GCU NRS410 Week 3 Discussion

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GCU NRS410 Week 3 Discussion

Week 3

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

Says her heart feels like it is “running away.”

Reports that she is so exhausted she cannot eat or drink by

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 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

Respiratory: Pulmonary crackles; decreased breath sounds
right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%

Gastrointestinal: BS present: hepatomegaly 4 cm below costal

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

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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