CASE STUDY 6,7,8,9,10 - Carl Edwards is a 75-year-old man with congestive heart failure

Question # 00805409 Posted By: rey_writer Updated on: 05/08/2021 10:42 AM Due on: 05/08/2021
Subject Education Topic General Education Tutorials:
Question
Dot Image

6.            Carl Edwards is a 75-year-old man with congestive heart failure. Having sustained three myocardial infarctions in the last 10 years, he has decreased left ventricular function. Mr. Edwards takes Digoxin, Capoten, Coreg, and Lasix for management of this disease. Today he presents to the emergency department with fatigue, generalized weakness, and feelings of “skipping” heartbeats. Upon arrival, he is placed on the cardiac monitor, his vital signs are assessed, and an IV is inserted. He currently denies chest pain, but is experiencing some shortness of breath, and is placed on 2 L of oxygen via nasal cannula. (Learning Objective 1)

a.            Which of his medications might be contributing to his symptoms of generalized weakness and heart irregularities?

b.            For what clinical manifestations should you assess to correlate to his left-sided heart failure?

c.             How do his medications treat his congestive heart failure?

d.            How does the hypokalemia affect the effects of Digitalis?

7.            Joan smith, a 55year old, is a female patient who presents to the intensive care unit with. antihypertensive suddenly because of the cost of the medications and she recently lost her job to outsourcing. The patient is slightly drowsy and complain of headache and blurring vision. The patient's blood pressure is 220/130 mm Hg upon presentation. The physician orders nicardipine hydrochloride 25mg/250ml, NS for peripheral IV starting at 2.5mg/hr, and titrate by 2.5mg/hr every 15 minutes to reach the goal for the first hour, which is to achieve 25% reduction of the initial MAP.

 •Call the physician if the dosing range of 15mh/hr has been reached and the MAP is still not at target goal for the first hour treatment or up to four dose increases.

•Lower the BP within 6hours to 160/100mmhg

•             Adjust the IV rate so that the IV fluids plus the nicardipine drip are equal to100ml/hr. in total. Cal the physician if the IV fluids must go above 100ml/hr to provide the nicardipine.

d.            According to the definitions set by the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure, which type of hypertensive crisis is the patient currently experiencing?

e.            Describe the treatment goal for handling the hypertensive crisis and apply the goals to the case study. Determine the current mean arterial pressure (MAP) and the goals for the treatment.

•             The physician orders nicardipine hydrochloride 25mg/250ml, NS for peripheral IV starting at 2.5mg/hr, and titrate by 2.5mg/hr every 15 minutes to reach the goal for the first hour, which is to achieve 25% reduction of the initial MAP.

Call the physician if the dosing range of 15mh/hr has been reached and the MAP is still not at target goal for the first hour treatment or up to four dose increases.

•             Lower the BP within 6hours to 160/100mmhg

•             Adjust the IV rate so that the IV fluids plus the nicardipine drip are equal to100ml/hr. in total. Cal the physician if the IV fluids must go above 100ml/hr to provide the nicardipine.

c. Explain what rate to set initially for both the nicardipine drip and the NS maintenance fluids.

d. Explain the process of titrating the nicardipine drip for the first hour to achieve the final MAP goal of 25% reduction of the original MAP.

8.            The community health nurse is preparing a program about hypertension for a local community center. The focus of the program is on the reduction of risk factors and compliance for those who have been diagnosed with high blood pressure. The target population includes older adults.

a.            The nurse focuses on primary hypertension because it accounts for 90% to 95% of hypertension in the United States. What risk factors does the nurse include for this population?

b.            The nurse prepares to discuss the changes in how the JNC 7 defines hypertension. What ranges and descriptions should the nurse include?

c.             Because this is a gerontologic audience, the nurse needs to review why blood pressure increases with age. Explain how the structural and functional changes of aging contribute to higher blood pressure in the older adult.

d.            What information does the nurse include about lifestyle modifications that may decrease risk of hypertension (or complications associated with diagnosed hypertension)?

9.            The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center.

10.          Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails.

                linical management is recommended for the patient during the pregnancy to help decre ase the risk of transmitting HIV to the unborn child?

b.The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from g etting HIV. How should the nurse respond?

c. What explanation about Retrovir should the nurse provide?

1              Retrovir Dosing

2              Drug interactions

3              Side effects

d.The patient asks the nurse if it will be safe to breastfeed her infant after the delivery.

The nurse should provide what explanation?

 e. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?

Dot Image
Tutorials for this Question
  1. Tutorial # 00800439 Posted By: rey_writer Posted on: 05/08/2021 10:43 AM
    Puchased By: 2
    Tutorial Preview
    The solution of CASE STUDY 6,7,8,9,10 - Carl Edwards is a 75-year-old man with congestive heart failure...
    Attachments
    Case_Study_6,7,8,9,10.docx (27.54 KB)

Great! We have found the solution of this question!

Whatsapp Lisa