, a 63-year-old woman with a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease. Mrs. J has been admitted to the hospital ICU due to acute decompensated heart failure and acute exacerbation of COPD. In this critical thinking essay, various aspects of Mrs. J’s situation will be discussed, including clinical manifestations, nursing interventions, cardiovascular conditions, drug interactions, health promotion and restoration, medication education, COPD triggers, and smoking cessation options.

1. Describe the clinical manifestations present in Mrs. J.
Mrs. J presented with sudden flu-like symptoms, including fever, productive cough, nausea, and malaise. She reported feeling anxious and having difficulty in breathing, chest pain, exhaustion, and inability to eat or drink without assistance. Her vital signs revealed an irregular heart rate, tachypnea, decreased oxygen saturation, pulmonary crackles, and blood-tinged sputum. Additionally, she had peripheral edema, elevated jugular venous pressure, and hepatomegaly.

2. 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.
The nursing interventions at the time of Mrs. J’s admission were appropriate. The medications administered to control her symptoms included IV furosemide, Enalapril, Metoprolol, IV morphine sulphate, inhaled short-acting bronchodilator, inhaled corticosteroid, and oxygen. Furosemide is a loop diuretic that helps reduce edema and fluid overload, Enalapril and Metoprolol are antihypertensive and heart failure medications that decrease blood pressure and improve heart function. Morphine is an analgesic used for pain management, while short-acting bronchodilators and corticosteroids improve airflow in patients with COPD. Oxygen is vital in improving oxygen saturation and reversing hypoxemia.

3. 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.
Four cardiovascular conditions that may lead to heart failure are coronary artery disease, hypertension, myocarditis, and valve abnormalities. Preventive measures for CAD include regular exercise, healthy diet, and control of risk factors such as smoking, diabetes, and hyperlipidemia. Hypertension can be prevented by maintaining a healthy weight, reducing salt intake, regular physical activity, and stress management. Myocarditis prevention involves vaccination against viral myocarditis, prompt treatment and management of viral infections, and proper screening of blood or organ donors. Valve abnormalities prevention may include prompt treatment of endocarditis, early intervention for valvular disease and regular monitoring of patients with known valve abnormalities.

4. 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.
Nursing interventions that can prevent problems caused by multiple drug interactions in older patients include: medication reconciliation, education, monitoring, and collaboration. Medication reconciliation involves reviewing the patient’s medications regularly and identifying any interactions or discrepancies. Education can be provided on the importance of taking medications as prescribed, possible side effects, drug interactions, and when to seek medical help. Monitoring of patients’ medication regimen is vital, including vital signs, laboratory values, and adverse drug reactions. Collaboration among healthcare providers can help prevent medication errors and adverse effects.

5. 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.
The health promotion and restoration teaching plan for Mrs. J should include self-care management strategies, such as regular exercise, healthy diet, smoking cessation, regular medication adherence, stress management, and regular medical follow-up. She should receive multidisciplinary resources such as respiratory therapy, physical therapy, and occupational therapy to improve respiratory function, physical endurance and daily living activities. Home modifications such as installing grab bars, raised toilet seats, and shower chairs will help Mrs. J’s transition to independence.

6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
The method of providing education for Mrs. J. regarding medications should involve verbal and written instructions. The nurse can explain the importance of taking medications as prescribed, possible side effects, interactions, and when to seek medical assistance. The nurse can also provide written instructions about the medications, including the name, dose, frequency, and the reason for taking each medication. The rationale for this is to ensure that Mrs. J understands her medications and can take them properly, thus preventing future hospital admissions.

7. 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.
COPD triggers that can increase exacerbation frequency include tobacco smoke, infections, air pollution, temperature changes, and stress. Given Mrs. J’s current and long-term tobacco use, smoking cessation options that can be offered include nicotine replacement therapy, prescription medications such as bupropion and varenicline, and cessation counseling. The nurse can also provide coping mechanisms for Mrs. J to manage stress and avoid triggers that can exacerbate COPD symptoms.

