Nursing Intervention Plan

Nursing interventions are actions used to further the course of treatment for a patient. Once the assessment and diagnosis are completed, the nurse must follow through with planning, interventions and evaluation. An elderly patient is presented with numerous medical issues and experiencing difficulty breathing. Once the patient is diagnosed with hypertension, COPD, GERD, and exacerbation, the nurse can approve appropriate interventions to treat the pathophysiology of each disease. An appropriate pharmacological therapy plan is essential in providing the accurate treatment for the patient. The pumping ability of the heart is compromised by a continuum between coronary artery disease, myocardial ischemia, and myocardial infarction. This

Hypertension affects the cardiovascular system and is associated with kidney disease, stroke, and myocardial infarction. (McCance 1149). Hypertension involves the combination of genetics and environmental risks along with the sympathetic nervous system (SNS), the renin-angiotensin-aldosterone-system (RAAS), and natriuretic peptides. The SNS promotes cardiac contractility and heart rate and induces arteriolar vasoconstriction leading to the maintenance of blood pressure and tissue perfusion. (McCance 1150). Over activity of the SNS increases heart rate, insulin and peripheral resistance while narrowing the arteries, which eventually causes the blood pressure to rise resulting in hypertension. Dysfunction of the RAAS leads to renal salt retention and peripheral resistance causing the blood pressure to increase leading to hypertension. Impairment of natriuretic peptides, along with changes in the RAAS and the SNA, leads to an increase in vascular tone contributing to the rise in blood pressure. (McCance 1151). Inflammation caused by endothelial injury and tissue ischemia result in stress and the release of cytokines that contributes to vascular

Epidemiological studies have recognized a strong association between hypertension and CAD. (Rosendoroff 1373). .Beta blockers, calcium channel blockers, and ace inhibitors are used in both diseases. Heart rate, preload, afterload, and contractility determines the demand for cardiac oxygen. (Burchum 581). Beta blockers reduce the demand for cardiac oxygen by causing a reduction in afterload, contractility and heart rate. They also increase oxygen supply and reduce angina pain. Beta blockers suppress reflex tachycardia and decrease renin release enabling the decrease of blood pressure. Common side effects for beta blockers are bradycardia, drowsiness, fatigue, dry mouth, nausea, vomiting, and diarrhea. Calcium channel blockers method of action is to prevent calcium ions from entering cells in order to treat effects on the heart and blood vessels. (Burchum 485). The intended outcome is to relax the coronary artery spasm and increase cardiac oxygen supply resulting in the decrease in afterload and contractility. (Burchum 588). Calcium channel blockers may cause constipation, dizziness, facial flushing, headache and edema. Angiotensin-converting enzyme (ACE) inhibitors prevent the formation of angiotensin II leading to the decrease in blood pressure. (Burchum 509). ACE inhibitors reduce blood volume and prevent changes in the heart and blood vessels.