Answered step-by-stepAssignment Content Perfusion Case Study An 89-year-old female...
Assignment Content
Perfusion Case Study
An 89-year-old female client is admitted to a telemetry unit with a diagnosis of heart failure exacerbation. She reports a medical history of osteoarthritis, choric lymphocytic leukemia, and coronary artery disease including myocardial infarction and coronary artery bypass surgery 22 years ago. She is alert and her daughter is at her bedside. The nurse's initial client assessment findings include.
- Oriented to person only
- Clear speech
- Follows simple commands
- Has sinus tachycardia
- Respiration+26 breath/min
- Oxygen saturation =90% (on room air)
- Breathing labored with the use of accessory muscles
- Has productive cough with pink frothy sputum
- Crepitus in bilateral knee joints
- Enlarged bony nodes on hands
- Hemoglobin=12.4 g/dL (124g/L)
- White blood cell count= 12,000 mm3 (12x109/L)
Highlight or place a checkmark next to the assessment findings that require follow-up by the nurse.
An 89-year-old female client is admitted to a telemetry unit with an exacerbation of health failure. She reports a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease including myocardial infarction and coronary artery bypass surgery 22 years ago. She is alert and her daughter is at her bedside. Indicate which nursing action listed in the far-left column is appropriate for each potential heart failure complication. Note that not all actions will be used.
Nursing Action | Potential TKA Complication | Appropriate Nursing Action for Each TKA Complication |
| Acute pulmonary |
|
| Fatigue |
|
| Hypokalemia |
|
| Cardiac dysrhythmias |
|
| Hypoxemia |
|
|
|
|
|
|
|
|
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|
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|
An 80-year-old female client was admitted to a telemetry unit with an exacerbation of health failure and has a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease surgery 22 years ago. The client is scheduled to be discharged today and will move in with her daughter until she feels well enough to go home alone. Which of the following discharge instructions will the nurse provide the client and her daughter?
Select all the apply
- "Weigh yourself each day at the same time scale to monitor for fluid retention."
- "Contact your primary healthcare provider if you experience cold symptoms lasting more than 3 days."
- "Exertion can cause another episode of heart failure, so help your mother by performance daily activities for her."
- "Notify your primary health care provider if you experience shortness of breath or chest pain while resting".
- "Do not use table salt, avoid salty foods, and read labels on all food items to ensure your diet is low in sodium."
- "Do not take metoprolol if your heart rate is less than then60 beats per minute."
- "Heart failure is a chronic condition, so you don't have to be alarmed when you experience heart palpitation.
Thinking Exercise
An 80-year-old female client was admitted to a telemetry unit with an exacerbation of heart failure, She has a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease including myocardial infarction and coronary artery disease including myocardial infarction and coronary artery bypass surgery 2 years ago. The client was discharged 2 weeks ago and is with her daughter for her follow-up primary health care provider visit. For each assessment finding, use an X to indicate whether the interventions were Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes).
Assessment finding | Effective | Ineffective | Unrelated |
States she has had no shortness of breath since hospital discharge |
|
|
|
Has 2+ pitting edema in both ankles and feet |
|
|
|
Blood Pressure=134/76 mm hg |
|
|
|
Has had no chest pain since the hospital stay |
|
|
|
Report feeling like she has more energy now when compared with before her hospital stay |
|
|
|
Has new-onset fungal skin infection |
|
|
|
Choose the most likely options for the information mission from the table below by selecting from the lists of options provided.
Medication | Dose, Route, Frequency | Drug Class | Indication |
Aspirin | 1 | Salicylate | Prevention of platelet aggregation |
Atorvastatin | 20 mg orally once a day | HMG-CoA reductase inhibitor | 2 |
3 | 12.5mg orally twice a day | Beta-adrenergic blocker | Management of hypertension heart failure |
Ibuprofen | 400 mg orally every 6-8hr as needed | Nonsteroidal anti-inflammatory drug | 4 |
5 | 0.125 mg orally once a day | Cardiac glycoside | Increase myocardial contractile force |
Lisinopril | 2.5 my orally once a day | 6 | Management of heart failure |
Options for 1 | Options for 2 | Option for 3 |
0,25 mg orally twice a day 81 mg orally every 4-5hrs as needed for pain 200mg subcutaneously every 8 hours 325mg orally once a day 1000mg as a transdermal patch everyday | Management of angina Treatment of bronchospasm Management of heart failure Management of hyperlipidemia Prevention of pulmonary hypertension | Carvedilol Hydrochlorothiazide furosemide Nesiritide Verapamil |
Options 4 | Option for 5 | Option for 6 |
Treatment for decreased cardiac output Prevention of dyspnea Management of extremity pain Treatment of pyrexia Prevention of tachycardia | Enalapril Eplerenone Digoxin Losartan Metoprolol | Aldosterone antagonist Angiotensin-converting enzyme Inhibitor Calcium channel blocker Histamine blocker Thiazide diuretic |
A 72-year-old male client is admitted to a telemetry unit after a fall at home secondary to severe weakness in his lower extremities. Past medical history provided by the client includes hyperlipidemia, aortic valve stenosis, and poliomyelitis when he was 2 years old. His most recent echo indicates moderate heart failure with an ejection fraction (EF) of 38%. He has been prescribed aspirin and a variety of cardiac medications. The nurse's initial client assessment findings include:
- Alert and oriented
- Blurred vision
- Reports lower extremity stiffness
- Ambulates with crutches
- Sinus rhythm with pre-ventricular contractions
- Cardiac murmur
- Report dyspnea with exertion
- Bilateral basilar crackles
- Blood urea nitrogen (BUN)= 11mg/dL (4.0 mmol/L)
- Creatinine kinase 1200 U/L (1200 IU/L)
- Potassium 5.2 mg/dL (5.2 mmol/L)
Highlight or place a checkmark next to the assessment findings that require follow-up by the nurse.
