What nursing interventions are appropriate for Mrs. J. at the time of her admission?
What nursing interventions are appropriate for Mrs. J. at the time of her admission?
Interventions:
-Oxygen
-Elevate head of bed
-Relieve anxiety
-Medications
-ECG & other diagnostic studies
Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?
1. IV furosemide (Lasix) is a diuretic used in heart failure patients because heart failure leads to renal retention of sodium and water, which will increase the blood volume and venous pressure, and cause edema formation. Pulmonary edema (caused during left ventricular failure) can be life threatening due to pulmonary oxygen exchange being compromised. Diuretics are used to promote renal loss of sodium and water which reduces chances of vascular congestion and edema.
2. Enalapril (Vasotec) is an angiotensin-converting enzyme (ACE inhibitor). It is used to help block the angiotensin-converting enzyme, which is what is used by the body to cause the blood vessels to constrict. When you block this enzyme the blood vessels relax which cause a lower blood pressure, that increases the efficiency of the heart. This is used to help the body pump more blood out to the rest of the body.
3. Metoprolol (Lopressor) is a beta-blocker. Beta-blockers are used to help treat left ventricular systolic dysfunction. They are typically used with other medications to treat heart failure. They are also used to treat diastolic heart failure. They do this by slowing the heart rate and allowing more time for the heart to fill with blood to increase the ejection fraction.
4. IV morphine sulphate (Morphine) is used to reduce preload, heart rate, and possibly afterload, the net effect of which is a reduction in myocardial oxygen demand.
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