Develop an accurate medication list for your patient. This medication list should be in words the patient can understand and include the name, dose, time for administration and the reason for each medication.

 
   1- We need to reassure Mrs. J to decrease her anxiety.  Lab work, chest x-ray and ECHO will be needed.  She will need a septic work-up and qualifies for a sepsis alert, however with signs and symptoms of congestive heart failure she may need an inotropic infusion instead of fluid bolus to correct her hypotension.  She may have developed pneumonia from the flu virus and could possibly have a pleural effusion.  The rationale for each of the medications ordered are as follows (U.S. National Library of Medicine, 2015)

Lasix      -for pulmonary edema – frothy blood-tinged sputum
Enalapril      – an ACE inhibitor is given for heart failure; it works by decreasing      vascular resistance – watch for further hypotension
Metoprolol      – a betablocker is for hypertension and heart failure; it slows the heart      rate and relaxes veins – again watch for hypotension
IV      morphine is usually for pain, but in this case, it is for the anxiolytic      properties and vasodilation (Naito, Kohno, & Fukuda, 2017).

       Four cardiovascular conditions that cause heart failure are coronary artery disease, myocardial infarction, myocarditis, and congenital heart defects (American Heart Association [AHA], 2017).  One condition is coronary artery disease caused by fatty deposits and cholesterol that clog arteries.  This can lead to the arteries that feed heart muscle becoming closed off resulting in heart muscle damage.  Second, a myocardial infarction happens when an artery that feeds the heart muscle is blocked causing lack of oxygen.  This ultimately results in death of the muscle and pump failure.  The blockage can be from a blood clot that traveled to the heart or from arteriosclerosis.  Another condition is myocarditis.  It is caused by an infection that attacks the heart muscle resulting in pump failure.  Finally, congenital heart defects can result in heart failure because the heart is malformed.  The malformation makes the heart work harder and the blood may not flow in an efficient manner (AHA, 2017). 
    For the most part, being active and eating a healthy diet are important factors to reduce the risks of developing heart failure.  Taking prescribed medications are very important to help improve heart function and reduce the heart’s work load.  For congenital heart defects, the patient may need surgery to correct the malformation; or sometimes, a heart transplant may be required.
    For medication safety,

Develop      an accurate medication list for your patient.  This medication list      should be in words the patient can understand and include the name, dose,      time for administration and the reason for each medication.       Encourage the patient to take ownership of her medications and keep the      list up to date.  Take it to every appointment no matter who the      doctor is.  Also, include any over the counter medications and check      for interactions with prescription medications.
Have      the patient use only one pharmacy for all of her prescriptions.  The      pharmacist will be able to identify any risks or issues with      contraindications or double medications for the same disease.
Have      your patient use a pill dispenser or other reminder system.  The pill      dispenser will not only keep the medications straight but will help the      patient know whether she took her medications for the day. 
Ask      your patient to bring her medications (the actual bottles) at least once a      year for evaluations.  This will allow for evaluation of dosages,      expired medications, etc.  This will also allow you to help the      patient dispose of medications that are no longer used or needed.       This will prevent the patient from accidentally taking the wrong pills.