Case Study: Mr. J. NRS 410 Case Study: Mr. J. NRS 410

Case Study: Mr. J. NRS 410 Case Study: Mr. J. NRS 410

This paper is an analysis of Mrs. J’s case study. Mrs. J is a 63-year-old woman with history of chronic heart failure, hypertension, and chronic obstructive pulmonary disease. Mrs. J is an active smoker despite being on oxygen. She was admitted due to sudden onset of flu-like symptoms, productive cough, fever, nausea and malaise. She has found it difficult to engage in activities of the daily living and needs assistance. Therefore, aspects of the case study such as clinical manifestations, appropriateness of the interventions, conditions leading to heart failure, and health promotion interventions are explored in this paper.

Mr. M is an elderly male who presents with memory problems for the past 2months with reports of trouble in recalling names of people and even objects such as things he read or his room number. This is associated with aggressive behaviors and has rendered him dependent on others to help with activities of daily living. The urinalysis done on the patient showed that his urine was cloudy in appearance with a considerable amount of leukocytes detected. The patient’s forgetfulness may be diagnosed as dementia which accounts for most of these cases, especially in old patients (Arvanitakis et al., 2019). Due to the forgetfulness in dementia, the patient may be frustrated at his inability to remember information thus the agitation and aggression that is reported by Mr. M. The agitation and aggression may also relate to deterioration in personality that usually results from dementia (Gale et al., 2018).

Clinical Manifestations

Mrs. J has several clinical manifestations that brought her to the hospital. They include productive cough, nausea, fever, and malaise. Mrs. J has history of obstructive pulmonary disease, hypertension and chronic heart failure. She has difficulties in engaging in activities of the daily living and requires assistance in walking short distances. She also has difficulties in breathing and appears anxious.

Whether the Interventions were Appropriate

The nursing interventions utilized in managing the patient at the point of admission were appropriate. The healthcare provider undertook subjective and objective assessments to determine the cause of Mrs. J’s problems. Subjective assessment relied on the information the client gave concerning her problems while the healthcare provider obtained objective data. The nurse needed to perform additional interventions such as minimizing physical activity by the patient, nursing her in semi-fowlers position, ensuring airway patency, and administering oxygen to ensure optimum tissue perfusion (Barber & Robertson, 2020).

Mrs. J has been started on Lasix, an antidiuretic that works by lowering the renal re-absorption of chloride and sodium for increased fluid loss. She has also been prescribed vasotect, which produces its effect by blocking the action of angiotensin converting enzyme. The client has also been started on metoprolol that works by blocking the beta-receptors to reduce cardiac contractility and overstimulation. Mrs. J has also been initiated on morphine to minimize pain through its action on mu and kappa receptors. Flovent has been administered to reduce the release of inflammatory biomarkers while oxygen has been used to ensure adequate tissue perfusion (Barber & Robertson, 2020).

Conditions that Can Lead to Heart Failure

The first condition that can cause heart failure is a previous history of heart failure. Patients with history of heart failure are increasingly at a risk of developing it in the future. The second condition is hypertension. Hypertension initiates cascades of events that cause damage to heart muscles and physiological functioning, hence, heart failure. Cardiomyopathy is the other condition that causes heart failure. Diseases that affect the heart muscles may lead to poor heart contractility and inadequate filling, hence, heart failure. The last condition is myocardial infarction. Myocardial infarction may lead to loss of tissue functioning, hence heart failure. Myocardial infarction is associated with risk factors such as atherosclerosis and coronary artery disease. The nursing interventions that can be adopted include educating about the need for reducing dietary intake of sodium, alcohol abuse, smoking, and engaging in regular physical activity (Ashraf & Rosenthal, 2020). There is also the need for the regular monitoring of blood pressure and medication adherence.

Nursing Interventions for Multiple Drug Interactions

One of the nursing interventions to minimize the effects of multiple drug interactions is avoiding contraindicated medications in patient treatments. Nurses should perform comprehensive history taking to identify the relevant drug allergies that patients have. The second intervent