Mrs. J Case Study

Clinical Manifestations Present in Mrs. J

Mrs. J is a 63-year-old married woman. From the medical information offered, it is clear that she has a medical history of COPD, heart failure, hypertension, and smoking. Her initial weight of 55.5kg and a height 1.75m denotes that she is obese. Moreover, the BMI acquired from the clinical condition is 21.2, which is slightly above 30.  Currently, the patient suffers from hypertension, respiratory distress, and low-grade fever tachycardia arrhythmia. There is also a sign of pulmonary edema, made worse by grave heart failure. This disorder, together with dyspnea, and tachycardia, are several of the symptomatic indications that Mrs. J may be ailing from congestive heart failure. Both HR and RR are elevated.

Nursing Interventions upon Admission

The interventions administered upon Mrs. J entail numerous medical procedures and oxygen at 2 LPM by using the nasal cannula from the case study. A review of the critical signs was also done. This includes monitoring cardiac activities and SPO2 telemetry and auscultation of her abdomen, lung fields, and heart, which may help demonstrate the other necessary interventions to regulate Mrs. J’s symptoms. With jugular vein distension, a decrease in breathing, the existence of pulmonic crackles, and an account of protracted heart failure, the management of intravenous Lasix were indispensable. According to Colucci (2018), they are revealing indicators for acute decompensated heart failure and pulmonary congestion. Enalapril, an ACE, was suitable as a result of Mrs. J’s decompensated heart failure. Moreover, another significant intervention is the Metoprolol intervention that reduces vasoconstrictors’ concentration, which includes both renin and norepinephrine.

Cardiovascular Conditions that can Course Heart Failure and Prevention of Heart Failure

Some of the cardiovascular situations that may result in heart failure if not treated, comprise hypertension and coronary artery ailment.  Other ailments may include myocardial infarction and atrial fibrillation. With these disorders, adherence to medical procedures and modification of lifestyle practices, weight loss, and averting tobacco use may significantly impact reducing the risk of heart failure. It is essential for health practitioners to guarantee that patients abide by the medical procedures and assist the patients that may require an adjustment of their lifestyle practices and educating the patients on the disease.  According to Carroll et al. (2020), one of the top-most priority for most patients ailing from heart failure should be to stop smoking. Therefore, it is essential for health practitioners to raise awareness of smoking risks on cardiovascular health.  Similarly, patients need to comprehend the link between physical activities and the diminished threat of cardiovascular disorders.

Polypharmacy and Nursing Implications

According to Custodio et al. (2015), Polypharmacy entails numerous forms of medication by a patient and is considered a common aspect amongst the elderly. The challenges linked to this form of treatment may include failing to comply, falls, and potential multiple drug interactions.  Some of the interventions that may help prevent these challenges include patient education regarding the medication and maintenance of an appropriate list of medications.  The medication list should comprise the generic and brand names, the aims of the prescriptions, and dose to guarantee that each patient comprehends the reasons for ingesting the medicines. Whereas regular medication reconciliation aids averting medication faults, appropriate organization of the medical procedures will help improve patients’ adherence to healthy practices.

Health Promotion Strategy and Restoration Plan for Mrs. J

The patient may require wide-ranging training and backing prior to and after being discharged from the medical facility. In her stay at the medical facility, Mrs. J will be well-informed on adapting to the changing environment due to her health condition.  Also, she will obtain tips on ways of conducting a self-assessment and self-care at her residence.  A respiratory therapist may be required to continually update Mrs. J on COPD and processes a patient can undertake in the event of heart failure. There ought to be an early connection in case supervision during the admission period. This assists in evaluating the patient’s needs when released from the hospital, if she may need to proceed to a nursing home or return to her place of residence. In this case, Mrs. J may require more aid in terms of physical rehabilitation and a home-based nurse.  A home-based practitioner will help assess her health status changes and manage her medications (Mantovani et al., 2015).  Incorporating the interventions in Mrs. J’s care will help understand, gain independence, and information the significance of being compliant.

Methods for Providing Medication Education

Health practitioners are crucial in offering education to patients regarding medicine and compliance to medical practices.  One mode that may be utilized in providing education is by integrating the teach-back approach.  The nurses should consider her willingness to be taught, including psychological and physical preparedness, to sufficiently take part sessions concerning medication training. Moreover, the providers should evaluate and comprehend the patient’s health knowledge to institute an expressive and patient-centered training mechanism. The teach-back method involves requesting Mrs. J to explain what was previously expounded in their own words and the significance of the material accorded to them.

COPD Triggers

There are many causes that lead to chronic obstructive pulmonary disease (COPD). The first significant COPD trigger is smoking.  In the Nursing case study assignment, cessation of smoking should be prioritized.  Other COPD causes include breathing infections, air pollution, high humidity levels, and life-threatening weather environment. With the long smoking history, the approaches for ceasing smoking that may be suitable for Mrs. J entail behavioral and pharmacological resources. 5A’s method will help the nurses offer quality nursing care to Mrs. J, bringing an end to smoking.  The health practitioners shall evaluate the patient’s willingness to abandon the practice, provide a quitting mechanism, and organize for check-ups.


Generally, Mrs. J requires comprehensive education, recommendations, and supplementary care. She also requires support from the family and home-based assessment to guarantee medical adherence.  Presenting Mrs. J with the resources she requires shall significantly advance her quality of life, comprehend her medical condition, and explain why it is vital to sustaining her treatment.




Carroll, A. J., Huffman, M. D., Zhao, L., Jacobs, D. R., Stewart, J. C., Kiefe, C. I., … & Hitsman, B. (2020). Associations between depressive symptoms, cigarette smoking, and cardiovascular health: Longitudinal results from CARDIA. Journal of affective disorders, 260, 583-591.

Colucci, W. (2018). Treatment of acute decompensated heart failure: Components of therapy. Retrieved from:

Custodio, I. L., Paz de Oliveira, S. K., Lima, F. E., Queiroz, A. P., Lavina, M. C., & Galcao, M. T. (2015). Health promotion actions to patients with cardiovascular diseases: integrative  review. Journal of Nursing UFPE On Line, 9(7), 8583-8592. doi: 10.5205/reuol.7651-67144-1-SM.0907201511

Mantovani, V. M., Ruschel, K. B., Nogueira de Souza, E., Mussi, C. & Rabelo-Silva, E. R. (2015). Treatment adherence in patients with heart failure receiving nurse-assisted home visits. Acta Paulista de Enfermagem, 28(1), 41-47. doi:

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