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Mrs. J. is a 63-year-old woman

Question # 00000961
Subject: General Questions
Due on: 09/17/2013
Posted On: 09/11/2013 02:59 PM
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Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions. Case Scenario Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure. 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 so exhausted she cannot eat or drink by herself. Objective Data Height 175 cm; Weight 95.5 kg Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58 Cardiovascular: Distant S1, S2, S3, S4 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 4 cm below costal margin Critical Thinking Questions What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications? IV furosemide (Lasix) Enalapril (Vasotec) Metoprolol (Lopressor) IV morphine sulphate (Morphine) 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 rationale for each of the interventions you recommend.
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Mrs J has been administered

Tutorial # 00000817
Posted On: 09/11/2013 03:00 PM
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Preview: very xxxx or xxxx beating of xxx heart Without xxxxxxxxxx the xxxxxxxxx xxx lead xx heart failure xx control arrhythmia, xxxxxx can xxxxxxxxxx xxxxx rate xxxxxxxxxxx drugs, anti-arrhythmia xxxxx or anti-coagulants xx prevent xxx xxxxxxxxx of xxxxx Cardiomyopathy is x disease of xxx heart xxxxxx xxxxxxx the xxxxxxx become thick, xxxxxxxx or rigid xxx may xxxx xxxx a xxxx tissue The xxxxx becomes weak xxx may xxxx xx heart xxxxxxx Nurses can xxxxx the symptoms xx cardiomyopathy xxx xxx cure.....
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Preview: having xx 5 xx It is xxxxxxxxx to discourage xxxx eating xxxxxx xx evade xxxx condition Therefore, xxxxxxxxxxx an ideal xxxx weight xxxxxxxx xxx to xxxxxxxxx regular body xxxxxxxx and have x healthy xxxxxxxx xxxx Smoking xxxxxxxxx the chances xx heart failure xx damaging xxxxxx xx the xxxxxxxx by making xxxx narrow Above xxxx the xxxxxxxx xx cigarettes xxxxxxxxxx one’s body xx produce a xxxxxxxxxxx amount xx xxxxxxxxxx that xxxxxxx to faster xxxxxxxxxxx which may xxxxx high xxxxx xxxxxxxx The xxxx way to xxxxxxx heart failure xx to xxxx xxxxxxx Question xxxx first nursing xxxxxxxxxxxx involves observation xxx checking xxx xxxxx signs xxxxxxxxxx cases of xxxx reactions in xxx older xxxxxxxx xx essential xxxxxxxxx offering a xxxxxxx nutritional intake xxxxx the xxxxx xxxxx be xxxxxx and in xxxx the patient xx weak, xxxxxxxx xxxx the xxxx are prone xx arise (Cameron, xxxxx Thirdly, xxxxxxxx xxxxxxxxxxx of xxx weight gain xxx ensuring proper xxxxxxxxxxx of xxx xxxxx patients’ xxxx to prevent xxxxxxxxxxxxx that might xxxxxxxxxx them xx xxxxxxxxxxxxx such xx hypertension,.....
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