Mrs. J. is a 63-year-old woman who has a history of hypertension chronic heart failure and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit.

Mrs. J. is a 63-year-old woman who has a history of hypertension chronic heart failure and sleep apnea. She has been smoking two packs of cigarettes a day for 40years and has refused to quit.
Use the following Case Scenario Subjective Data and Objective Data to answer the Critical Thinking Questions.
Case ScenarioMrs. J. is a 63-year-old woman who has a history of hypertension chronic heart failure and sleep apnea. She has been smoking two packs of cigarettes a day for 40years and has refused to quit. Three days ago she had an onset of flu with fever pharyngitis and malaise. She has not taken her antihypertensive medications or hermedications to control her heart failure for 4 days. Today she has been admitted to the hospital ICU with acute decompensated heart failure.Subjective Data1.Is very anxious and asks whether she is going to die.2.Denies pain but says she feels like she cannot get enough air.3.Says her heart feels like it is running away.4.Reports that she is so exhausted she cannot eat or drink by herself.Objective Data1.Height 175 cm; Weight 95.5 kg2.Vital signs: T 37.6 C HR 118 and irregular RR 34 BP 90/583.Cardiovascular: Distant S1 S2 S3 S4 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiacmonitoring indicates a ventricular rate of 132 and atrial fibrillation4.Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%5.Gastrointestinal: BS present: hepatomegaly 4 cm below costal marginCritical Thinking QuestionsWhat nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationalefor the administration of each of the following medications?1.IV furosemide (Lasix)2.Enalapril (Vasotec)3.Metoprolol (Lopressor)4.IV morphine sulphate (Morphine)Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development ofheart failure in each condition.Taking into consideration the fact that most mature adults take at least six prescription medications discuss four nursing interventions that can help preventproblems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

 
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