Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.
The American Heart Association describes Heart Failure as “Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen.” (American Heart Association, 2019). Heart Failure is a definite threat to morbidity and mortality of the patient. Mrs. J needs much help in terms of medical and nursing interventions in light of her current situation.
As far as nursing interventions, oxygen is definitely warranted for this patient and may even benefit from BiPAP to aide with the pulmonary edema as evidenced by the pulmonary crackles and frothy blood-tinged sputum. Along with this, the patient should be sat up in a high-fowler’s position and vital signs, ECG and oxygen saturation all need to be monitored closely to watch for further decompensation. Diuretics such as Lasix are effective in reducing the volume or preload coming into the heart which can help the heart contract more effectively and improve cardiac output. ACE Inhibitors such as Vasotec “are the primary drug of choice for blocking the RAAS system in HF patients with systolic dysfunction…The conversion of angiotensin I to the potent vasoconstrictor angiotensin II requires the presence of ACE. ACE Inhibitors also decrease the development of ventricular remodeling by inhibiting ventricular hypertrophy.” (Lewis et al, 2011). Beta-adrenergic blockers can decrease the heart rate by blocking the effects of the sympathetic nervous system on the heart’s beta receptors. Lastly, Morphine reduces preload and afterload by dilating “pulmonary and systemic blood vessels, a goal in decreasing pulmonary pressures and improving the gas exchange.” (Lewis et al, 2015). Four cardiovascular conditions that may lead to heart failure include coronary artery disease, hypertension, valvular diseases such as stenosis, and congenital heart defects. Coronary artery disease can be aided by exercise and nutritional diet and may also helped by stenting of coronary arteries when precipitated by angina or MI. Hypertension can also be helped by exercise and nutritional diet and antihypertensive medications. Valvular diseases such as stenosis can be repaired or replaced by mechanical or bioprosthetic valves. Lastly, congenital heart defects can be surgically repaired.
Four interventions to prevent drug interactions for older adults include:
Encourage older adults to check with their PCP or pharmacist before taking any OTC, herbal or prescription medications to make sure that there are no interactions between the medications. Secondly, have a system to properly identify medications and take them in the appropriate doses and right medication, these can include a clearly labeled weekly pill organizer. This can prevent taking wrong medications at wrong times or overdosing. Thirdly, set alarms or reminders to reinforce taking medications at the right times. Some medications need to be spaced out to prevent adverse events or complications. Lastly, promptly report adverse effects to the PCP or pharmacist or seek medical treatment, whichever is warranted by the gravity and urgency of the adverse effect.