Nursing interventions may include conducting a patient assessment to identify the drug side effects a patient reports and identifying the drug interaction that could be causing the side effects (Cantlay, Glyn & Barton, 2016). The nurse can document the reported side effects and recommend the drugs that should be stopped to the prescribing clinician to help lower the severity of side effects. Additional nursing interventions include conducting a comprehensive drug evaluation of every drug prescribed to a patient (Cantlay, Glyn & Barton, 2016). This can help identify the drugs that may have multiple drug interactions and recommend for modification of the treatment plan. Furthermore, the nurse can recommend alternative non-pharmacological measures to manage chronic illnesses and symptoms such as chronic pain (Cantlay, Glyn & Barton, 2016). For example, heat and cold massages and physiotherapy can be used to manage pain, while lifestyle interventions can be recommended for lifestyle diseases.
The health promotion plan for Mrs. J will focus on lifestyle modification to promote better self-management of chronic conditions and prevent disease progression. The first lifestyle intervention will be on cessation of smoking to avoid exacerbation of bronchospasms secondary to COPD and slow the advancement of COPD (Rosenberg & Kalhan, 2017). The second intervention will be to increase physical activity by engaging in moderate exercises such as brisk walking and jogging that the patient can tolerate. This will promote weight loss, improve lung function, maintain blood pressure within a normal range, and boost heart functioning (Thomas, 2019). Besides, the patient will be recommended on healthy dieting such as the DASH diet to help manage blood pressure and promote weight loss.
Multidisciplinary resources needed to rehabilitate Mrs. J will consist of nutritional interventions, assistance in activities of daily living, energy-saving techniques, physical training, and health education on self-management (Riley & Masters, 2016). The rehabilitation resources will help Mrs. J transition to independence by helping her adopt self-management skills that will enable her to conduct daily living activities. Besides, energy-saving techniques will help the patient perform her activities independently with minimal restrictions (Riley & Masters, 2016). Physical training will help increase lung function and enable the patient to work independently without exertional dyspnea.
Mrs. J should be educated on drug adherence to prevent future hospitalization due to COPD exacerbations, hypertension urgency, or worsening heart failure. The patient and the caregiver can be advised to have a list of all her drugs with their frequency, dosages, and indication for each drug (Cantlay, Glyn & Barton, 2016). They can be instructed to use the list when taking medications to ensure she has taken all the essential drugs. She can also be instructed to label each drug container according to the indication for each, to ensure she has taken drugs for each health condition (Cantlay, Glyn & Barton, 2016). Besides, she can use color-code pill containers to avoid confusion or drug overdose (Cantlay, Glyn & Barton, 2016). Mrs. J can also be recommended to store the essential drugs where she can see and use reminders to help her remember to take her drugs.
Tobacco smoke is the most common COPD trigger, which accounts for 80-90% of exacerbations due to bronchoconstriction (Rosenberg & Kalhan, 2017). Exposure to second-hand smoke, carbon monoxide, and dust may also trigger COPD exacerbations leading to hospitalization (Rosenberg & Kalhan, 2017). Mrs. J can be offered smoking cessation options such as professional counseling with education on how tobacco smoking causes COPD exacerbations and leads to the progression of hypertension and heart failure. Group counseling should be provided for the patient to interact with individuals who are in the process of tobacco smoking to increase the likelihood of complete tobacco cessation.
Aronow W. S. (2018). Antihypertensive drug therapy. Annals of translational medicine, 6(7), 123. https://doi.org/10.21037/atm.2018.01.26
Cantlay, A., Glyn, T., & Barton, N. (2016). Polypharmacy in the elderly. InnovAiT, 9(2), 69-77. https://doi.org/10.1177/1755738015614038
Order this paper