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Ms. J has chronic heart failure, her vital signs reveal Atrial Fibrillation, tachypnea, and hypotension. She will need Oxygen for O2 sat of 82 %, telemetry to watch for cardiac arrhythmia’s, continuous O2 monitor, vital signs every 15 minutes, monitor intake and output every 4 hours, elevate head of the bed, establish IV, start IVF to keep vein open, and leave call light in reach.

 Ms. J will need to initiate treatment for heart failure.  Lasix is a diuretic that is needed to remove excess fluid in the body, it works by blocking the absorption of sodium, chloride, and water.  Given IV, the onset of action is within five minutes and last about 2 hours. Careful medical supervision is needed to monitor effects of Lasix on sodium, potassium, chloride, and hypotension. Angiotensin converting enzyme (ACE) inhibitor is meant for lowering blood pressure, and increasing oxygen to the heart by relaxing blood vessels, and this means that the heart doesn’t have to work that hard to get blood to the rest of the body. With Ms. J medication may need to be spaced out to prevent a significant drop in blood pressure. Metoprolol is a beta blocker, it slows down the heart rate and allows more time for the heart to fill with blood more completely, and pump out more blood to the body. Morphine produces a calming effect, vasodilation, and respiratory relaxation to help with “air hunger”, which is very distressing to the patient (Copstead, Kirkhorn, L, Banasik, J.L. 2014).

Four Cardiovascular conditions that can lead to heart failure are hypertension, atrial fibrillation, coronary artery disease (CAD), and so-me viruses.  The heart needs oxygen and nutrients continuously. When there is a disruption in cardiac blood flow, there is damage to cardiac tissue.  Hypertension can be controlled by treating the underlying cause such as stress, caffeine, smoking, drinking, sleep apnea, and by taking antihypertensive medication. Atrial fibrillation can be caused by caffeine, smoking, and alcohol. Abstaining from these products will help survival. Coronary artery disease is the most common cause of heart failure. Atherosclerosis is when plaque builds up in arteries. CAD can be managed to prevent heart failure by eating healthy, such as eating more fruits adds vegetables, less red meat, taking medication for cholesterol (Copstead-Kirkhorn, L., Banasik, J. L. 2014).  

Some nursing interventions to help prevent problems related to multiple drug interactions are:

  1. Advise patient to make a list of all medications names, brand and generic
  2. Bring all medication to doctors’ appointments to prevent duplication of prescriptions and to see if the patient has duplicate medications
  3. Advise patient of dietary interactions and side effects of medication and when to notify the clinic about problems or reactions
  4. Advised patients to use only one pharmacy to fill medications, so that medications can be monitored closer (Woodruff, K. 2017).



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