Case Study: Mrs. J

CASE STUDY: MRS J 8

Case Study: Mrs J

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The clinical manifestation of Mrs. J

The symptoms presented by Mrs. J is an indication that she might be suffering from chronic obstructive pulmonary disease (COPD) and high blood pressure. Some of the pieces of evidence or symptoms pointing out to these two conditions are due to the rise in temperature, productive cough, malaise, and nausea. The patient is having a reduced ADL ability and requires support from other people. The patient is emotionally affected due to the worry about her condition and is becoming much concerned that she might die soon. She is having a problem with getting adequate air, an indication that she might also be suffering from the asthmatic attack. She is experiencing headaches, dizziness, and nose bleeding as a result of not being able to have food. The patient foot, leg, and ankles are swollen and this is due to the inadequate supply of air into the body tissues (Alqahtani et al., 2020).

Discussion on whether nursing interventions at her time of admission were suitable and the reason for each medication

The key important aspect in the diagnosis of the patient is the performance of the assessment i.e. both subjective and objective data. Before the admission of the patient, it was necessary to assess the patient to determine the type of problem that she was experiencing. The performance of the systematic health assessment was important towards the development of a suitable cure since the patient had some heart problems. The assessment in this case could have been important in the identification of the causative factors, the associated risk factors, the current clinical status, the aggravating factors, and the quality of life. The head to toe assessment of the patient's health is important in this situation since it helps in the detection of the abnormalities (Batelaan et al., 2016).

The patient is provided with the Lasix to help in dealing with the fluid overload to help in the improvement of the adequate supply of the extracellular fluid that helps in the generation of the circulatory overload and increase in the mean artery pressure. The intravenous morphine sulfate is prescribed to help in the relaxation of the respiratory. Metoprolol help in the reduction in the pumping rate of the heart and the possibility of tachycardia development. Enapril is prescribed to help in increase in the supply of oxygenated blood into the heart (Alqahtani et al., 2020).

The four cardiovascular conditions that are likely to cause heart failure the medication or nursing intervention to prevent such developments

Diabetes is one of the cardiovascular conditions linked to heart failure. Diabetes is exposing individuals to high LDL cholesterol and insufficient HDL cholesterol. It causes biochemical and molecular changes thus leading to diastolic dysfunction. This condition is prevented by following the guideline son diabetes management and proper insulin medication. Dyslipidemia is associated with a high level of LDL and insufficient HDL cholesterol. This exposes individuals to heart failure as a result of the blockage of the blood vessels. Engagement in physical activities helps in burning unhealthy and excess fats in the body (Alqahtani et al., 2020).

Atherosclerosis causes the narrowing of the blood vessels and exposing individuals to diabetes and a high level of cholesterol. The disease results in poor flow of blood into the heart hence hardening of the heart and exposing individuals to heart failure. The prevention approaches are targeted at salt reduction intake and engaging in exercise to reduce weight gain. The risk for the development of heart failure is also associated with sleep apnea. This condition leads to the stoppage of breathing for about five-time every hour. The condition is caused by obesity and this exposes individuals to the closure of the airways thus leading to breathing difficulties. This condition is prevented through having regular physical exercise and healthy nutrition (Mantoani et al., 2016).

The nursing interventions that can help in the prevention of the problems associated with multiple drug interaction in elderly patients

Polypharmacy is a term used to describe a situation where there is an intake of multiple medications in managing health problems. The prevention of polypharmacy can be achieved through ensuring that there are accurate lists of the medications i.e. the dosing frequencies, reasons for the medication, the dosages, and the brand or generic names. Another approach is ensuring that there is close monitoring through ongoing communication with healthcare providers. The patients must also be informed about the side effects of multiple medications (Higginson & Parry, 2018).

Health promotion and restoration teaching plan for Mrs. J and how rehabilitation resources and modifications are helpful to the transition and independence of the patient

The condition of Mrs. J can be linked to some of the triggers that are either present in her environment or her behavior. Therefore, the patient, in this case, is educated on the importance of avoiding some triggers for example the behavior to ensure that she remains healthy. The patient is advised to take part in physical activities or exercise to reduce the risk of having a healthy weight and excess fats in the body. The patient provided with the dietary steps to help in ensuring that the required meals are taken to ensure that the condition is managed effectively. The patient is taught on the importance of avoiding the smoking habit. The patient is also advised to follow the prescriptions as indicated by the healthcare provider (Demeyer et al., 2017).

The method of providing education to Mrs. J concerning the medications to help in maintaining health

The teaching program will involve the use of the teach-back to help in assessing the understanding of the patient concerning her health and some of the control measures. The patient is involved in a brainstorming teaching process by being asked to mention some of the recommended proposals in making improvements in her health condition. The method is important in ensuring that the patient is adhering to the proposed guidelines in managing her condition (Baker & Fatoye, 2019).

The COPD triggers

One of the potential triggers is the smoking habit since Mrs. J is using tobacco. Therefore the patient is advised to stop the smoking habit by informing her about some of the consequences or health complications associated with tobacco use. In this case, cognitive-behavioral therapy would be helpful since it improves the cognition of the patient to change the behavior. The patient is also advised to avoid exposure to heavy air pollution to prevent any complication that might exacerbate the condition (Higginson & Parry, 2018).

References

Alqahtani, J. S., Oyelade, T., Aldhahir, A. M., Almehmadi, M., & Alqahtani, A. S. (2020). Prevalence, severity, and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PloS one,, 1(5), e0233147. doi.org/10.1371/journal.pone.0233147 Baker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: a systematic review of qualitative research. International Journal of Nursing Studies, 91, 22-34. https://doi.org/10.1016/j.ijnurstu.2018.12.004 Batelaan, N. M., Seldenrijk, A., Bot, M., van Balkom, A., & Penninx, B. (2016). Anxiety and new onset of cardiovascular disease: critical review and meta-analysis. The British journal of psychiatry, 208(3), 223-231. doi.org/10.1192/bjp.bp.114.156554 Demeyer, H., Louvaris, Z., Rabinovich, A., Hopkin, N., & de Jong, C. (2017). Physical activity is increased by a 12-week semiautomated telecoaching program in patients with COPD: a multicentre randomized controlled trial. Thorax, 72(5), 415-423. doi.org/10.1136/thoraxjnl-2016-209026 Higginson, R., & Parry, A. (2018). Managing chronic obstructive pulmonary disease in the community setting. British journal of community nursing, 23(1), 6-12. doi.org/10.12968/bjcn.2018.23.1.6 Lahman, A., McDonald, C., & Holland, A. E. (2016). Exercise training alone or with the addition of activity counseling improves physical activity levels in COPD: a systematic review and meta-analysis of randomized controlled trials. International Journal of Chronic Obstructive Pulmonary Disease, 11, 3121. doi.org/10.2147/copd.s121263 Mantoani, L. C., Rubio, N., McKinstry, B., MacNee, W., & Rabinovich, R. A. (2016). Interventions to modify physical activity in patients with COPD: a systematic review. European Respiratory Journal, 48(1), 69-81. DOI: 10.1183/13993003.01744-2015