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An EKG to monitor the heart rhythms.  Oxygen saturation needs to be monitored (*82% is low) and provided with additional oxygen via nasal cannula.  In addition, keeping the bed elevated will open the airways and aide in the flow of oxygen to the lungs and throughout the body. The patient’s labs need to be observed for any additional changes, and physical assessments need to take place for signs of edema, and enlargement, such as swelling in the lower extremity of the body.

Medications and Rationales (Drugs.com, 2017)

Lasix (furosemide) is a loop diuretic (water pill) that prevents your body from absorbing too much salt. Lasix is used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome.

Enalapril (Vasotec) is an ACE inhibitor. ACE stands for angiotensin converting enzyme. Enalapril is used to treat high blood pressure (hypertension) in adults and children who are at least 1 month old. Enalapril is also used to treat congestive heart failure in adults.

Metoprolol (Lopressor) is a beta-adrenergic blocking agent (beta-blocker) and diuretic combination. The beta-blocker works by slowing down the heartbeat, helping the heart beat more regularly, and reducing the amount of work the heart has to do. The diuretic increases the elimination of excess fluid, which helps to decrease blood pressure.

Morphine Sulfate (IV) Morphine is used to treat moderate to severe pain. In addition, it can help with the anxiety and mechanisms of the heart.

Four Cardiovascular conditions that can lead to heart failure

1. Coronary artery disease (AHA, 2017)
2. High blood pressure (AHA, 2017 
3. Previous heart attack (AHA, 2017)
4. Myocarditis (Mayo Clinic, 2017)

Suggestions for prevention include: a lifestyle change of bad habits, such as smoking, alcohol consumption, and losing weight, adding an exercise regimen that involved 30-35 min of exercise that increases the heart rate at least 3 times a week, and a well-balanced diet not rich in fast food choices and high in fried or fatty foods.  All these suggestions will help with all the conditions listed above that could occur (AHA< 2017).

Interventions for drug-Problems in the Elderly    

There are some creative and non-creative ways to assess and implement whether an elderly person has too many medications at the same time, or similar ones.  Hence, the term polypharmacy.  One example, is the Brown bag method to help reduce polypharmacy in the elderly population, because “A recent study found that this method produces a more accurate list of the drugs an elderly patient takes” (Modern Science, 2017. A second example is a pill organizer.  I love the application Pinterest and I have seen many creative ways to organize pills (Pinterest, 2017). These can be organized by day and night, am or pm, and so on. Last, suggesting that the elderly patient use the same pharmacy for all prescriptions. 

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