In conclusion, Mrs. J’s situation presents multiple challenges that require a comprehensive approach to her care. Nursing interventions such as drug therapy, health promotion, rehabilitation, education, and smoking cessation can improve her health outcomes and prevent future hospital admissions.

Share This Post

Email
WhatsApp
Facebook
Twitter
LinkedIn
Pinterest
Reddit

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

Describe and critique a current article that relates to Nursing Assignment Help

Describe and critique a current article that relates to hospital financing and competitive practices in healthcare. (Article should be from a scholarly, peer-reviewed journal published within the last 3-5 years). Submit 1,000-1,500-word paper with a KU title page and reference page in a scholarly format. You are a medical professor

GCU Patient Preferences in Care Discussion Reply Nursing Assignment Help

please respond to the following discussion as a peer making a comment. Hello everyone, Integrating patient preferences and values with clinician expertise is essential when making evidence-based decisions. This approach leads to patient-centered care, improves treatment adherence, and enhances health outcomes. Patients’ unique values, beliefs, priorities, and circumstances can significantly

UM Administrator in Training Rotation Experience Report Nursing Assignment Help

Complete and Submit the Three Sections of the Report for the Assignment: AIT Experience: LTC Settings and Services Report Template (ATTACHED) APA: Include APA 7th Edition Formatted Reference Page. ALL RESPONSES IN PARAGRAPH FORM. Complete Section 1 of the Report Select the Long Term Care (LTC) Settings and Services: ALREADY

NYU Autoimmune Disease of Myelin Abstract Nursing Assignment Help

`The disease is called MS You should read Wikipedia “Immune System”, “Antibody”,  “Antigen”, “T  cell”, “B cell”, “Macrophage”, “Dendritic cell”  for writing your abstract. It would also be good to read the Wikipedia article on MS.  The purpose of writing an abstract is to condense the material you have read

Within the Professions of Psychology Paper Nursing Assignment Help

PSY 540 Final Project Guidelines and Rubric Overview Within the professions of psychology, it can be typical for you to work on proposals for programs, studies, or new initiatives. For example, you may work for a university that regularly partners with foundations and corporations to identify grant opportunities for projects

Professional Ethics Instructions Baccalaureate education Nursing Assignment Help

Professional Ethics Instructions Baccalaureate education includes the development of professional values and value-based behavior (AACN, 2008). Ethics define professional ethics and their importance in the healthcare environment. The American Nurses Association has approved 13 standardized languages that support nursing care.  The benefits of standardized language include: better communication among nurses

Select one of the following populations: Aging Nursing Assignment Help

Select one of the following populations: Aging Population Homelessness Migrant Workers LGBTQIA+ Other Identified Vulnerable Populations from Your Reading Then complete the following steps for your discussion post: Identify which vulnerable population you have chosen to use for this post and describe what this vulnerable population looks like in your

WGU Population Health Data Analysis Paper Nursing Assignment Help

In this course, you learned that Informatics for Transforming Nursing Care integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. This provides knowledge and skills to apply informatics concepts, communications, and data critical to facilitating interprofessional

Professional EthicsInstructions Baccalaureate education Nursing Assignment Help

Professional EthicsInstructions Baccalaureate education includes the development of professional values and value-based behavior (AACN, 2008). Ethics define professional ethics and their importance in the healthcare environment. The American Nurses Association has approved 13 standardized languages that support nursing care.  The benefits of standardized language include: better communication among nurses and

HSA 599 SU Public Health Emergencies Discussion Nursing Assignment Help

I’m working on a health & medical discussion question and need the explanation and answer to help me learn. Discuss a life-threatening event or a natural disaster in your community, such as a severe weather event, terrorist attack, or other type of public health emergency. Examine an overall strategy that

Develop a literature map or a visual representation of the Nursing Assignment Help

Develop a literature map or a visual representation of the Public Health Informatics literature.  Also include a powerpoint presentation explaining the literature map with the slides Constructing a literature map helps you: develop an understanding of the key issues and research findings in the literature organize ideas see how different research studies