CHF Nursing Situation – What would you expect skin condition/lower extremities to be like
Patient is a 82 year old male who presented to the ED at 5am for shortness of breath worsening over the past day, PMH includes CHF, HTN, hyperlipidemia, CAD s/p cardiac stents in 2014, DM, osteoarthrtis, BPH, depression, CKD st 3.
Admitted for CHF exacerbation, pneumonia, acute on chronic renal disease
You receive him on the floor at 11:30 am, he appears to be alert and oriented, but lethargic, states he hasn’t taken any home meds yet today, has not eaten yet either. Lives at ALF, uses walker
In the ED, he received IV furosemide 40mg, 650mg Tylenol, 500mg IV levofloxacin and an albuterol/ipratropium nebulizer treatment
Selected labs, diagnostics, and orders
WBC
18.2
Hgb
10.4
K (potassium)
3.1
creatinine
4.1
308
BNP
8023
Urine – blood
large
Urine – leukocytes
+3
Urine – culture
pending
COVID 19 PCR – negative
bilateral infiltrates, pleural effusions
sputum sample to be collected
normal sinus rhythm on tele monitor
170/64, P55, R23, O2 90% room air, temp 100.4, ht 178cm, wt 90kg
Diet: cardiac, 1800 ADA, 1 liter free water restriction
Activity: as tolerated
Strict I&O
home medications – have all been profiled to MAR
Hospital meds
metoprolol
25mg
BID
albuterol/ipratropium
Q6hrs
amlodipine
5mg
QAM
furosemide IV
40mg
once 6pm
lisinopril
20mg
QAM
levafloxacin IV
500mg
Q24hrs
atorvastatin
40mg
QPM
tylenol
650mg
Q6hrs PRN
tamsulosin
0.4mg
QPM
IV potassium 10 meq
x3
clopidogrel
75mg
QAM
aspirin
81mg
QAM
escitalopram
10mg
QAM
metformin
1000mg
BID
tramadol
50mg
Q8hrs PRN
gabapentin
200mg
BID
temazepam
7.5mg
QHS PRN
Consults pending – cardiology, ID, nephrology
Personal history
former smoker, quit 35 years ago
does not drink alcohol
did not get flu shot this year
Are you looking for answers to a similar assignment? customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (CHF Nursing Situation – What would you expect skin condition/lower extremities to be like)
Discussion
What would you expect breath sounds may be like (document this in EHR)?
What would you expect skin condition/lower extremities to be like (document this in EHR)?
What interventions would you perform (safety, patient care, medication, etc)
What else are you concerned about when assessing?
Think about questions to ask the patient so you have a better report to give to consulting providers if they call
What does each medication do? Would you hold any?
Additional assessment to document in EHR:
GI – bowel sounds in all quadrants, soft non-tender
GU – noted this in urinal
Cardiac S1S2, pulses ok in all ext, normal cap refill
HEENT – seems a bit hard of hearing, head without wounds, eyes, nose, oral mucosa ok. Has dentures (upper and lower)
Resp – seems to cough a lot after drinking water/taking pills
Pain – no issues
IV – left forearm 20g, flushes well, no leaks
Possessions – has glasses, iPhone, bottle of home tramadol
Retired engineer, married, lives at ALF with spouse
Nursing Discussion Examples
| Nursing Discussion Post Writing – How To Write A Nursing Discussion Post For Your Nursing Class | How to write a nursing discussion post for your nursing class (Nursing Discussion Post Writing), Steps to Complete a Substantive Discussion, and Steps to Complete a peer response. |
| Capella University Fundamental Principles Of Care Coordination Discussion | Capella University Fundamental Principles Of Care Coordination Discussion |
| N582 Mod 8 Discussion: Students Evaluation | N582 Mod 8 Discussion: Students Evaluation |
| Discussion and Conclusion of a DNP Capstone Project [Outline] | A Discussion and Conclusion of a DNP Capstone Project summarizes the main points of the paper and provides a closure to the reader. |
| How to write a Nursing Discussion Post [+Examples] | Nursing discussion post Writing In this post, we will be discussing how to write a nursing discussion post. This type of post is common in online nursing programs and can be used to discuss a variety of topics related to nursing. |
Related FAQs
1. What is the nursing priority for heart failure?
Nursing Priorities
Improve myocardial contractility/systemic perfusion. Reduce fluid volume overload. Prevent complications. Provide information about disease/prognosis, therapy needs, and prevention of recurrences.
2. What are priority assessments for CHF?
Assessment of CHF:
- Vital Signs. Baseline vital signs are important here as well as for our other assessments, including an apical pulse; history is also important.
- Cardiovascular. Assess heart rhythm, and strength of the heartbeat. …
- Respiratory. Assess lung sounds for congestion, rales.
- General Medical.
3. What is nursing diagnosis for CHF?
Nursing Diagnosis: Decreased Cardiac Output related to increased preload and afterload and impaired contractility as evidenced by irregular heartbeat, heart rate of 128, dyspnea upon exertion, and fatigue. Desired outcome: The patient will be able to maintain adequate cardiac output.
4. What are interventions for CHF?
Immediate interventions
Obtaining a room air pulse oximetry, administering supplemental oxygen as needed, obtaining IV access to offload the fluid overload, obtaining baseline lab work, and administering diuretics. These things should all be done immediately for a CHF patient, says Swailes.
Read More:
Explain The Advocacy Efforts Of Lillian Wald – Solution
Describe how the nursing profession is viewed by the general public. Discuss factors that influence the public’s perception of nursing. Describe ways to educate the general public on the professional nurse’s role and scope of nursing within a changing health care system – Solution