Complete Heart Failure

930 Words Feb 15th, 2016 4 Pages
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? The patient most likely failed to adequately apply the fluid and sodium restrction diet properly. Upon discharge
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Answer: A, B, C

Case Study Progress:
After reviewing M.G.’s medications, the physician writes these medication orders:

Chart View:
Medication Orders: Enalapril (Vasotec) 5 mg po bid Carvedilol (Coreg) 100 mg po every morning Glipizide (Glucotrol) 10 mg po every morning Furosemide (Lasix) 80 mg IV push now, then 40mg/day IVP Potassium Chloride (K-dur) 20meq/day po

4. What is the rationale for changing the route of the furosemide (Lasix)? b. IV drugs work more quickly than drugs by PO. The Lasix (a diuretic) is used in patients with CHF due to the drugs ability to remove fluids from the body via the kidneys. When given IV, the patient begins to experience diaphoresis, providing the patient quick symptomatic relief. In this particular patient, she is still gaining weight on a weekly basis so it is imparative that the fluids be reduced in the body, to help in relief of the CHF.

5. You administer furosemide (Lasix) 80mg IVP. Identify three parameters you would use to monitor the effectiveness of this medication. c. Log of daily weight to see if patient is losing weight appropriately d. Decrese in pitting edmea (if present) and decrease in adventitious lung sounds. e. Decrease in Blood Pressure

6. What laboratory tests should be ordered for M.G. related to the order for furosemide (Lasix)? (Select all that apply) f. Magnesium level g. Sodium level h. Complete blood count

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