Alicia Case Study: Mrs. J

The work of medical staff includes assessing patient health parameters and reaching final verdicts. In this case, the choice of specific practices, diets, and exercises should be justified by the individual characteristics of the patient. The clinical picture of the disease should consist not only of biological health indicators but also psychological well-being. A patient who shows good results in the course of therapy, but is not in the mood for recovery, risks staying in the hospital room. This work aims to create an epicrisis for Mrs. J. based on her anamnesis.

The initial parameter for analysis may be Mrs. J’s heart rate, equal to 118 beats per minute. Such a rate is higher than the norm for an adult, which may be inextricably linked to rapid breathing and a sense of anxiety. Patients’ lungs are at 34 moves per minute, which is also above average. There is an increase in body temperature that can be justified as natural for a person with inflammatory processes (Miravitlles & Ribera, 2017). According to biometrical parameters, the body mass index of a woman exceeds value 31 that speaks about obesity of the first degree. The lungs do not have enough oxygen, as its maximum concentration does not exceed 82 percent. Pathologies in the lungs can hurt the heart, so medical personnel should take steps to facilitate heart attacks. The described results, along with foamy blood sputum and dilation of the jugular vein, indicate a potential presence of COPD in the patient (Miravitlles & Ribera, 2017). The overall clinical picture may be supplemented by heart failure, obesity, and arrhythmia.

The deterioration of the patient’s condition in the last three days shows the ineffectiveness of the measures applied by nurses. Mrs. Jay continued to smoke, although, in her state, it is strictly forbidden. The nurse should talk to the patient and explain the severity of the consequences of continued smoking. Given the length of time, Mrs. J. has smoked, it will be difficult for clinicians to dissuade her without effect on treatment from bad habits (Ianosi et al., 2018). To ensure that the patient’s condition does not deteriorate due to stress, it is recommended that she be offered alternative ways of delivering nicotine to the blood, such as patching. Moreover, the nurses should act as psychologists and friends for the sick person. In connection with the panic attacks observed in Mrs. J., the clinic staff should pay attention to this problem, just as they should ensure that the woman’s food and water consumption is comfortable. It should be reminded of the importance of leading a good life and following a diet, especially for her situation. Daily physical activity may include a short walk or breathing practice. The patient’s actions should be monitored at first, but over time this should become the norm for the woman. If medical rules are not followed, she smokes, becomes infected with additional infections, or overstresses, COPD risks becoming more acute.

Increasing body weight may be associated with heart failure. It is known that in pathologies of the heart, there is excess moisture and salts stored by the body. IV furosemide can quickly reduce the load on the heart by expanding veins (Medications Used, 2017). It reduces the pressure in the pulmonary artery and the filling pressure in the left ventricle. Taking Enalapril is not the first necessity in this case, but still, it is worth pointing out that the drug promotes the regeneration of the walls of blood vessels, as well as reduces pressure and dilates the lumen of veins and arteries (Medications Used, 2017). Metoprolol, by blocking β-adrenoceptors of the heart, reduces heart rate, depresses conductivity and excitability, and reduces contractility of the myocardium. Morphine, injected intravenously, allows quite quickly neutralize panic and pain syndrome, and, in addition, minimize cough reflexes. ProAir HFA, in the form of inhalation, relieves bronchospasm and relaxes smooth muscles. Flovent HFA acts directly on the lungs, suppressing the inflammatory process, what is especially important in COPD and asthma. Oxygen in the volume of 2L/ NC is needed to restore gas concentration in the respiratory system. At the same time, it is important to remember that the possibility of sharing drugs should be analyzed, as improperly designed medication can be harmful to health. Mrs. J has the right to refuse medication or ask for an analog, but such cases must be addressed on time. The nurse should explain to the patient the importance of taking combination medication and the harm caused by not following the instructions.

Medical staff should regularly monitor Mrs. J’s basic biophysical parameters of health. Due to low pressure and elevated temperature, these parameters should be strictly controlled. In addition, the patient should be examined daily for HR, RR, and body weight. A continuing trend in increasing body weight while on a clinical diet may be an indicator of developing heart failure. If the patient is not being cared for correctly or if the woman does not comply with the doctor’s instructions, the situation may deteriorate to the point of acute heart failure. Smoking, abnormal blood pressure, obesity, and attacks of asphyxiation may be the leading causes of the worsening situation (Causes of heart failure, 2017). Higher or lower blood pressure does not have a positive effect on heart muscle wear, so a nurse should prescribe normalizers. The presence of excess weight forms a fat layer around the heart, preventing the free pumping of blood. For the heart to continue working usually, a woman needs to lose weight. Obesity is often the cause of asphyxiation, during which the patient can have an acute lack of oxygen.


Causes of heart failure. (2017). American Heart Association. Web.

Ianosi, E. S., Postolache, P., Macovei, L. A., Szathmary, M., Szasz, S., Nemes, R. M., & Jimborean, G. (2018). Smoking cessation in COPD patients by a selective partial nicotinic agonist. Revista de Chimie, 69(7), 1766-1769. Web.

Medications Used to Treat Heart Failure. (2017). American Heart Association. Web.

Miravitlles, M., & Ribera, A. (2017). Understanding the impact of symptoms on the burden of COPD. Respiratory research, 18(1), 67-78. Web.

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