The subjective information indicates that Mrs. J is experiencing anxiety, and feeling like she’s about to die. Her heart feels “going away” and she has trouble breathing. She feels tired and unable to drink, eat or do her regular ADLs. A flu-like condition, which included symptoms such as fever, productive and severe coughs, nausea, lethargy, and fatigue, struck her three days back. Mrs. J stands at 1.75m and weighs 210.5kg. A fever of 37.6°C, a heart beat of 118 and an irregular respiration of 34 indicate that she has blood pressures of 90/58. She fainted and her cardiovascular data indicated that she had a S1-S2-3 distant S3. All of her peripheral pulses are 1+. The first cardiac monitoring revealed that her bilateral jugular vessel distension was 1+. A respiratory analysis revealed pulmonary crackles and diminished breathing sounds in her right lower lobe. There was also Sp02 at 82%. The gastrointestinal data reveals the presence of BS as well as a 4cm hepatomegaly under the coast. This client was diagnosed with acute COPD exacerbation and severe heart failure.
Nursing interventions: IV furosemide (Lasix).
The drug could be considered acceptable because it had the purpose of decreasing and eliminating concomitant diseases and triggering events that might have led to an exacerbation or recurrence of heart failure. (Hamo and al. 2020). These symptoms include edema, dyspnea and fatigue. It is a very effective medication in increasing the diuretic capacity.
b. Enalapril/Vasotec
Because it increased dopamine (which has a good inotropic effect), the medicine delivery was appropriate. It delayed the effects of neurohormonal stimulation on cardiac remodeling, which in turn helped improve LVEF (Chavey et. al. 2017, 2017). This occurs after the acute coronary infarction component.
c. Metoprolol (Lopressor).
The administration of beta-adrenergic antagonists, which help to interrupt the neurohormonal vicious circle for patients’ identified problems, was required (Zahatari and al., 2002).
d) IV morphine sulfate (Morphine)
It has both anticipated anxiolytic as well as vasodilatory properties, which was considered acceptable. It acts as a decongestive medication agent, to relieve the predetermined symptoms of AHF or dyspnea. (Agewall 2021).
e. Inhaled short acting bronchodilator ProAir HFA. This was because the client had a history of heart failure and chronic obstruction. This drug was able to relax client’s narrowing of the airways. It also made it easier for him to breathe (Kerwin, et al. 2017, 2017). The drug can also relieve acute shortness and mucus buildup in the lungs.