Polypharmacy And Drug Interactions

Running head: PATHOPHYSIOLOGY 1
Pathophysiology; Evaluation of a Hypertensive Patient with COPD
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College of Nursing
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Term and Year

PATHOPHYSIOLOGY 2
Mrs. J's clinical manifestations at the time of hospital admission were quite evident and
predictable as her medical history also helps add weight unto the manifestations. It is obvious
that Mrs. J has an existing cardiovascular conditions. At the time of hospital admission, she
exhibited clinical manifestations that suggested an exacerbation of the chronic obstructive
pulmonary disease.
She has a high heart rate of 118 beats per minute. This is explained in terms of the
physiological response of the body, which is trying compensate for the imbalances brought forth
(Chowdhury et. al., 2019). Her bilateral jugular vein distension suggests heart failure as the heart
chambers are congested. Her point of maximal impulse is the sixth intercostal space. Normally,
this point is ussually the 4th intercosatl space (Aimee et. al., 2019). This further suggests heart
failure. Her blood presure of 90/58 is unexpectedly low as her medical history shows that she
had not taken her antihypertensive drugs for the past three days.
The nursing interventions at her admission were appropriate. Her medical history
indicates that she had not taken her antihypertensive drugs for three days. This warranted the
administration of intravenous furosemide, which works within 5 minutes to offset the fluid
overload (Chowdhury et. al., 2019). Other antihypertensive drugs such as enalapril and
metoprolol were also given.
She explained that she felt exhausted and breathless. To ensure adequate gaseous
exchange, she was given a short acting bronchodilator which was inhaled to help dilate the
airway. She was also given inhaled corticosteroid because of her chronic obstructive pulmonary
disease to help reduce the resulting inflammatory process (Yıldırım & Kılınç, 2017). The

PATHOPHYSIOLOGY 3
measures to reduce the respiratory manifestations were enhanced by the administration of 2 liters
of oxygen.
There are several cardiovascular conditions that can lead to heart failure. The first of one
is coronary heart disease. This is a vascular disease of the blood vessels that supply the heart
with oxygenated blood (Assefa, Kedir & Kahaliw, 2020). Any interuptions in these vessels may
lead to poor oxygen supply to the heart and hence the onset of heart failure. The myocardium has
spontaneous contractions that need a lot of energy which should be maintanined by the delivery
of enough oxygen (Assefa, Kedir & Kahaliw, 2020).
Another cardiovascular condition is hypertension. The normal blood pressure is 120/80
(Aimee et. al., 2019). Hypertension has several causes and some data shows that it may have a
genetic predisposition. High blood pressure tolerated for a very long period of time overworks
the heart muscle (Edelmann et.al., 2018). This is because the blood vessels in the body cannot
absord all the force in the blood created by the pumping action of the heart (Aimee et. al., 2019).
The other condition is previous episodes of heart failure.
Polypharmacy is a major concern especially to the elderly population. Existing data
suggests that around 12% of the elderly population take more than 6 drugs (Marrouche et. al.,
2018). The first nursing intervention to reduce polypharmacy is to monitor for possible side
effects of the drugs administered (Aimee et. al., 2019). Any obvious side effects should be noted
early enough in order to start the mitigation process. The second intervention is to offer the drugs
that are only relevant to the patient in question. The nurse should have adequate knowledge of
the drugs and give the minimal number of the drugs as possible (Assefa, Kedir & Kahaliw,
2020). The third and most important intervention educating the patient on how to take the drugs.