Taking into consideration the fact that most mature adults
Taking into consideration the fact that most mature adults take at… Taking into consideration the fact that most 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. Provide a rationale for each of the interventions you recommend.Health History and Medical InformationHealth HistoryMrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.Subjective DataIs very anxious and asks whether she is going to die.Denies pain but says she feels like she cannot get enough air.Says her heart feels like it is “running away.”Reports that she is exhausted and cannot eat or drink by herself.Objective DataHeight 175 cm; Weight 95.5kg.Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.InterventionThe following medications administered through drug therapy control her symptoms:IV furosemide (Lasix)Enalapril (Vasotec)Metoprolol (Lopressor)IV morphine sulfate (Morphine)Inhaled short-acting bronchodilator (ProAir HFA)Inhaled corticosteroid (Flovent HFA)Oxygen delivered at 2L/ NCHealth Science Science Nursing NRS 410
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