Case Study Progress The client was discharged 2 weeks ago and is… Ca

Case Study Progress The client was discharged 2 weeks ago and is… Case Study ProgressThe 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 are Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (not related to the expected outcomes). Assessment findingEffectiveIneffectiveUnrelatedStates that she has had no shortness of breath since hospital discharge   Has 2+ pitting edema in both ankles and feet   Blood pressure of 134.76 mm Hg   Has had no chest pain since hospital discharge   Reports feeling like she has more energy now when compared with before her hospital stay   Has new onset fungal skin infection                     ScenarioIdentify the Top 3 client areas for the nurse to assess.A 72-year-old male client is admitted to a telemetry unit after a fall at home.  The clients is experiencing severe weakness in his lower extremities and states, “I got out of bed at 0430 this morning, my legs gave out on my way to the bathroom, and I was unable to get up.”  Emergency medical services transported the client to the hospital.  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.  He saw his cardiologist and had an echocardiogram completed 3 weeks ago.   He also received his influenza and pneumococcal vaccines this year.  The client is married and has two adult children.  He lives in a single-story home, ambulates with a cane, and completes ADLs independently.  His echocardiogram reports moderate heart failure with an ejection fraction (EF) of 38%.  The client’s wife provides a list of his current medications, but the list is not complete.  Choose the most likely options for the information missing from the paragraph by selecting from the lists of options provided.             Next GEN NCLEX: What matters most?  Noticing, Tanner’s Clinical Judgement model  MedicationDose, Route, FrequencyDrug ClassIndicationaspirin1SalicylatePrevention of platelet aggregationAtorvastatin20 mg orally once a dayStatin2312.5 mg orally twice a dayBeta-adrenergic blockerManagement of hypertension and heart failureIbuprofen400 mg orally every 6-8 hr as neededNonsteroidal anti-inflammatory drug450.125 mg orally once a dayCardiac glycosideIncrease myocardial contractile forcelisinopril2.5 mg orally once a day6Management of heart failure Options for 1Options for 2Options for 30.25 mg orally twice a dayManagement of anginacarvedilol81 mg orally every 4-5 hr as needed for painTreatment of bronchospasmhydrochlorothiazide200 mg subcutaneously every 8 hoursManagement of heart failurefurosemide325 mg orally once a dayManagement of hyperlipidemianesiritide1000 mg transdermal patch every 2 daysPrevention of pulmonary hypertensionverapamilOptions for 4                   Option for 5Option for 6Treatment for decreased cardiac outputenalaprilAldosterone antagonistPrevention of dyspneaspironolactoneAngiotensin-converting enzyme inhibitorManagement of extremity paindigoxinCalcium channel blockerTreatment of pyrexialosartanHistamine blockerPrevention of tachycardiametroprololThiazide diureticCase Study ProgressAfter completing the medication reconciliation with the patient’s wife, the nurse completed the initial assessment.  The nurse’s findings include:Alert and orientedBlurred visionReports lower extremity stiffness; Ambulates with crutchesSinus rhythm with preventricular contractions (PVCs); Cardiac murmurReports dyspnea on exertion; Bilateral basilar cracklesBlood urea nitrogen (BUN) = 11 mg/dL and Creatinine kinases 1200 U/LPotassium 5.3 mg/dL   Case Study ProgressThe provider arrives to the telemetry unit to discuss the diagnosis and plan with the patient and wife. 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 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.  Manifestations of pulmonary congestion include _____4_____, _____5_____, and _____6_____.  If the client experiences acute pulmonary edema, the nurse would place the client in a sitting position and administer _____7_____ and _____8_____.  Options for 1, 2, and 3Options for 4, 5, and 6Options for 7 and 8ConfusionCracklesAlbuterol nebulizerChest painDyspneachest percussionnauseaFatigueLorazepam orallyoliguriaJugular vein distentionMorphine intravenous pushorthopneaStridorNitroglycerin sublingualpallorTachypneaSupplemental oxygenpolyuriaWeight gainFurosemide intravenous push   Health Science Science Nursing NURSING 301 Share EmailCopy link Comments (0)

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