Case Study: Mrs. T. It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span. Evaluate the Health History and Medical Information for Mrs. T., presented below. Health History and Medical Information Mrs. T., a 42-year-old female, has been living at home with her two high school age children, husband, and dog. She is a schoolteacher who works full-time teaching at the local grade school. She tries to be active by walking with her husband and dog for 20 minutes on the weekend but is starting to add weight as she gets older. She has no known allergies. She is a pack-a-day smoker and drinks three glasses of wine/per night after work. She tries to eat healthy but likes to eat out at fast food restaurants to avoid having to cook.
Pathophysiology
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Pathophysiology
At her age (62 years), Mrs. J. has a history of hypertension and other chronic diseases. despite her health complications, she continues to smoke 2 packs of cigarettes a day which she has done for the last 40 years. Based on the supplied facts, it is clear that Mrs. J. is going through a health crisis. She has presented a history of chronic health difficulties which has led to the deterioration of her current health. It is important to note that, her not taking medication as prescribed has exacerbated her illness.
Because of her age and severity, she is anxious and asks whether she is going to die. Based on her continuous chronic health difficulties, she says it is difficult for her to get enough air. After developing flu-like symptoms which included fever, productive cough, nausea, and malaise, she has been unable to perform basic ADLs. Additionally, she has since been able to take her antihypertensive medications to control her heart condition for the last three days. Upon admission, she had vitals signs read; T 37.6C, HR 118 and irregular, RR 34, BP 90/58. Decreased breath within the respiratory range.
Following the presentation of Mrs. J, she is at risk of these four cardiovascular conditions which include; coronary heart disease, stroke, peripheral arterial disease, and aortic disease. Coronary heart disease occurs when the heart muscle is interrupted by the build-up of fatty substances which can be greatly impacted by hypertension (Green, 2020). A stroke occurs when the blood supply to the brain is disturbed. Our case has a history of heart failure which may result in a stroke. Mrs. J's inability to perform ADLs and require assistance suggests peripheral arterial disease which occurs when there is a blockage in the arteries to the limps making it difficult for the patient to locomote. The last cardiovascular condition that Mrs. J is at risk of is Aortic disease which occurs when the wall of the aorta becomes weakened and bulges outwards causing enormous pain. All these conditions may lead to heart failure.
Nurses in this case have the role of assessing the vital signs. They should therefore assess SPO2 and cardiac monitoring to ensure Mrs. J's respiratory returns to normal. Given the role Smoking played in the development of chronic heart conditions, smoking cessation should be a priority intervention. Therefore, to stabilize her breath, ACE inhibitors are to be used especially in this case where the patient has cases of decompensated heart failure (Longhini et al., 2022; Fuchs & Whelton, 2020). This will further decrease venous and arterial pressures which improve oxygen consumption lowering the level of vasoconstrictors and primarily aid in the stimulation of beta 1receptors within the myocardial tissue which will lead to recovery of inotropic and chronotropic sensitivity.
Nurses can also offer a full set analysis of vital signs and telemetry to indicate other varied interventions including the medications that are necessary to control Mrs. J’s symptoms. Considering her age and tobacco abuse, nurses need to conduct auscultation of her heart, lung field, and abdomen to not only speed up recovery processes but also determine other necessary interventions. As an intervention, they can use intravenous Lasix is a loop diuretic hence it is important because of her history of chronic heart failure and the objective presence of pulmonary crackles, decreased breath, and jugular vein distensions (Renzi et al., 2022). These objective data indicate pulmonary congestion and acute decompensated heart failure. This will manage water levels which is related to fluid overload within the chest cavity.
To reduce anxiety, IV morphine can be administered which will further help in decreasing breathing. Normally, when opiates are administered to patients with anxiety and stress-related issues, they improve arteriolar and venous dilation. Supplementary oxygen is also an intervention but is not advisable to patients with SpO2 levels greater than 90 because of the risk of vasoconstriction and reduction of cardiac output (Renzi et al., 2022). At the time of admission, interventions that were conducted had the priority of stabilizing his breath. Administering furosemide (lasix), morphine sulfate, and supplementary oxygen played a critical role in ensuring the patient's breathing is stable. I would not change any intervention; I would introduce one non-pharmacological intervention