Nursing Interventions and Rationale for Administration of Drugs

Nursing Interventions and Rationale for Administration of Drugs The patient is brought in while anxious about her condition. She has been non-compliant with her medications and did not quit smoking, despite being hypertensive, having chronic heart failure and sleep apnea. Based on her current situation, the immediate nursing intervention required is the assessment of her apical pulse by auscultation and the reassessment of her ventricular rate. Also, the vital signs have to be re-assessed for observation and recording. This includes monitoring her blood pressure and observing her skin color and temperature.

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IV furosemide (Lasix) is a loop diuretic and is used to reduce fluid retention or edema in patients with congestive heart failure and other conditions. Enalapril (Vasotec) is an ACE inhibitor (Gahart & Nazareno, 2013). In this case, it is administered to dilate vessels and consequently improve blood flow to the heart. Metoprolol (Lopressor) is as a beta blocker. It is administered to reduce heart rate and inhibit isoproterenol-induced tachycardia. IV morphine sulphate (Morphine) is a narcotic and is administered as an analgesic to treat pain and also calm the patient.

Cardiovascular Conditions that May Lead to Heart Failure and Interventions to Prevent Heart Failure Atherosclerosis is the narrowing and hardening of arteries due to the build-up of plaque on the walls of arteries. This can cause increased blood pressure, increased workload of the heart and decreased blood supply to the heart muscles causing heart failure. Proper dieting, maintaining a healthy weight, exercising and proper management of the condition are some of the interventions to prevent heart failure in atherosclerosis. Congenital heart defects are another possible cause of heart failure. These defects may cause strain on the functional part of the heart leading to heart failure. Proper treatment and management are useful in reducing the risks of heart failure (DeSilva, 2013).

Hypertension strains the heart muscle to pump blood. Over a period, the muscles may become too stiff or too weak due to extra exertion and consequently fail to adequately pump blood. Dieting, exercising, and proper treatment can prevent the worsening of hypertension.

Cardiomyopathy, damage to the heart muscle can result in heart failure. Damage to the heart muscles can occur due to diseases, infections, alcohol abuse, toxicity by drugs, genetics or

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chemotherapy. The preventive measure, in this case, is by addressing, treating or eliminating the primary cause of cardiomyopathy (NIH, 2017).

Nursing Interventions to Prevent Problems Caused by Multiple Drug Interactions in Older Patients and their Rationales Older adults are prone to having multiple drug interactions due to polypharmacy and having multiple chronic conditions. One of the approach to prevent drug interactions is by promoting and prioritizing non-pharmacological approaches over drug use in managing certain conditions. By doing so, the number of drugs taken by the patient is reduced (Lavan & Gallagher, 2016). Nurses should also identify the indications of the drugs and the diagnosis they have been prescribed for. This enables to keep track of the drugs taken by the patient and also encourage safe prescribing.

Also, de-prescribing can help reduce polypharmacy. Nurses should continually review the medications taken by the patient and reduce or discontinue some medications. This is because the patient could be taking unnecessary drugs unknowingly. Risk vs. benefit approach can be used in reducing the medications taken by the patient. Lastly, they should instruct the patient to take their medications as prescribed, store them appropriately and always consult with their care provider before starting, discontinuing or making any changes in their medications.

This way it is easier to keep track of the drugs they use and consequently preventing or reducing drug interactions (Lavan & Gallagher, 2016).

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DeSilva, R. (2013). Heart disease. Santa Barbara, CA: ABC-CLIO. Gahart, B., & Nazareno, A. R. (2013). 2014 intravenous medications - E-book: A handbook for nurses and health professionals. Amsterdam: Elsevier Health Sciences.

Lavan, A. H., & Gallagher, P. (2016). Predicting risk of adverse drug reactions in older adults.

Therapeutic Advances in Drug Safety, 7(1), 11-22. doi: 10.1177/2042098615615472 NIH. (2017). Heart failure. Retrieved from https://www.nhlbi.nih.gov/health-topics/heart-failure