What are five nursing interventions and why

What are five nursing interventions and why for this patient and what does each lab results indicate about this patient diagnosis? I am having trouble with this. See patient report below. Patient Background 78 year old female came into the ED on 9/10/22 c/o nausea, vomiting, generalized weakness, and shortness of breath. Pro BNP level 3856 (normal: less than 450 for 75+ year-olds), potassium is 3.2. Patient was admitted for further evaluation and treatment Medical history: HTN, chronic diastolic heart failure, paroxysmal atrial fibrillation, severe mitral valve regurgitation, mitral val prolapse, COPD, chronic respiratory failure with 2.5 L NC at home, chronic back pain, mixed connective tissue, GERD, hard of hearing. Surgical history: carotid endarterectomy, appendectomy, hysterectomy, cervical fusion surgeries. Social history: Denies alcohol, tobacco, drugs. Pt is widowed and lives with daughter. Can ambulate and perform ADLs independently. Assessment findings: Alert and oriented x4, pulse 71, respiration 22, BP 182/76, SpO2 95% on 2.5 L nasal cannula, temp. 98.2F (oral). Patient is lying in bed, no apparent distress. Pulses 2+ in all extremities. Heart sounds normal, S1 and S2 noted, no murmurs, no gallops, no clicks. Breath sounds coarse bilaterally, diminished at base. Bowel sounds present in all quadrants, abdomen soft, nontender, and nondistended. Skin intact without significant lesions or rashes. According to Maslow’s Hierarchy of needs client requires oxygen to keep saturation above 90%, reduce the work of breathing, and workload of heart. Antiemetics for nausea and vomiting. Erik Erikson stage of development Integrity vs Despair. Admitting diagnosis Etiology: Mitral valve prolapse Progression: Mitral valve prolapse progresses to severe mitral regurgitation over years Pathophysiology: In mitral valve prolapse, one or both mitral valve leaflets have extra tissue or stretch more than usual. The leaflets can bulge backward (prolapse) like a parachute into the left upper heart chamber (left atrium) each time the heart contracts to pump blood. The bulging may keep the valve from closing tightly causing regurgitation Lab Results CMP: Sodium – 148 H Potassium – 4.2 Chloride – 112 Anion gap – 9.2 BUN – 15 Creatinine – 0.97 Albumin – 3.2 L Calcium – 8.4 L Bilirubin – 0.50 AST – 52 H ALT – 8.0 L GFR – 60 CBC: WBC – 6.9 RBC – 2.65 L Hemoglobin – 8.0 L Hematocrit – 24.0 L Platelet – 97 L ABG: pH – 7.42 PaCO2 – 39.0 PaO2 – 65 L HCO3 – 25.2 BE – 1.0 iCa – 1.16 CXR impression: There is increased density in the left lung base. This could be related to atelectasis versus small pleural effusion. US carotid duplex bilateral impression: No hemodynamically significant stenosis in either carotid arterial system. Otherwise maintained systolic and diastolic velocities. Antegrade flow in the vertebral arteries. Minimal homogenous atherosclerosis changes. US renal bilateral impression: Normal sonographic appearance of both kidneys. The bladder is decompressed and not well evaluated on this study. Medications: Fentanyl citrate, 25 mcg, IV, Q2H, PRN, short-term analgesia, Elderly may be more sensitive to effects Tramadol HCL, 50MG, PO, Q4H, PRN, moderate to severe pain, use with extreme caution in patients >75 yr Dexmedetomidine w/Nacl, 1000 mcg, IV, ASDIR, sedation/anxiolytic, higher incidence of bradycardia and hypotension in patients >65yr Pravastatin Sodium, 20 mg, PO, bedtime, hypercholesterolemia, no impact of age and gender Methocarbamol, 500mg, PO, Q8H, PRN, muscle spasm, assess geriatric patients for anticholinergic effects Docusate sodium, 200 mg, PO, BID, prevent constipation, no age or gender impact. Morphine sulfate, 2mg, IV, Q1H PRN, mild to moderate pain, use lower doses as elderly may be more sensitive. Acetaminophen, 650 mg, PO, Q4H PRN, mild pain, no age or gender impact Ondansetron HCL, 4mg, IV, Q8H PRN, nausea, no age or gender impact. Norepinephrine, 4mg, IV, ASDIR PRN, hypotension, use with caution in elderly patients Famotidine, 3 mg, PO, bedtime PRN, GERD, no age/gender impact SCIENCE HEALTH SCIENCE NURSING NURSING MS 5311

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