Diagnoses and Intervention: Anxiety, Anemia and CAD

The patient is a 47-year-old male and has come in complaining of feeling weak and being short of breath. The patient has a history of CAD and chronic systolic heart failure. The patient smokes 0.25 packs a day and drinks. There are three possible diagnoses for this patient, and one could very well be psychosocial in nature. The intervention for this particular diagnosis would include therapy or a medication that aids in the prevention of depression or anxiety. If it were a psychosocial problem, it is likely that the patient is suffering from anxiety.

Other diagnoses for the patient are heart problems, complications of CAD from smoking and drinking, and anxiety that could be stemming from living in one house with three children, his spouse, and his sister. However, he is not suffering from chest pain or nausea, and x-rays show that his heart is stable and that the lungs are clear. It is suggested that he slow down and adopt a better diet.

The chart outlines the three diagnoses for the patient. They are anxiety, symptoms or complications from his past Coronary Artery Disease or a possible case of mild anemia (due to the shortness of breath).

(Diagnoses Chart omitted for preview. Available via download)

The following are the medications that could be recommended for this patient, listed with: generic and trade name, routes of administration, mechanism of action, half-life, indications for use for this patient, recommended dose based on this patient’s condition, most common side effects, most common adverse effects, contraindications for this patient, any black box warnings and nursing priorities regarding this drug for this patient.

Medications

Digoxin. Digoxin is used to treat congestive heart failure and it is also called digitalis, taken via a water pill, inhibitor, or via injection. It is used to improve the efficiency and strength of the heart and to control how fast it is beating.

Captopril. Captopril is used to treat high blood pressure and heart failure, and to lower blood pressure lowers the risk of heart attack and stroke. It is also called Capoten (brand name) and is taken orally as a tablet, liquid or capsule. With other drugs, it is used to treat hypertension. Nurses should watch dosage under the dangers of overdose, and should not be taken if the patient has breathing problems, or if the patient has had heart problems. This medication should not be taken by the patient because of this risk.

Metoprolol. Metoprolol treats high blood pressure, chest pain, and heart failure. It also works when given after a heart attack. This type of medicine is called a beta-blocker. It is taking by tablet, with one fast-acting variation. It would not be recommended for this patient unless he showed symptoms of his heart problem.

Furosemide. Furosemide is also known as Lasix or Furomide M.D. and is used to treat the retention of fluid and swelling that is caused by heart, liver and kidney problems. It is administered to patients via injections. The patient does not display a need for this medication, so it would not be recommended.

Potassium Chloride. Potassium Chloride is a supplement for patients who have too little potassium in their bodies.

Docusate Sodium. Docusate Sodium is a stool softener and the typical recommended dose is 100 mg. It would not be recommended for this patient because it is not necessary.

Nitroglycerin. Nitroglycerin is used to treat high blood pressure and the symptoms associated with angina, but it is not fast-acting. It is typically taken as an injection. The nurse has to monitor this medication because it is taken via IV, and it ‘drips.’

Morphine Sulfate. Other names for Morphine Sulfate are DepoDur, and it is a pain reliever. It is taken via an epidural, injection or by mouth (tablet), and would not be recommended to this patient as he is not in any pain; Morphine Sulfate is a very strong pain reliever.

Alprazolam. Alprazolam is more commonly known as Xanax and is used to treat anxiety disorders. It would be recommended to this patient because he seems to be exhibiting symptoms of high stress and anxiety.

Aspirin. Aspirin is a pain reliever.

Acetaminophen. Acetaminophen is also used to relieve pain and contains caffeine.

Atorvastatin. Atorvastatin is a medication that helps to lower cholesterol, and triglyceride levels. It also reduces the risk of heart attack and chest pain, which the patient is at risk for because of his personal and family history.

References

U.S. National Library of Medicine. (2013). Digoxin. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009944/?report=details

U.S. National Library of Medicine. (2013). Captopril. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009433/?report=details

U.S. National Library of Medicine. (2013). Metoprolol. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011186/?report=details

U.S. National Library of Medicine. (2013). Furosemide. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0010415/?report=details.

U.S. National Library of Medicine. (2013). Furosemide. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011792/.

U.S. National Library of Medicine. (2013). Nitroglycerin. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011432/?report=details.

U.S. National Library of Medicine. (2013). Morphine Sulfate. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011274/?report=details.

U.S. National Library of Medicine. (2013). Atorvastatin. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0009143/?report=details.