Mrs. J.’s health history represents a complicated situation with comorbidities and complications. Some of the patient’s health concerns can be attributed primarily to her lifestyle choices, which shows the necessity of patient education in this case. Lately, Mrs. J’s. experiences fever, productive cough, nausea, and malaise. These clinical manifestations are seemingly linked to respiratory disease – possibly pneumonia, to which patients with chronic obstructive pulmonary disease are more vulnerable. Therefore, Mrs. J’s, further treatment is planned to encompass several related conditions and incorporate lifestyle changes.
A significant number of medications were administered to the patient so that her symptoms could be managed and alleviated. Both Metoprolol and Enalapril were used to treat hypertension from which Mrs. J. suffers for a long time (Uwase et al., 2019). IV furosemide aims to reduce fluid build-up caused by heart failure. Furthermore, to alleviate pain associated with it, IV morphine sulfate was administrated. In addition to the medications for heart failure and antihypertensive drugs, the patient was provided with inhaled short-acting bronchodilator and corticosteroid – these interventions were supposed to open the patient’s airways and prevent inflammatory processes consequently relieving Mrs. J’s. breathing problems (Uwase et al., 2019). As a part of symptoms regulation, oxygen delivery was also organized. These interventions were based on the need for cardiovascular and respiratory management as well as increasing pain levels that Mrs. J. experienced. Therefore, the outlined drug therapy was adequately selected with consideration to the patient’s disease history and significant complaints.
Heart failure is one of the leading causes of death and can be prompted by several cardiovascular diseases. For instance, a myocardial infarction is caused by a clot hindering blood circulating in the heart – the condition can be prevented by implementing lifestyle modifications initiated by patient education. High blood pressure is another common precursor for heart failure (Ziaeian & Fonarow, 2016). This long-term condition is manifested by elevated BP levels in arteries, and such nursing intervention as regular BP control can indicate and thus potentially prevent further complications. Coronary artery disease is manifested by damaged arteries supplying blood to the heart – to avoid complications of the disease, its risk factors should be reduced (Ziaeian & Fonarow, 2016). Such interventions as creating dietary plans can decrease the likelihood of the condition’s progression since obesity is one of its principal causes. Lastly, deceleration in heart rhythm during prolonged periods (bradycardia) can also ultimately result in heart failure. Such intervention as performing an electrocardiogram can identify the disease and suggest treatment depending on the type of problem causing slow rhythm.
The growth in the elderly population contributes to polypharmacy, which can lead to hospitalization or fatal outcomes. Methods based on control and education can be useful for nurses in preventing the issue (Cojutti et al., 2016). Therefore, it could be advisable to create a medication list with essential patients information, so they know the name, purposes, effects, and dosage for each. Encouraging patients to keep a complete written record of their medication is an alternative strategy (Cojutti et al., 2016). Furthermore, nurses’ assistance in the process should be provided in some cases to ensure the accuracy of medication administration. Generally, instructing patients about polypharmacy risks and educating them about prescribed medication seems to be an essential intervention that ensures the security of concurrent use of drugs.
Given Mrs. J’s. health condition and habits that contribute to its aggravation, health promotion, and restoration teaching plan should revolve around changes in the patient’s lifestyle. Therefore, the plan would include elements aimed at changing Mrs. J’s. attitude to health, namely: a diet based on fruits, vegetables, and low-fat dairy, smoking cessation methods, continual professional monitoring, supportive medication administration, and eventually light physical activities. Extensive patient education regarding the proposed rehabilitation should provide Mrs. J. with information about the ways to implement and sustain the alterations after inpatient treatment. Eventual exercises could serve as a means to gain more physical autonomy and independence. If possible, family members or caregivers could also be instructed.
Avoiding COPD triggers is indispensable for reducing exacerbation frequency, resulting in return visits. Air pollution, cigarette smoke, dust particles, and specific weather condition are seemingly the most damaging and frequently encountered triggers (Werchan et al., 2018). Since tobacco is one of them, smoking cessation methods such as behavioral therapy, pharmacological treatment, nicotine replacement therapy, or combinatory approach could be considered. Given how long Mrs. J. has been smoking and the extent of this habit, a fusion between behavioral and nicotine replacement therapies seems to be the most recommendable. Therefore, smoking cessation is imperative for the alleviation of the patient’s chronic obstructive pulmonary disease.
Using medication correctly and adhering strictly to prescriptions is one of the main conditions for its effectiveness. Educating the patient about the issues that could result from inadequate medication administration and describing it as a direct threat to well-being is crucial for preparing Mrs. J. for the post-stationary period. Therefore, to prevent future hospitalization, Mrs. J. could be provided with oral instruction and a detailed list of prescribed medications explaining time, order, dosage, and side-effects briefly enough but preserving necessary details. This patient education procedure could ensure that Mrs. J. has a reminder and can navigate her prescriptions independently.
Cojutti, P., Arnoldo, L., Cattani, G., Brusaferro, S., & Pea, F. (2016). Polytherapy and the risk of potentially inappropriate prescriptions (PIPs) among elderly and very elderly patients in three different settings (hospital, community, long-term care facilities) of the Friuli Venezia Giulia region, Italy: are the very elderly. Pharmacoepidemiology and Drug Safety, 25(9), 1070–1078.
Uwase, I. M. A., Sowmiya, S., Senthilvelan, M., Baburaj, K, & Elaiyaraja, A. (2019). A study on prescribing pattern of antihypertensive drugs in medicine department in a tertiary care teaching hospital. Pharma Innovation Journal, 8(9), 146-149.
Werchan, C. A., Steele, A. M., Janssens, T., Millard, M. W., & Ritz, T. (2018). Towards an assessment of perceived COPD exacerbation triggers: Initial development and validation of a questionnaire. Respirology, 1–7.
Ziaeian, B., & Fonarow, G. C. (2016). Epidemiology and aetiology of heart failure. Nature Reviews Cardiology, 13(6), 368–378.