Hypertension, chronic heart failure, and sleep apnea

Hypertension, chronic heart failure, and sleep apnea

Hypertension, chronic heart failure, and sleep apnea
Mrs. J., 63, has hypertension, chronic heart failure, and sleep apnea. She has refused to quit smoking two packs of cigarettes per day for the past 40 years. She got the flu three days ago, with fever, pharyngitis, and malaise. For the past four days, she has not taken her antihypertensive or heart failure medications. She was admitted to the hospital’s intensive care unit today with acute decompensated heart failure.
Subjective Information
1. Is very concerned and wonders if she will die.
2. Denies feeling pain but claims she can’t get enough air.
3. She claims that her heart is “running away.”
4. Reports that she is so exhausted that she is unable to eat or drink on her own.
Data that is objective
1. 175 cm in height; 95.5 kg in weight
2. Vital signs: T 37.6 degrees Celsius, HR 118 and irregular, RR 34, BP 90/58
3. Cardiovascular: Distant S1, S2, S3, S4 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; preliminary cardiac monitoring shows a ventricular rate of 132 and atrial fibrillation.

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4. Respiratory: Pulmonary crackles, decreased breath sounds in the right lower lobe, coughing up frothy blood-tinged sputum 82 percent SpO2
5. Gastrointestinal: BS is present, with hepatomegaly 4 cm below the costal margin.
Sleep apnea, hypertension, and chronic heart failure
What nursing interventions are appropriate for Mrs. J. during her hospitalization? Mrs. J. begins drug therapy to control her symptoms. What is the rationale for administering each of the medications listed below?
1. intravenous furosemide (Lasix)
2nd. Enalapril (Vasotec)
3rd. Metoprolol (Lopressor)
4. morphine sulphate IV (Morphine)

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