Upon admission to the unit, she will need a head to toe assessment as well as a peripheral IV. Labs will need to be drawn (CBC and BMP). Her VS will need to be monitored along with daily weight. Ms J. will need to be monitored with telemetry as well. She will need O2 and to be placed on a fluid restriction as well as strict I&O.
Lasix is a loop diuretic and is used to remove excess fluid from the body via the urinary system. By doing so, the heart and blood vessels are less strained decreasing blood pressure and stain on the vessels. This will also alleviate shortness of breath and difficulty breathing. Vasotec is an ACE inhibitor. ACE inhibitors relax vessels to make blood flow easier. They are commonly used to treat HTN therefore reducing risk of stroke, heart attack and kidney damage. Metoprolol is a beta-blocker and is typically used in conjunction with the Vasotec to treat HTN. Morphine can be used to treat breathlessness by reducing anxiety.
Diabetes: Uncontrolled diabetes has long-term effects on the vascular system causing damage that can lead to atherosclerosis as well as nerve damage that may cause dysfunction in the heart as well. Managing blood sugar is the best intervention for these clients. Through diet, exercise and medication, maintaining a healthy blood sugar can eliminate risk.
Hypertension: Over time, high blood pressure causes damage to the heart because the heart has to work harder and is less efficient. Medication and lifestyle changes can help reduce damage.
Myocardial infarction: After a patient has experienced an MI there is damage done to the heart muscle itself which causes the heart to be less efficient and oxygenated. Patients who have experienced MI need close follow up and medication adherence.
Obesity: The heart has to work harder for those who suffer from obesity. Lifestyle changes can help reduce risk of heart failure over time.
The patient needs a current med list including brand and generic names along with doses and timing. The medical providers should all be up to date on meds taken by the patient either via the list or EMR. Patients need an organized system of storage for medications as well as assistance if there is any question regarding capability in managing medications. Nurses need to provide education regarding medications and written material to be taken home with them regarding instructions for taking meds. Written material needs to be in the patient’s primary language as well as large enough print to be read.
