Case Study 1 Heart Failure M.G., a “frequent flier,” is admitted to the emergency department (ED) with a diagnosis of heart failure (HF). She was discharged from the hospital 10 days ago and comes in today stating, “I just had to come to the hospital today because I can't catch my breath and my legs are as big as tree trunks.” After further questioning, you learn she is strictly following the fluid and salt restriction ordered during her last hospital admission. She reports gaining 1 to 2 pounds every day since her discharge. 1. What error in teaching most likely occurred when M.G. was discharged 10 days ago? If M.G. is currently following her fluid and salt restriction strictly but is still exhibiting the symptoms of fluid …show more content…
What is the rationale for changing the route of the furosemide (Lasix)? The medication will work quicker via the IVP route because it is available to the bloodstream much quicker than with the oral route, this will allow M.G. to start losing the excess fluid that is causing her unwanted symptoms. 5. You administer furosemide (Lasix) 80mg IVP. Identify three parameters you would use to monitor the effectiveness of this medication. The three parameters to check for effectiveness of the furosemide would be: urine output, lung sounds (no crackles) and daily weights. 6. What laboratory tests should be ordered for M.G. related to the order for furosemide (Lasix)? (Select all that apply) a. Magnesium level b. Sodium level c. Complete blood count (CBC) d. Serum glucose levels e. Potassium level f. Coagulation studies 7. What is the purpose of the beta blocker carvedilol? It is given to: g. Increase the contractility of the heart h. Cause peripheral dilation i. Increase urine output j. Reduce cardiac stimulation by catecholamines Case Study
Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of
Furosemide 80 mg is a potent diuretic, which may cause the loss of potassium and magnesium.
General: no history of weight change, fever or chills, weakness, fatigue, or change in appetite;
8. If the biochemical test requires an incubation of 24 hours, what do you need to do? (1 pt)
11. The fact that a patient has experienced recent weight loss, fatigue, and loss of appetite would be included in which part of the review of systems (ROS)?
Uncle Jake and Aunt Leah were playing golf last week. On the sixth hole, Jake told Leah that he was having unusual pain in his left arm and chest. All of a sudden he felt weak and complained that his shirt was much too tight. A dentist playing one hole behind them examined Jake and found he was short of breath, pale, and sweating. He called 911 on his cell phone and told Jake to lie down and wait for the ambulance. The paramedics rushed Jake to the hospital where he was evaluated by a cardiologist. The tests showed that he had four clogged arteries. He was scheduled for surgery the next day.
Upon physical assessment and review of lab work, the following signs and symptoms can be generated:
M.J. decides to decrease the vancomycin infusion rate to be given over 2 hours, every 6 hours and he also orders diphenhydramine 50 mg
radiological procedures comprised the majority of the sample (40/44). The remaining 4 subjects were admitted for dehydration and lab testing. The type of
75-year-old patient with the diagnosis of Congestive Heart failure. These three questions would ask the student nurse; what should you do if you see that your patient is having shortness of breath, tachycardia, and sounds very congested? What would you do if you see that the patient’s weight increased 3 pounds since yesterday and has three plus edema on his ankles and feet? What would you do if your patient is very anxious and wanted to know what is wrong with him? By asking these three questions, the student nurse should be able to critically think and prepare herself. The student nurse would know the cause of the disease, the sign and symptoms of the disease, and what are the important steps to manage the patient with CHF like, apply oxygen if saturation is low, inform the doctor and administer the medicine prescribed
The efficacy parameters for evaluation entails the level of severity of the patient towards the nasal symptoms (Kazdin, 2011). Further, issues such as general life quality are also indicated in the plan with the rationale of showing the nature and magnitude of the symptoms before and after the consumption of the drug.
Elderly Heart Failure patients would be the most appropriate researchable population for use in the research project. Firstly, they are the ones suffering the most; hence understanding their problems would be the best approach towards yielding competent results (Fraley & Hudson, 2014). Secondly, both research questions revolve around the challenges facing the patients. In such case, understanding the level of care the population gets would help to know whether or not the nurses are equipped with competent as well as necessary knowledge, attitudes, and skills. Further, data collected from the population would help to implement effective evidence-based techniques for the efficient Transitional Care program for the patients rather than when relying on another population (Fraley & Hudson, 2014).
DOI: 4/1/2015. Patient is a 58-year-old female heart failure program coordinator who sustained a work-related injury due to excessive use of computer. Per PQME report dated 10/29/15, the patient has not yet reached MMI.
Researchers will test the drug on a small number of people for the first time this is to be able to evaluate its possible side effects that it may have. Approximately about 15 patients will be used in this phase. The results that are taken from the trial will give a better view for the risk assessment that will be carried out in phase III. I this phase there will need to be tested on 15 patients.
The other test I would like to tell you about is the Lethal Dose 50