An Evaluation of Mrs. J’s Health History and Medical Information

Registered Nurses (RNs) play an essential role in providing quality care to patients in the health environment. On many occasions, individuals suffering from different ailments experience challenges that affect their way of life. In this case, Mrs. J’s health history and medical information will be evaluated to develop a report highlighting the aspects, which should be considered during the administration of care.

Clinical Manifestations


When examining Mrs. J, she was anxious and asked questions regarding her survival chances. She was afraid of death because of her inability to breathe, despite denying experiencing pain. Since her pulse rate was high, Mrs. J stated that she felt like her heart was running away. In the same vein, the patient indicated her inability to feed herself because of general body weakness, which affected her mobility.


The patient weighed 95.5 kgs and was 175cm tall. When examining her vital signs, I realized that her Respiratory Rate (RR) of 34 was above the standard levels. Likewise, Mrs. J’s Heart Rate (HR) of 118 was irregular and contributed significantly towards her health status. With her Blood Pressure (BP) of 90/58 being low, her temperature of 37.6C was slightly above the recommended range of 37.2C. A cardiovascular examination on Mrs. J revealed decreased breath sounds as she coughed frothy blood-tinged sputum.

Nursing Interventions

Since Mrs. J’s breathing patterns were ineffective, the nursing interventions administered on her played a significant role in mitigating the effects of the condition on her deteriorating health. The inhaled short-acting bronchodilator, the inhaled corticosteroid, and the oxygen delivered at 2L/NC helped Mrs. J regain control of her breathing pattern. Examining the patient’s symptoms enabled the nursing practitioner to develop a series of proactive interventions and treatment regimens, which helped Mrs. J to recover from the impending health condition. When administering IV furosemide, RNs should slowly inject the medicine at a 4 mg/minute rate. The Vasotec medication enabled Mrs. J to overcome her high blood pressure to prevent heart failure. Given her inability to breathe effectively, Lopressor was administered to help Mrs. J overcome her low blood flow. A milligram of morphine sulfate medication was administered intravenously to eliminate the patient’s pain.

Cardiovascular Conditions that Lead to Heart Failure

Coronary Artery Disease

This cardiovascular condition is caused by a continued build-up of cholesterol and fat deposits around the arterial walls (Monticone, Burrello, Tizzani, Bertello, Viola, Buffolo, & Veglio, 2017). Treatment options include surgery, medications, and medical procedures that inhibit the condition. Individuals are advised to maintain a healthy lifestyle, quit smoking, and reduce LDC cholesterol.

High Blood Pressure

Patients experiencing high blood pressure experience a surreal moment of dizziness, pounding feeling in their chest, and headaches. Treatment options include medication and embracing healthy ways of living to overcome conditions that affect their medical status. Nursing interventions involve the limitation of salt consumption, drinking more water, and wearing compression stockings.

Previous Heart Attack

The blockage of blood flow causes heart attacks to the arteries due to a buildup of fatty deposits and cholesterol on the arterial walls. Symptoms include fatigue, lightheadedness, and abnormal heartbeats. A person who experienced a heart attack is likely to succumb to heart failure because of the heart’s weakening state. Nursing interventions involve the administration of oxygen and medication therapy to aid the recovery process of an individual.

Nursing Interventions for Problems Caused by Multiple Drug Interactions

Individuals should take advantage of medical reconciliation reviews to interact with the RNs to eliminate recurring medications when treating an acute medical problem. Duplications are synonymous with treating acute conditions because of multiple providers who may avail systematic treatment due to their limited interactions (Francis & Tang, 2019).

Patients and RNs should complete medication reviews and take action on polypharmacy’s rising impact on the elderly population. Multiple drug interactions expose patients to a wide range of health risks that interfere with their recovery process. In this regard, participating in medication reviews equips one with an understanding of the medications that can be avoided because of their recurrence.

Embracing behavioral modification strategies in health facilities enables RNs and patients to create healthy interactions that promote the provision of quality care. Significantly, adjusting a patient’s immediate environment to incorporate aspects such as preferred music and pets changes the perspectives towards the treatment regimen.

Prescribed medication should include the indicators and symptoms to avoid a mismatch that may result in death in extreme cases. Including the diagnosis for which a specific medical prescription has been developed enables RNs to evaluate its impact and the administered drugs’ ability to resolve the health issue.

Health Promotion and Restoration Teaching Plan

In deploying the three strategies for health promotion, I will develop treatment approaches that enable, mediate, and advocate for a healthy way of life. In this regard, Mrs. J should quit smoking and embark on a healthy lifestyle to overcome the medical condition affecting her health status. Given her dormant lifestyle, Mrs. J will be introduced to a series of activities that will promote her physical activity to overcome the challenges posed by her cardiovascular medical condition. Likewise, Mrs. J will be exposed to smoking cessation programs such as “quit” activities and “brief interventions” that will enable her to achieve a healthy way of life. Nurses can assist patients with transitions that will allow them to accomplish their desired goals and objectives.

Health Awareness

Mrs. J should be exposed to a readmission prevention-focused collaboration to overcome issues that hinder her from fulfilling her medical obligations. Even though the patient will be rehabilitated to quit smoking and embrace a healthy way of life, there is a need to demonstrate the importance of aligning her interests with the recommended health practices to reduce future readmission (Morris & Jenkins, 2018).

COPD Triggers

Cigarette smoking and other irritants increase the probability of succumbing to COPD because of the nature of the body to retaliate to the consumed drugs. In the same vein, air pollution, secondhand smoke, and exposure to dust may trigger Mrs. J’s COPD, which will affect her overall health. Prescription nicotine is a viable option that can be used to control the patient’s smoking habits because of its impact on her overall health status. Bupropion and varenicline are some of the prescription non-nicotine approaches that should discourage the patient’s smoking urge.


In this analysis, Mrs. J’s health history and medical information were evaluated, and various treatment regimens developed to enable her to recover from the medical condition affecting her life. Notably, the paper has assessed the nursing interventions used to expedite her recovery process and eradicate her smoking habits by using prescription nicotine and non-nicotine medications.




Francis, G. S., & Tang, W. W. (2019). Pathophysiology of congestive heart failure. Reviews in cardiovascular medicine4(S2), 14-20.

Monticone, S., Burrello, J., Tizzani, D., Bertello, C., Viola, A., Buffolo, F., … & Veglio, F. (2017). Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. Journal of the American College of Cardiology69(14), 1811-1820.

Morris, D. M., & Jenkins, G. R. (2018). Preparing physical and occupational therapists to be health promotion practitioners: a call for action. International journal of environmental research and public health15(2), 392.

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