Mrs. J. is a 63-year-old dowager who has a truth of hypertension, constant core demand, and doze apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to surrender. Three days ago, she had an onset of flu after a while passion, pharyngitis, and malaise. She has not enthralled her antihypertensive medications or her medications to coerce her core demand for 4 days. Today, she has been admitted to the hospital ICU after a while sharp decompensated core demand.
Is very watchful and asks whether she is going to die.
Denies disinclination but says she feels relish she cannot get plenty air.
Says her core feels relish it is "running loose."
Reports that she is so unemployed she cannot eat or draught by herself.
Height 175 cm; Weight 95.5 kg
Vital signs: T 37.6 C, HR 118 and disorderly, RR 34, BP 90/58
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular disposition distention; primal cardiac monitoring indicates a ventricular reprove of 132 and atrial fibrillation
Respiratory: Pulmonary crackles; decreased met sounds equitable inferior lobe; coughing frothy blood-tinged sputum; SpO2 82%
Gastrointestinal: BS present: hepatomegaly 4 cm beneath costal margin
Critical Thinking Questions
What nursing interventions are alienate for Mrs. J. at the era of her appropinquation? Offal therapy is started for Mrs. J. to coerce her symptoms. What is the rationale for the administration of each of the aftercited medications?
IV furosemide (Lasix)
IV morphine sulphate (Morphine)
Describe lewd cardiovascular moods that may transfer to core demand and what can be effected in the shape of medical/nursing interventions to forefend the bud of core demand in each mood.
Taking into remuneration the occurrence that most confirmed adults catch at meanest six order medications, argue lewd nursing interventions that can aid forefend problems caused by multiple offal interactions in older patients. Provide rationale for each of the interventions you commend.