Week 3 essay
The history, signs and symptoms of this patient indicates that she is suffering from heart failure, a condition considered as a medical emergency. As they wait for the doctor ,nurses should admit the patient under intensive care unit ,put the patient in half-upright position to decrease the patients intra thoracic volume, rest the patient and keep her calm, the room must be well ventilated to improve air circulation, loosen tight clothing, put the patient under oxygen supply to improve breathing. Ask the patient for any history of chest pain medication, and then assist the patient take nitroglycerin to help her lower tension in blood pressure. A tourniquet can be tied on thigh to exclude some blood from circulation. In case the patient is unconscious, begin Cardiopulmonary Resuscitation.
Furosemide is a diuretic drug which stimulates the kidneys to eliminate excess fluid that might stress the heart. In this way, it prevents oedema, and high blood pressure. Enalapril is an inhibitor for Angiotensin Converting Enzyme, a blood vessel dilator. Inhibition of these enzymes helps to reduce heart rate thus lowering the blood pressure. Metaprolol is a beta blocker and is used to reduce blood pressure and prevent effects of certain hormones which might promote disease progression. They are used to treat chest pain, myocardial infuction and coronary heart failure. Morphine sulfate is an opiate analgesic used as a pain killer due to its action on the central nervous system (Heart failure. (n.d.)
Causes of heart failure
Hypertension accounts for nearly 75% of incidences of heart failure .It develops when the muscles of the heart thickens due to high blood pressure. This is managed by keeping the patient calm, providing enough rest and treatment with antihypertensive such as furosemide and enalapril. Coronary Artery Disease and Heart Attack are caused by atherosclerosis, a process in which the arteries harden due to accumulation of excess cholesterol. This accumulation may create injury and inflammation in the blood vessel .The narrowing of the arteries then creates pumping problems in the hearts left chamber, thus resulting in heart failure. Management involves provision of sufficient rest and keeping calm to relieve stress. Drug therapy can be done using beta blockers, calcium antagonists, nitroglycerin among others. Surgical intervention such as grafting, coronary stent implantation and angioplasty can also be embraced.
Valvular Heart Disease is caused by abnormalities in the valves which control blood flow in and out of the heart. These defects may cause blood to leak back to the heart. Treatment for this condition can be achieved by use of antibiotics. In cardiomyopathy the heart muscle is damaged leading to poor pumping of blood thus leading to heart failure. This can be caused by viral myocarditis leading to dilated cardiomyopathy, hypertrophic cardiomyopathy or restrictive cardiomyopathy. Treatment for symptoms for heart failure and agina can be used against this condition. Heart transplant, angioplasty and use of a defibrillators are necessary for control of this condition. However change in lifestyle is very essential for management of cardiomyopathy (Heart FailureTreatment. (n.d.)
Adverse drug effect and drug interaction is important for the safety of the patient. This can be done by avoiding dispensing and prescription errors .Ways of avoiding these effects include, long term care which involves surveillance and reporting of such problems, community care to enforce adherence to medication as directed by the doctor, prescription in a systematic way, discontinuation of unnecessary therapy, dosing schedule should also be simplified and ensure prescription of beneficial therapy only (Rochon, (2014)
Rochon, P. (2014). REFERENCES. Drug prescribing for older adults. Retrieved March 18, 2014, from http://www.uptodate.com/contents/drug-prescribing-for-older-adults
Heart failure. (n.d.). University of Maryland Medical Center. Retrieved March 16, 2014, from http://umm.edu/health/medical/reports/articles/heart-failure
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