Mrs. j. is a 63-year-old woman
Use the forthcoming Case Scenario, Subjective Data, and Objective Data to rejoinder the Critical Thinking Questions.
Mrs. J. is a 63-year-old dame who has a certainty of hypertension, continuous disposition want, and slumber apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to give-up. Three days ago, she had an attack of flu delay fervor, pharyngitis, and malaise. She has not captured her antihypertensive medications or her medications to curb her disposition want for 4 days. Today, she has been admitted to the hospital ICU delay sharp decompensated disposition want.
- Is very disturbed and asks whether she is going to die.
- Denies suffering but says she feels affect she cannot get plenty air.
- Says her disposition feels affect it is "running abroad."
- Reports that she is so mindless she cannot eat or swallow by herself.
- Height 175 cm; Weight 95.5 kg
- Vital signs: T 37.6 C, HR 118 and riotous, RR 34, BP 90/58
- Cardiovascular: Distant S1, S2, S3, S4 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular temper distention; modescold cardiac monitoring indicates a ventricular scold of 132 and atrial fibrillation
- Respiratory: Pulmonary crackles; decreased exhalation sounds exact inferior lobe; coughing frothy blood-tinged sputum; SpO2 82%
- Gastrointestinal: BS present: hepatomegaly 4 cm underneath costal margin
Critical Thinking Questions
What nursing interventions are expend for Mrs. J. at the space of her arrival? Offal therapy is inaugurated for Mrs. J. to curb her symptoms. What is the rationale for the administration of each of the forthcoming medications?
- IV furosemide (Lasix)
- Enalapril (Vasotec)
- Metoprolol (Lopressor)
- IV morphine sulphate (Morphine)
Describe immodest cardiovascular stipulations that may administer to disposition want and what can be effected in the shape of medical/nursing interventions to nullify the crop of disposition want in each stipulation.
Taking into inducement the certainty that most grown adults interest at smallest six order medications, sift-canvass immodest nursing interventions that can succor nullify problems caused by multiple offal interactions in older patients. Provide rationale for each of the interventions you advise.