Directions Use The Following Case Scenario Subjective Data

Directionsuse The Following Case Scenario Subjective Data And Object

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario: Mrs. J. is a 63-year-old woman with a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes daily for 40 years and has refused to quit. Three days ago, she experienced flu symptoms including fever, pharyngitis, and malaise. She has not taken her antihypertensive or heart failure medications for four days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data:

• Expresses high anxiety, questioning if she will die.
• Denies pain but reports difficulty in breathing.
• Describes her heart as "running away."
• States she is so exhausted she cannot eat or drink alone.

Objective Data:

• Height: 175 cm; Weight: 95.5 kg
• Vital signs: Temperature 37.6°C, Heart rate 118 bpm (irregular), Respirations 34, Blood pressure 90/58 mmHg
• Cardiovascular: Distant S1 and S2, S3 present; PMI at sixth intercostal space, faint; all peripheral pulses 1+; bilateral jugular vein distention; ventricular rate 132 bpm, atrial fibrillation on cardiac monitor
• Respiratory: Pulmonary crackles; decreased breath sounds in right lower lobe; frothy blood-tinged sputum; SpO₂ 82%
• Gastrointestinal: Bowel sounds present; hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is initiated to control her symptoms. What is the rationale for administering each of the following medications?

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and propose medical and nursing interventions to prevent the development of heart failure in each condition.

Considering that many mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients, including the rationale for each intervention.

Body Systems Terminology and Reflection

Research the human body's body systems, list their organs and basic functions, identify two conditions or diseases per system, and recognize interactions with other systems. Write a paragraph reflecting on your understanding of human body systems, including your strengths and areas for improvement. Support your reflection with at least three scholarly references.

References

• Bickley, L. S., & Szilagyi, P. G. (2017). Bates' Guide to Physical Examination and History Taking. Wolters Kluwer.
• Fox, S. I. (2019). Human Physiology. McGraw-Hill Education.
• Guyton, A. C., & Hall, J. E. (2016). Textbook of Medical Physiology. Elsevier Saunders.
• Melmed, S., Polonsky, K. S., Larsen, P. R., & Kronenberg, H. M. (2019). Williams Textbook of Endocrinology. Elsevier.
• Marieb, E. N., & Hoehn, K. (2018). Anatomy & Physiology. Pearson.
• Schneider, M. R., & Hall, M. C. (2020). Multidrug interactions in older adults: Nursing perspectives. Journal of Geriatric Pharmacotherapy, 16(2), 123-131.
• Smith, J. D., & Jones, A. L. (2018). Polypharmacy in the elderly: Strategies for safe medication management. Geriatrics & Aging, 21(4), 45-52.
• Watson, R., et al. (2021). Preventing medication interactions: Nursing roles and strategies. Journal of Clinical Nursing, 30(15-16), 2340-2350.
• Williams, J. M., & Pruitt, L. D. (2019). The impact of multiple medications on older adults: Approaches for nursing care. Nursing Clinics of North America, 54(2), 241-258.
• Yen, C., et al. (2020). Human body systems overview. PubMed Central. https://www.ncbi.nlm.nih.gov