Answer the Critical Thinking Questions by referring to the Case Scenario, Subjective Data, and Objective Data in the following sections.

Example of a Case Scenario

A 63-year-old woman named Mrs. J. has a history of hypertension, chronic heart failure, and sleep apnea, among other conditions. In spite of her best efforts, she has continued to smoke two packs of cigarettes per day for more than 40 years. She developed flu-like symptoms three days ago, including fever, pharyngitis, and malaise. Four days have passed since she last took her antihypertensive medications or the medications she needs to control her heart failure. She was admitted to the intensive care unit of the hospital today with acute decompensated heart failure.

Data that is based on subjective judgment

She is extremely anxious and wonders aloud if she is going to die.

She claims she is not in pain, but she claims she is struggling to get enough air.

Her heart feels as if it is “running away,” she claims.

She claims to be exhausted to the point where she is unable to eat or drink on her own.

Information with a clear objective

The following measurements: height 175 cm; weight 95.5 kg

Vital signs: temperature 37.6 degrees Celsius, heart rate 118 and irregular, RR 34, blood pressure 90/58

Acute coronary syndrome (ACS): distal S1, S2, and S3 are present; PMI at sixth ICS is faint; all peripheral pulses are 1+. distention of the jugular veins on both sides; Initial cardiac monitoring reveals a ventricular rate of 132 beats per minute as well as atrial fibrillation.

In the respiratory system, there are crackles in the lungs, decreased breath sounds in the right lower lobe, and coughing up frothy blood-tinged sputum. 82 percent of the population has a saturation of oxygen.

The following symptoms are present in the gastrointestinal system: hepatomegaly 4 cm below the costal margin;

Questions about Critical Thinking

Mrs. J. has been admitted to the hospital, and what nursing interventions are appropriate for her at this time? Mrs. J. is starting a medication regimen to help control her symptoms. In each of the following cases, what is the rationale for the administration of the medication?

IV furosemide is administered intravenously (Lasix)

Enalapril is a prescription medication (Vasotec)

Metoprolol is a prescription medication (Lopressor)

IV morphine sulfate is administered (Morphine)

Describe four cardiovascular conditions that can lead to heart failure, as well as what can be done in the form of medical or nursing interventions to prevent the development of heart failure in each of the conditions listed.

Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients, taking into consideration the fact that the majority of mature adults take at least six prescription medications. Justifications should be provided for each of the interventions you recommend.