Nursing interventions appropriate for Mrs. J at the time of her admission include elevating the head of the bed to her comfort, administering oxygen as needed, suctioning as needed, ordering EKG/imaging studies to assess heart function, placing an IV for medication administration, obtaining laboratory studies such as lactic acid and arterial blood gases (ABGs), administering necessary medications, and monitoring vital signs. These interventions are aimed at providing immediate care and stabilization for the patient.
The rationale for administering medications to control Mrs. J’s symptoms is to alleviate her symptoms and improve her overall heart function. However, given the patient’s low blood pressure (90/58), it is important to consider the potential side effect of hypotension from these medications. Careful monitoring of blood pressure and titration of medication doses may be necessary to prevent further drops in blood pressure.
Four cardiovascular conditions that may lead to heart failure are obesity, smoking, hypertension, and irregular heart rate. In obesity, excess body weight places increased strain on the heart, leading to enlargement and decreased heart function. Nursing interventions to prevent the development of heart failure in obesity include promoting weight loss through diet and exercise counseling, monitoring blood pressure and heart rate, and ensuring compliance with antihypertensive medications.
Smoking is a major risk factor for heart disease and can lead to the development of heart failure. Nursing interventions to prevent heart failure in smokers include providing smoking cessation counseling and resources, monitoring lung function, and facilitating access to smoking cessation programs and medications.
Hypertension is a leading cause of heart failure. Nursing interventions to prevent heart failure in patients with hypertension involve monitoring blood pressure and ensuring compliance with antihypertensive medications, providing education on lifestyle modifications such as reducing salt intake and increasing physical activity, and regular follow-up to assess blood pressure control.
Irregular heart rate, or arrhythmia, can lead to heart failure by causing ineffective pumping of blood. Nursing interventions to prevent heart failure in patients with arrhythmias include monitoring heart rate and rhythm, administering medications to control heart rate or rhythm, and providing education on the importance of medication adherence and recognizing signs of worsening symptoms.
In older patients who often take multiple prescription medications, there is a risk of drug interactions and adverse effects. Four nursing interventions to prevent problems caused by multiple drug interactions in older patients include:
1. Educating the patient about their prescribed medications: This will help them understand the purpose, dosage, and potential side effects of each medication. Simple language should be used to enhance understanding.
2. Organizing medications in an order that can be easily followed: This can include using pill organizers or providing clear written instructions on the sequence and timing of medication administration. This can help prevent medication errors and confusion.
3. Keeping a list of all current medications: This list should include the names of the providers and pharmacy contact information. It is important for patients to have this information readily available in case of emergency, and to bring it to all medical appointments to ensure accurate and up-to-date medication management.
4. Regularly reviewing and reconciling medications: Nursing staff should regularly review the patient’s medication regimen for potential drug interactions or duplications. This can be done in collaboration with the healthcare team, including the prescribing provider and pharmacist. Adjustments may need to be made to optimize medication therapy and minimize the risk of adverse effects.
Overall, these nursing interventions aim to promote medication safety and optimize patient outcomes in older adults with multiple medications. By educating patients, organizing medications, keeping track of their medication regimen, and regularly reviewing and reconciling medications, nurses can help prevent problems caused by drug interactions in this vulnerable population (American Nurse Today, 2017; Medscape, 2017).
