Hypertension Case Study Comprehensive Nursing Essay Example-1

Hypertension Case Study Comprehensive Nursing Essay Example

Clinical Manifestation

Mrs. J has previous suffered from hypertension, chronic heart failure, and chronic obstructive pulmonary disease. She has been under oxygen but has continued to smoke two packs of cigarettes a day. Cigarette smoking increases the risks of heart failure. Her condition worsens, and she cannot perform daily activities and requires assistance. She suddenly experiences fever, nausea, productive cough, and malaise. Not taking heart failure control medications would lead to her worsening condition.

The clinical manifestation present in Mrs. J includes fever, high heart rate, high respiratory rate, and high blood pressure. The heart sound S3 is a pathological indication. She also has a left ventricular dilation, a faint pulse, jugular vein bulge, shortness of breath, and a rapid heart rate. Her lungs are filled with fluid, which indicates lung infection resulting in low oxygen in the lungs. These manifestations indicate acute decompensated heart failure (ADHF) and chronic obstructive pulmonary disease COPD. (Hypertension Case Study Comprehensive Nursing Essay Example)

Nursing Interventions

AFTER HER ADMISSION, Mrs. J undergoes drug therapy, which was appropriate in controlling her symptoms. The drugs provided include IV furosemide (Lasix), which is used for ADHF patients as a diuretic to treat excessive fluid accumulation and body edema (Hamo et al., 2020). Enalapril (Vasotec) controls high blood pressure, acting as angiotensin-converting enzyme inhibitors that reduce high blood pressure. Metoprolol (Lopressor) is a beta-blocker medication that reduces high blood pressure and chest pain.

It relaxes blood vessels, reduces heart rate, ensuring optimum blood flow. IV morphine sulphate (Morphine) is an opioid that lowers preload in heart failure and relieves pain. Inhaled short-acting bronchodilator (ProAir HFA) treats wheezing and shortness of breath caused by COPD. It offers quick relief by opening airways. Inhaled corticosteroid (Flovent HFA) is a corticosteroid that reduces airway inflammation. Oxygen delivered at 2L/ NC treats shortness of breath.(Hypertension Case Study Comprehensive Nursing Essay Example)

Four Cardiovascular Conditions That May Lead To Heart Failure

Coronary artery disease involves cholesterol build-up and fatty deposits in heart arteries, meaning less blood reaches the heart. The accumulation affects blood flow, and when it is obstructed, a heart attack can occur. Cholesterol-modifying medications, beta-blockers, and calcium channel blockers can reduce the risk of heart failure from coronary artery disease. High blood pressure is a significant risk factor for heart failure when not controlled. When the heart pumps harder, it tires, and chambers become larger and weaker, leading to heart failure.

Medications such as diuretics and beta-blockers can help lower blood pressure. Abnormal heart valves can result from infections, diseases, and defects at birth. When valves do not function properly, the heart pumps harder, which can lead to heart failure (American Heart Association, 2017). The transcatheter aortic valve replacement (TAVR) procedure replaces the abnormal heart valves. Severe lung disease prompts the heart to work harder, which can lead to heart failure. Bronchodilators such as ProAir HFA, Ventolin HFA can help regulate lung functioning by controlling shortness of breath and relaxing muscles around airways.(Hypertension Case Study Comprehensive Nursing Essay Example)

Four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients

Nurses can work closely with patients to prevent and reduce the consequences of drug interactions. Nurses should keep track of side effects by inquiring from patients about new symptoms. The nurses should ask patients to bring all the medications, prescribed and off-the-counter, for review and education on how they should take them (Accetta, 2016). Nurses should educate patients about the drugs, package descriptions, directions, what foods to take with each drug, and when to stop taking a particular drug. Nurses should also ensure the patients keep a precise list of all the medications they are taking currently. Recording the drugs by name, dosage, and reason reduces mistakes.(Hypertension Case Study Comprehensive Nursing Essay Example)

Health Promotion and Restoration Teaching Plan

Mrs. J. has previously suffered from hypertension, chronic heart failure, and chronic obstructive pulmonary disease. However, she continues her smoking behavior of two cigarette packs a day. Heavy cigarette smoking affects the lungs, which overloads the heart as it tries to supply the body with enough oxygen. Mrs. J. needs to quit smoking, exercise often, have enough sleep, and maintain a healthy diet to reduce body weight. Smoking cessation would control the lung infection, optimizing performance. Better sleep increases body performance and quality of life.

Mrs. J. had not taken medication to control heart failure for three days. Effective use of medications would enhance her well-being and ADHF and COPD management. Her teaching plan should include guidelines of a healthy diet and exercises to adopt. Increased awareness of ADHF and COPD symptoms is also necessary. Mrs. J. should understand that she requires lifestyle changes to achieve better health outcomes.(Hypertension Case Study Comprehensive Nursing Essay Example)

Patient Education

Structured patient-centered education for ADHF and COPD would help ensure effective medications. This method provides a partnership between the healthcare practitioners, the patient, and the family. The approach avails information the patient requires to make better medical decisions (Gallagher et al., (2019). The process increases the patient’s ability to synthesize information and get clarifications. This method ensures that every intervention adopted to optimize medications’ use considers the patient’s needs. Therefore, the nurses and Mrs. J. should maintain close contact after being discharged.(Hypertension Case Study Comprehensive Nursing Essay Example)

COPD triggers that can increase exacerbation frequency, resulting in return visits

Smocking or exposure to smoke and air pollutants can cause exacerbation. Mrs. J. is a smoker and needs to quit to avoid return visits due to lung and heart complications resulting from cigarette smoking (Dransfield et al., 2017). Smoking alternatives include nicotine replacement therapy, bupropion, and varenicline, which are medication strategies for smoke cessation. Other alternative habits include eating a dill pickle and Popsicle, chewing gum, and drinking water.   (Hypertension Case Study Comprehensive Nursing Essay Example)

References

Accetta, R. C. (2016). Polypharmacy: Strategies for Reducing the Consequences of Multiple Medications.

American Heart Association. (2017). Causes of Heart Failure. Retrieved from https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure(Hypertension Case Study Comprehensive Nursing Essay Example)

Dransfield, M. T., Kunisaki, K. M., Strand, M. J., Anzueto, A., Bhatt, S. P., Bowler, R. P., … & Make, B. J. (2017). Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine, 195(3), 324-330.(Hypertension Case Study Comprehensive Nursing Essay Example)

Gallagher, C., Rowett, D., Nyfort-Hansen, K., Simmons, S., Brooks, A. G., Moss, J. R., … & Sanders, P. (2019). Patient-centered educational resources for atrial fibrillation. JACC: Clinical Electrophysiology, 5(10), 1101-1114.(Hypertension Case Study Comprehensive Nursing Essay Example)

Hamo, C. E., Abdelmoneim, S. S., Han, S. Y., Chandy, E., Muntean, C., Khan, S. A., … & Heitner, J. F. (2020). Outpatient Intravenous Lasix Trial in Reducing Hospitalization for Acute Decompensated Heart Failure (OUTLAST). Circulation, 142(Suppl_3), A15299-A15299.(Hypertension Case Study Comprehensive Nursing Essay Example)

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