Thinking Exercise
A 72-year-old male client is admitted to a telemetry unit after a fall at home secondary to severe weakness in his lower extremities. Past medical history provided by the client includes high cholesterol, aortic valve stenosis, and residual lower extremity muscle pain and weakness secondary to poliomyelitis as a child. His most recent echo reports moderate heart failure with an ejection fraction (EF) of 38%. He has been prescribed aspirin and a variety of cardiac medications. The client is diagnosed with rhabdomyolysis. Prescriptions to place a large-bore intravenous catheter and administer normal saline 0.9% at 125 mL/hr. are received. Choose the most likely options for the information missing from the paragraph below by selecting from the lists of options provided.
When caring for a client who has left ventricular dysfunction, the nurse assesses for 1____________ related to inadequate cerebral perfusion, 2_________________ related to inadequate myocardium perfusion, and 3_________________ related to inadequate renal perfusion. The nurse monitors a client who has heart failure closely for complications of pulmonary congestion when administering intravenous fluids. Manifestation of pulmonary congestion include 4_________________ 5____________________, and 6_____________ If the client experience acute pulmonary edema, the nurse would place the client in a sitting position and administer 7______________________ and 8___________________
Options for 1, 2, and 3 | Options for 4,5, and 6 | Options for 7 and 8 |
Confusion Chest pain Nausea Oliguria Orthopnea Pallor Polyuria | Crackles Dyspnea Fatigue Jugular vein distention Stridor Tachypnea Weight gain | Albuterol nebulizer Chest percussion Lorazepam orally Morphine intravenous push Nitroglycerin sublingual Supplemental oxygen Furosemide intravenous push |
Perfusion
An 89-year-old female client is admitted to a telemetry unit with a diagnosis of heart failure exacerbation. She reports a medical history of osteoarthritis, choric lymphocytic leukemia, and coronary artery disease including myocardial infarction and coronary artery bypass surgery 22 years ago. She is alert and her daughter is at her bedside. The nurse's initial client assessment findings include.
- Oriented to person only
- Clear speech
- Follows simple commands
- Has sinus tachycardia
- Respiration+26 breath/min
- Oxygen saturation =90% (on room air)
- Breathing labored with the use of accessory muscles
- Has productive cough with pink frothy sputum
- Crepitus in bilateral knee joints
- Enlarged bony nodes on hands
- Hemoglobin=12.4 g/dL (124g/L)
- White blood cell count= 12,000 mm3 (12x109/L)
Highlight or place a checkmark next to the assessment findings that require follow-up by the nurse.
An 80-year-old female client is admitted to a telemetry unit with an exacerbation of health failure. She reports a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease including myocardial infarction and coronary artery bypass surgery 22 years ago. She is alert and her daughter is at her bedside. Indicate which nursing action listed in the far-left column is appropriate for each potential heart failure complication. Note that not all actions will be used.
Nursing Action | Potential TKA Complication | Appropriate Nursing Action for Each TKA Complication |
| Acute pulmonary |
|
| Fatigue |
|
| Hypokalemia |
|
| Cardiac dysrhythmias |
|
| Hypoxemia |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
An 80-year-old female client was admitted to a telemetry unit with an exacerbation of health failure and has a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease surgery 22 years ago. The client is scheduled to be discharged today and will move in with her daughter until she feels well enough to go home alone. Which of the following discharge instructions will the nurse provide the client and her daughter?
Select all the apply
- "Weigh yourself each day at the same time scale to monitor for fluid retention."
- "Contact your primary healthcare provider if you experience cold symptoms lasting more than 3 days."
- "Exertion can cause another episode of heart failure, so help your mother by performance daily activities for her."
- "Notify your primary health care provider if you experience shortness of breath or chest pain while resting".
- "Do not use table salt, avoid salty foods, and read labels on all food items to ensure your diet is low in sodium."
- "Do not take metoprolol if your heart rate is less than then60 beats per minute."
- "Heart failure is a chronic condition, so you don't have to be alarmed when you experience heart palpitation.
