NRS 410V Module 3 Mrs. J Case Study [UPDATED] NRS 410V Module 3 Mrs. J Case Study [UPDATED] | Page 2

Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is "running away."
Reports that she is so exhausted she cannot eat or drink by herself.
Objective Data
Height 175 cm; Weight 95.5 kg
Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
Cardiovascular: Distant S1, S2, S3, S4 present; PMI at sixth ICS and faint; all
peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac
monitoring indicates a ventricular rate of 132 and atrial fibrillation
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe;
coughing frothy blood-tinged sputum; SpO2 82%
Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin
Critical Thinking Questions
What 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 rationale for the administration of each of the following medications?
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
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 of heart failure in each condition.