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The interventions should address the priority problem and are…

 

The interventions should address the priority problem and are actions. Also, assessments are not actions that will be the most important for addressing a priority problem.

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Mrs. G is an 83 y/o female admitted with worsening heart failure. She has experienced increasing fatigue and “gets winded just walking out to the mailbox to get her mail.” She also is crying because her rings do not fit and she is waking up at night with trouble breathing. Sometimes she forgets to take her medicine, and she has had a poor appetite, and sometimes just eats a little toast and milk for dinner.

 

Admission labs are:

Sodium 138

Chloride 102

Potassium 2.9

Glucose 93

 

She has an EKG that shows Normal Sinus Rhythm at 72

The doctor has reordered her home meds listed below

Digoxin 0.25 mg po every morning

Lasix 80 mg po every morning

Metoprolol XL 25 mg po daily

 

The nurse assesses the patient:

Dyspnea with exertion and needs HOB elevated to be able to breath while in the bed.

Has 2 plus pitting edema in feet, ankles, and lower legs

Says not eating because feels full all the time

VS T 97.7, Apical heart rate is 64, RR is 22, Pulse Oximetry is 92% on room air.

 

  1. The nurse is going to call the doctor.  Review all of the above information and identify 3 additional assessments the nurse will want to perform before calling the doctor and give the rationale for each.
  2. Identify ONE priority patient problem (you are not required to write a nursing diagnosis) and at least 3 interventions with rationale (that address that priority problem) the nurse should institute at this time This is where you really need to choose the most important patient problem–remember to use ABC’s, Maslow’s, acute rather than chronic)

This patient problem should discuss the potentially serious physiological problem for the patient based on the above assessment and the nursing interventions must be specific to the problem. Keep in mind this case study is about heart failure, so use your book to look at what the authors of the textbook see as priorities in heart failure.

  1. How and why is each prescribed medication being used in the treatment of heart failure. (how do they work and why are they being given for heart failure)
  • Digoxin

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