Thinking Exercise
An 80-year-old female client was admitted to a telemetry unit with an exacerbation of heart failure, She has a medical history of osteoarthritis, chronic renal insufficiency, and coronary artery disease including myocardial infarction and coronary artery disease including myocardial infarction and coronary artery bypass surgery 2 years ago. The client was discharged 2 weeks ago and is with her daughter for her follow-up primary health care provider visit. For each assessment finding, use an X to indicate whether the interventions were Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes).
Assessment finding | Effective | Ineffective | Unrelated |
States she has had no shortness of breath since hospital discharge |
|
|
|
Has 2+ pitting edema in both ankles and feet |
|
|
|
Blood Pressure=134/76 mm hg |
|
|
|
Has had no chest pain since hospital stay |
|
|
|
Report feeling like she has more energy now when compared with before her hospital stay |
|
|
|
Has new-onset fungal skin infection |
|
|
|
Choose the most likely options for the information mission from the table below by selecting from the lists of options provided.
Medication | Dose, Route, Frequency | Drug Class | Indication |
Aspirin | 1 | Salicylate | Prevention of platelet aggregation |
Atorvastatin | 20 mg orally once a day | HMG-CoA reductase inhibitor | 2 |
3 | 12.5mg orally twice a day | Beta-adrenergic blocker | Management of hypertension heart failure |
Ibuprofen | 400 mg orally every 6-8hr as needed | Nonsteroidal anti-inflammatory drug | 4 |
5 | 0.125 mg orally once a day | Cardiac glycoside | Increase myocardial contractile force |
Lisinopril | 2.5 mg orally once a day | 6 | Management of heart failure |
Options for 1 | Options for 2 | Option for 3 |
0,25 mg orally twice a day 81 mg orally every 4-5hrs as needed for pain 200mg subcutaneously every 8 hours 325mg orally once a day 1000mg as a transdermal patch every day | Management of angina Treatment of bronchospasm Management of heart failure Management of hyperlipidemia Prevention of pulmonary hypertension | Carvedilol Hydrochlorothiazide furosemide Nesiritide Verapamil |
Options 4 | Option for 5 | Option for 6 |
Treatment for decreased cardiac output Prevention of dyspnea Management of extremity pain Treatment of pyrexia Prevention of tachycardia | Enalapril Eplerenone Digoxin Losartan Metoprolol | Aldosterone antagonist Angiotensin-converting enzyme Inhibitor Calcium channel blocker Histamine blocker Thiazide diuretic |
A 72-year-old male client is admitted to a telemetry unit after a fall at home secondary to severe weakness in his lower extremities. Past medical history provided by the client includes hyperlipidemia, aortic valve stenosis, and poliomyelitis when he was 2 years old. His most recent echo indicates moderate heart failure with an ejection fraction (EF) of 38%. He has been prescribed aspirin and a variety of cardiac medications. The nurse's initial client assessment findings include:
- Alert and oriented
- Blurred vision
- Reports lower extremity stiffness
- Ambulates with crutches
- Sinus rhythm with pre-ventricular contractions
- Cardiac murmur
- Report dyspnea with exertion
- Bilateral basilar crackles
- Blood urea nitrogen (BUN)= 11mg/dL (4.0 mmol/L)
- Creatinine kinase 1200 U/L (1200 IU/L)
- Potassium 5.2 mg/dL (5.2 mmol/L)
Highlight or place a checkmark next to the assessment findings that require follow-up by the nurse.
Thinking Exercise
A 72-year-old male client is admitted to a telemetry unit after a fall at home secondary to severe weakness in his lower extremities. Past medical history provided by the client includes high cholesterol, aortic valve stenosis, and residual lower extremity muscle pain and weakness secondary to poliomyelitis as a child. His most recent echo reports moderate heart failure with an ejection fraction (EF) of 38%. He has been prescribed aspirin and a variety of cardiac medications. The client is diagnosed with rhabdomyolysis. Prescriptions to place a large-bore intravenous catheter and administer normal saline 0.9% at 125 mL/hr. are received. Choose the most likely options for the information missing from the paragraph below by selecting from the lists of options provided.
When caring for a client who has left ventricular dysfunction, the nurse assesses for 1____________ related to inadequate cerebral perfusion, 2_________________ related to inadequate myocardium perfusion, and 3_________________ related to inadequate renal perfusion. The nurse monitors a client who has heart failure closely for complications of pulmonary congestion when administering intravenous fluids. Manifestation of pulmonary congestion include 4_________________ 5____________________, and 6_____________ If the client experience acute pulmonary edema, the nurse would place the client in a sitting position and administer 7______________________ and 8___________________
Options for 1, 2, and 3 | Options for 4,5, and 6 | Options for 7 and 8 |
Confusion Chest pain Nausea Oliguria Orthopnea Pallor Polyuria | Crackles Dyspnea Fatigue Jugular vein distention Stridor Tachypnea Weight gain | Albuterol nebulizer Chest percussion Lorazepam orally Morphine intravenous push Nitroglycerin sublingual Supplemental oxygen Furosemide intravenous push |
Answer & Explanation
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