student Essay

864 WordsApr 9, 20144 Pages
1 Cardiovascular Disorders Case Study 1 Heart Failure Diffi culty: Beginning Setting: Emergency department, hospital Index Words: heart failure (HF), cardiomyopathy, volume overload, quality of life Scenario M.G., a “frequent fl ier,” 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 fl uid 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…show more content…
3. You administer furosemide 80 mg IVP. Identify three parameters you would use to monitor the effectiveness of this medication. [k] • Daily weight • I&O • Decreased dependent edema • Decreased SOB, decreased crackles in the bases of the lungs, and possibly decreased O2 demands • Decreased JVD 4. What laboratory tests should be ordered for M.G. related to (R/T) the order for furosemide? [c] Furosemide 80 mg is a potent diuretic, which may cause the loss of potassium and magnesium. These 2 electrolytes are important in maintaining a stable heart rhythm. These electrolytes will need to be supplemented if the levels are low. ✽ Note: Most HF admissions are R/T fl uid volume overload. Patients who do not require intensive care monitoring can most often be treated initially with IVP diuretics, O2, and angiotensin-converting enzyme (ACE) inhibitors. 5. How do ACE inhibitors help in HF? [k] ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in systemic vasodilation, thereby reducing preload (reducing the volume of blood entering the left ventricle) and afterload (reducing the resistance to the left ventricular contraction) in patients in HF. ✽ Instructor Note: You could tell the students that the most frequent side effect of ACE inhibitors is a persistent, nonproductive cough.
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