Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.  Case Scenario  Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.  Subjective Data 1.Is very anxious and asks whether she is going to die. 2.Denies pain but says she feels like she cannot get enough air. 3.Says her heart feels like it is “running away.” 4.Reports that she is so exhausted she cannot eat or drink by herself.  Objective Data 1.Height 175 cm; Weight 95.5 kg 2.Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58 3.Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation 4.Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82% 5.Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin  Critical Thinking Questions  What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications? 1.IV furosemide (Lasix) 2.Enalapril (Vasotec) 3.Metoprolol (Lopressor) 4.IV morphine sulphate (Morphine)  Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.  Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

APA format 2 pages 4 peer review references 2 from Walden University Library

Due Monday April 30th at 7pm EST

Discussion: Urinary Tract Infections

Urinary tract infections (UTIs) are caused by bacteria—most often, Escherichia coli. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes, as well as among different age groups. It is important to understand how these factors and others impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

To prepare:

• Review Chapter 30 in the Huether and McCance text and Chapter 32 of the Arcangelo text. Identify the pathophysiology of lower urinary tract and upper urinary tract infections. Consider the similarities and differences between the two types of infections.
• Consider one type of drug that would be used to treat symptoms associated with urinary tract infections.
• Consider gender and one of the following patient factors: genetics, ethnicity, age, or behavior. Consider how gender and the factor you selected might impact the pathophysiology of the urinary tract infections. Then, reflect on how these factors might impact the effects of prescribed drugs, as well as any measures you might take to help reduce any negative side effects.

By Day 3

Post a description of the pathophysiology of lower urinary tract and upper urinary tract infections, including their similarities and differences. Then, describe one type of drug that would be prescribed to treat symptoms associated with urinary tract infections. Finally, explain how gender and another patient factor might impact the pathophysiology of the urinary tract infections and the effects of prescribed drugs. Explain measures you might take to help reduce any negative side effects.