Saturday, March 2, 2019
Quality of life Scenario Essay
destiny ONE Medical-Surgical Cases2. What is the rationale for changing the method of administering furosemide? c M.G. is fl uid overloaded and require to decrease fl uid volume in a short period. IV constitution is delivered directly into the vascular system, where it can start to work immediately. In HF, rake fl ow to the entire GI system is compromised therefore the absorption of vivaly ingested medications may be variable and take longer to work.3. You administer furosemide 80 mg IVP. Identify three parameters you would use to monitor the gistiveness of this medication. k perfunctory weight I&O fall dependent edema Decreased SOB, decreased crackles in the bases of the lungs, and possibly decreased O2 demands Decreased JVD4. What laboratory tests should be ordered for M.G. related to (R/T) the order for furosemide? cFurosemide 80 mg is a potent diuretic, which may cause the loss of potassium and magnesium. These 2 electrolytes ar important in maintaining a stable heart r hythm. These electrolytes ordain 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 intensifier care monitoring can most often be toughened initially with IVP diuretics, O2, and angiotensin-converting enzyme (ACE) inhibitors.5. How do ACE inhibitors help in HF? kACE inhibitors impede the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in systemic vasodilation, thereby reducing preload (reducing the volume of consanguinity 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 sideeffect of ACE inhibitors is a persistent, nonproductive cough. The intensity of the symptoms tends to be dose related the higher the dose, the more intense the cough. An important alternative medication is an angiotensin II receptor blocker (ARB), often called an ACE without a cough. Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. 3chapter 1 Cardiovascular Disorders Case Study 16. M.G.s symptoms improve with IV diuretics. She is ordered back on oral furosemide once her weight loss is deemed tolerable to achieve a euvolemic state. What will determine if the oral dose will be adequate to consider her for discharge? k It is critical to help the primary care provider assess whether the change from IV to oral diuretics can maintain a stable weight. One of the fl uid management goals for patients in HF is to maintain a target weight. This is done by monitoring daily morning weight, holding an accurate I&O, and recording subjective symptoms.7. M.G. is ready for discharge. What key management concepts should be taught to prevent relapse and another admission? Hint theatrical role the mnemonic MAWDS. kThe most essential aspect of teaching hospitalized patients without overloading them is to focus on realistic key points. Teaching should be aimed at tips to improve symptoms and prevent readmission. The 5 most important concepts for patients with HF are included in MAWDS instructions.Medications Take as directed, do not skip a dose, and do not run out of medications. Activity Stay as dynamic as you can while furbish uping your symptoms. Weight Weigh all morning. Call if you gain or lose 2 pounds overnight or 5 pounds from your target weight.Diet Follow a low-salt diet and limit fl uids to less than 2 quarts or liters per day. Symptoms Know what symptoms to physical composition to your provider report early to prevent readmission.Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.