Reference no: EM133544982
ASSIGNMENT:
Case Study
Ms. Ruth is 85 yrs old. Admitted to the telemetry floor 3 days ago with SOB and dyspnea. Medical diagnosis: CHF exacerbation. Medical history of MI, CVA with no residual effect, HTN, hyperlipidemia, AFIB, diabetes type 2. Ms. Ruth is alert and oriented x3 and verbalized her needs with mild to moderate dyspnea on exertion.
Vital signs 3 hours ago: T 98.2 oral, apical pulse 52, bp 101/68 RR 22, 02 sat 92% on Room air. BG 310 at 5 am, 2nd BG 360 at 0830 am. Pt weighs 195 lbs gained 10 lbs in the last 7 days. The doctor's orders are as follow: Medication to be given metoprolol 50mg po daily, Lisinopril 10 mg po daily. Tylenol 650 mg po for pain daily PRN. Potassium chloride 20 Meq PO daily. Furesomide 40 mg IV push daily. Atorvastatin 10 mg PO daily. Meds are due at 10am. Vital signs Q4 hrs.
Labs: chemistry is unremarkable except for K+ 3.0, BNP 1600. CBC WNL. Echo result shows EF of 30%, Chest x-ray result: cardiomegaly. With mild to moderate pulmonary effusion. Ms. Ruth needs education and will need further education upon discharge.
1. Which medications should the nurse hold and why?
2. What are the two MOST important body system the nurse need to assess?
3. What position should Ms. Ruth's bed be and why?
4. List 2 MOST important nursing education for Ms. Ruth upon discharge including medication education.
5. Prior to the Furosemide administration what important lab should the nurse check first and be aware of?