Quality of life Scenario Essay

PART ONE Medical-Surgical Cases2. What is the rationale for changing the method of diffuseing furosemide? c M.G. is fl uid overloaded and fills to shine fl uid tawdriness in a short period. IV administration is delivered directly into the vascular system, where it can get cracking to work immediately. In HF, blood fl ow to the entire GI system is compromised therefore the absorption of vivaly ingested medications whitethorn be variable and take longer to work.3. You administer furosemide 80 mg IVP. Identify cardinal parameters you would use to monitor the marrowiveness of this medication. k Daily system of weights I&O Decreased dependent oedema Decreased SOB, reduced crackles in the bases of the lungs, and possibly decreased O2 demands Decreased JVD4. What laboratory tests should be ordered for M.G. link to (R/T) the order for furosemide? cFurosemide 80 mg is a steadfast diuretic, which may cause the detriment of potassium and magnesium. These 2 electrolytes are import ant in maintaining a stable heart rhythm. These electrolytes will need to be supplemented if the levels are low. spirit Most HF admissions are R/T fl uid volume overload. Patients who do not require intensive heraldic bearing observe can most often be tempered initially with IVP diuretics, O2, and angiotensin-converting enzyme (ACE) inhibitors.5. How do ACE inhibitors booster in HF? kACE inhibitors balk the changeover of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in systemic vasodilation, thereby reducing preload (reducing the volume of blood entering the leave 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 desirous the cough. An important alternative medication is an angio tensin 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 mend with IV diuretics. She is ordered back on oral exam furosemide once her weight loss is deemed decorous to achieve a euvolemic state. What will determine if the oral dose will be adequate to debate 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. oneness of the fl uid management goals for patients in HF is to maintain a target weight. This is done by monitoring workaday morning weight, keeping an accurate I&O, and save subjective symptoms.7. M.G. is ready for discharge. What get wind management concepts should be taught to prevent relapse and another admission? pinpoint Use the mnemonic MAWDS. kThe most essential cyclorama 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 active as you can while restricting your symptoms. Weight Weigh every morning. Call if you make headway 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 report to your provider report early on to prevent readmission.Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.