Cecile Case Study: Mrs. J.

Clinical Manifestations Present in Mrs. J.

As Mrs. J.’s case description demonstrates, the patient was admitted to the hospital with flu-like symptoms. The clinical manifestation or the symptomatic indications of a disease or deterioration in bodily systems present in the patient include nausea, malaise, cough, and fever. The patient indicates diminished walking capacity, requires assistance, and experiences acute decompensated heart failure and acute exacerbation of chronic obstructive pulmonary disease (COPD). These clinical manifestations, in combination with the chronic conditions present in Mrs. J., namely hypertension, chronic heart failure, and COPD, serve as the basis for referring to the hospital.

Appropriateness of the Nursing Interventions at the time of Admissions and Medication Rationale

The nursing interventions at the time of admission addressed the patient’s chronic conditions. In particular, Mrs. J. had not taken her prescription medication for three days before admission. Therefore, administering the medications and oxygen to address the daily requirements under chronic conditions is essential. Moreover, the patient’s vital signs play a crucial role in deciding what nursing interventions are appropriate and the most required. At the time of admission, Mrs. J.’s oxygen saturation is low and decreased to the point of 82%; her heart rate is high with 118 beats per minute, and her blood pressure is low at 90/58. Therefore, the interventions and medications are appropriate since they were aimed at stabilizing the vital signs of the patient.

In particular, Mrs. J. was administered IV furosemide, enalapril, metoprolol, IV morphine sulphate, inhaled short-acting bronchodilator, inhaled corticosteroid, and oxygen delivered at 2L/ NC. Furosemide administered intravenously helps regulate fluid accumulation caused by heart failure. Enalapril is commonly used with furosemide to address hypertension. Metoprolol stimulates blood flow and is aimed to help with blood pressure. IV morphine sulphate is administered to manage pain in the patient. As for the oxygen, bronchodilator and corticosteroid administered for inhalation are aimed at regulating lung function, normalize oxygen saturation, and cure inflammatory processes in the respiratory system.

Cardiovascular Conditions Leading to Heart Failure and Preventative Nursing Interventions

There are multiple cardiovascular conditions that might be the triggers of predecessors of heart failure. Firstly, coronary heart disease, which is characterized by dysfunction of heart arteries, complicating the flow of blood rich in oxygen (“Heart failure,” 2021).

To prevent heart failure in the aftermath of coronary heart disease, a healthy lifestyle, regular medications, or even surgery might be appropriate. Secondly, heart inflammation is a condition that is characterized by inflammatory processes in different parts of the heart and might lead to heart failure (“Heart failure,” 2021). To prevent it, patients with heart inflammation should ensure timely diagnosis, procedural and medication-based treatment, or surgery. Thirdly, high blood pressure is another cardiovascular condition that might lead to heart failure (“Heart failure,” 2021).

To prevent it from deteriorating heart functioning, proper dieting to regulate possible body mass excess and physical activity, as well as medications, should be prioritized. Fourthly, cardiomyopathy, or the inability of the heart to deliver blood to all body parts, should be addressed by healthy dieting, medication intake, physical activity, and minimization of substance use to prevent heart failure (“Heart failure,” 2021).

Nursing Interventions Addressing Multiple Drug Interactions

As in the case of Mrs. J., the intake of several medications requires adequate nursing interventions that would minimize the risks of complications, hospitalization, and drug incompatibility. Firstly, a nurse should verify a patient’s understanding of the regimen of prescribed drugs (Azhagesan, 2017). Secondly, the information-related intervention should be implemented to provide the patient with an accurate list of all medications and the regimen of their intake, provide contacts of medical providers, and the phone number of local pharmacies.

Thirdly, educational or instructional interventions should include teaching the patient what medications are addressing her conditions and in which way, as well as their possible side effects and the risks of not taking the medications as directed (Azhagesan, 2017). Fourthly, interventions aimed at organizations include directions to dispose of old medications on time, store drugs in a specific place or refrigerator if needed, and avoid sharing medications (Azhagesan, 2017). These nursing interventions will ensure patients’ understanding of the importance of managing polypharmacy properly and prevent adverse outcomes.

Health Promotion and Restoration Teaching Plan

A health promotion plan for Mr. J. should include the following:

  • smoking cessation;
  • moderate daily physical activity;
  • take medications regularly;
  • stick to a healthy diet;
  • attend to scheduled follow-up physician appointments;
  • install and use health care applications to monitor heart rate and blood pressure;
  • use online and handout resources with information on heart failure and COPD management.

The rehabilitation resources, including online materials and applications on Mrs. J.’s condition, will help her manage and modify her daily routine according to the guidelines obtained from the resources. In such a manner, the patient will have an opportunity to receive answers to her questions independently and avoid complications.

Education Method Regarding Medications

The method of education for Mrs. J. to improve her self-management and medication intake after hospitalization should be verbal education through one-on-one communication (“Choosing effective patient education materials,” 2021). According to this method, the information is delivered to the patient verbally with the opportunity to answer Mrs. J.’s questions and ensure her comprehension. The rationale for this method is based on the severity of Mrs. J.’s chronic conditions and the necessity to ensure that she comprehends possible outcomes of improper medication intake.

COPD Triggers and Smoking Cessation Options

The triggers that should be avoided include household dust and fumes from cooking or cleaning products (“COPD signs and symptoms,” 2019). Also, Mrs. J. should avoid catching a cold or pneumonia and exposure to polluted air or a cold environment. Finally, the most significant issue in Mrs. J.’s case is smoking cessation that should be prioritized to avoid repeated hospitalization with COPD. To assist the patient with the smoking cessation procedure, a nurse might introduce nicotine patches and behavioral therapy; however, medications are not recommended since the patient is already exposed to polypharmacy.


Azhagesan, C. (2017). Role of nurse in polypharmacy. Nursing and Healthcare International Journal, 1(4), 1-4. Web.

Choosing effective patient education materials. (2021). Web.

COPD signs and symptoms. (2019). Web.

Heart failure. (2021). Web.

Video Voice-over

Cite this paper

Select style


NursingBird. (2023, September 4). Cecile Case Study: Mrs. J. Retrieved from https://nursingbird.com/cecile-case-study-mrs-j/


NursingBird. (2023, September 4). Cecile Case Study: Mrs. J. https://nursingbird.com/cecile-case-study-mrs-j/

Work Cited

"Cecile Case Study: Mrs. J." NursingBird, 4 Sept. 2023, nursingbird.com/cecile-case-study-mrs-j/.


NursingBird. (2023) 'Cecile Case Study: Mrs. J'. 4 September.


NursingBird. 2023. "Cecile Case Study: Mrs. J." September 4, 2023. https://nursingbird.com/cecile-case-study-mrs-j/.

1. NursingBird. "Cecile Case Study: Mrs. J." September 4, 2023. https://nursingbird.com/cecile-case-study-mrs-j/.


NursingBird. "Cecile Case Study: Mrs. J." September 4, 2023. https://nursingbird.com/cecile-case-study-mrs-j/.