Case Study: Cardiorespiratory

Case Study: Cardiorespiratory

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below. Case Study: Cardiorespiratory

Health History and Medical Information

Health History

Mrs. 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. Case Study: Cardiorespiratory

Subjective Data

1.  Is very anxious and asks whether she is going to die.

2.  Denies pain but says she feels like she cannot get enough air.

3.  Says her heart feels like it is “running away.”

4.  Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1.  Height 175 cm; Weight 95.5kg.

2.  Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

3.  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. Case Study: Cardiorespiratory

4.  Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

5.  Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1.  IV furosemide (Lasix)

2.  Enalapril (Vasotec)

3.  Metoprolol (Lopressor)

4.  IV morphine sulphate (Morphine)

5.  Inhaled short-acting bronchodilator (ProAir HFA)

6.  Inhaled corticosteroid (Flovent HFA)

7.  Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 850 words, critically evaluate Mrs. J.’s situation. Include the following:

1.  Describe the clinical manifestations present in Mrs. J. Case Study: Cardiorespiratory

2.  Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

3.  Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

4.  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.

5.  Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence. Case Study: Cardiorespiratory

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6.  Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

7.  Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, and abstract is required

Cardiorespiratory endurance is the level at which your heart, lungs, and muscles work together when you’re exercising for an extended period of time. This shows how efficiently your cardiorespiratory system functions, and is an indicator of how physically fit and healthy you are. Case Study: Cardiorespiratory

It’s useful to know your cardiorespiratory endurance level because it can either be a sign of health or a sign that you need to improve your level of fitness. Increasing cardiorespiratory endurance has a positive effect on your overall health. Your lungs and heart are able to better use oxygen. This allows you to exercise for longer periods without getting tired. Most people can increase their cardiorespiratory endurance by doing regular exercise

Metabolic equivalents (METs) are used to measure your intensity of exercise and uptake of oxygen. They measure energy expenditure at rest.

Cardiorespiratory endurance is measured by maximum oxygen uptake (VO2 max) and how it’s used during intense exercise. Higher amounts of oxygen uptake show that you’re using more oxygen and that your cardiorespiratory system is functioning efficiently. Case Study: Cardiorespiratory

VO2 tests are usually done with a clinician or exercise physiologist in a laboratory, hospital, or clinic. You can do submaximal tests with a qualified fitness instructor.

Submaximal exercise tests are used to measure your cardiorespiratory endurance. If you’re physically fit or an athlete, you can measure your cardiorespiratory fitness using:

  • the Astrand treadmill test
  • the 2.4 km run test
  • the multistage bleep test

More sedentary people can do the Cooper 1.5-mile walk-run test. You can also do a treadmill test or estimate your own levels comparing how fast you run to average results from races.

The tests can help provide information about how well your heart and lungs are working to get oxygen to your muscles during exercise. Your results may indicate your risk for developing heart disease or other chronic diseases. They will include resting blood pressure and heart rate. The results can then be used to help determine the type of exercise and weight loss programs that may be needed Case Study: Cardiorespiratory

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