Nrs 410 week 1 assignment Case Study: Mrs. J.
Nrs 410 week 1 assignment. It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
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.Nrs 410 week 1 assignment
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.Nrs 410 week 1 assignment
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.Nrs 410 week 1 assignment
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
Nrs 410 week 1 assignment Answer
Critical Thinking Essay: Comprehensive Patient Assessment and Medication Appropriateness
Mrs. J, a 63-year-old female with a complex medical history, presents with symptoms indicative of acute exacerbation of chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). A thorough clinical assessment reveals various manifestations, emphasizing the need for a comprehensive approach to her care.Nrs 410 week 1 assignment
Patient Presentation:
Mrs. J’s clinical manifestations encompass cough, nausea, malaise, impaired activities of daily living (ADLs), exhaustion, fatigue, anxiety, shortness of breath, and difficulty eating or drinking. Physical examination highlights key findings such as obesity, fever, elevated respiratory rate (RR), low blood pressure, faint pulse, reduced breath sounds in the right lower lobe, frothy blood-stained sputum, and pulmonary crackles.Nrs 410 week 1 assignment
Medication Appropriateness:
One of the medications prescribed for Mrs. J is intravenous (IV) furosemide (Lasix), a diuretic commonly used in the management of acute decompensated heart failure (ADHF). Furosemide’s mechanism of action involves reducing hypervolemia-associated pressure by eliminating excess fluids, thus alleviating stress on the heart. The intravenous administration ensures a rapid onset of diuretic effects, crucial in addressing the acute nature of Mrs. J’s condition (Yancy et al., 2017).Nrs 410 week 1 assignment
However, the appropriateness of this medication warrants careful consideration, considering Mrs. J’s comorbidities, notably hypertension and COPD. The potential impact of diuresis on blood pressure and respiratory function must be evaluated, as excessive fluid removal may lead to hypotension and worsen COPD symptoms. Collaborative decision-making involving the healthcare team is crucial to balancing the benefits and risks of IV furosemide administration (Yancy et al., 2017; Wilcox, 2018).Nrs 410 week 1 assignment
In conjunction with diuretic therapy, addressing Mrs. J’s smoking history becomes paramount. Smoking cessation interventions should be integrated into her care plan to mitigate further exacerbation of respiratory symptoms and enhance overall cardiovascular health (Benowitz, 2010).
Conclusion:
In navigating Mrs. J’s complex clinical scenario, critical thinking is imperative for evaluating the appropriateness of interventions, considering the intricate interplay of her multiple comorbidities. The collaborative decision-making process ensures a patient-centered approach, optimizing outcomes while minimizing potential risks associated with medication administration.Nrs 410 week 1 assignment
References:
Benowitz, N. L. (2010). Nicotine addiction. New England Journal of Medicine, 362(24), 2295–2303.
Wilcox, C. S. (2018). Use of loop diuretics. UpToDate. Retrieved from https://www.uptodate.com/contents/use-of-loop-diuretics
Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Drazner, M. H., … & Wilkoff, B. L. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of the American College of Cardiology, 70(6), 776–803.
