Question

. The patient was a 77-year-old female admitted with Congestive Heart Failure, and past medical history of an Acute MI, four to six months before admission date. She had been taking Lasix 40mg PO BID and Cardizem 30 mg TID.

In a report, I heard that her last O2 saturation was 77% on 3 liters via nasal cannula. Vital signs- afebrile, HR 108, RR 22, BP 148/88. She had an IV of D5W at KVO, the EKG was done, and it showed Sinus Tachycardia with PVCs.

By the time I got out of a report, labs were on the chart; cardiac enzymes were negative, BNP 200, Na 140, K 2.0. Also, ABGs were drawn and showed a pH of 7.32, paO2 =55, CO2=48.

After the report, I went ahead and started my assessment. She was resting comfortably, but as she talked she did get short of breath. She complained it felt like her heart was beating too fast. I checked orders. I noticed there were new orders to be carried out.

Ordered: Digoxin 0.5mg IVP now follows up in 6 hours with an additional Dig 0.25mg IV. Then in six hours from that time another Dig 0.125 mg IV then she was to be on a daily dose of Dig 0.25 mg IV.

1. Tell me what would you do in this situation based on what little assessment data I gave you.

2. What concerns you about the assessment data?

3. What does it indicate? (Don’t forget to address the lab results)

4. What classification is Digoxin? What is the action of Digoxin?

5. Why is a loading dose given?

6. How do you determine if the dosage of Digoxin is right for this patient?

7. What are nursing considerations there with giving Digoxin?

8. What are three appropriate nursing diagnoses and patient goals for this patient?

Answer 1

Tell me what would you do in this situation based on what little assessment data I gave you.

Assessment factors thought about were auscultation of lung sounds, heart sounds, rate and cadence, pulse, weight, edema, respiratory exertion, and customer's face, lip, and nail shading. The screen nurture will probably assert variation from the norm than the genuine medical attendant was while surveying the shade of nails. The genuine medical attendant got lower leg edema, pedal edema, and inspiratory wheeze more as often as possible than did the screen nurture. The two medical attendants and patients announced the need genuine attendant home visits alongside telemedicine visits.

What concerns you about the assessment data?

The comparability of medical caretakers' physical evaluation discoveries was assessed utilizing a creative two-way, telemedicine varying media framework. Medical attendants were arbitrarily doled out to a technique for customer evaluation: on location or telemedicine. Every evaluation was performed inside 11 minutes of each other. Evaluation factors analyzed were auscultation of lung sounds, heart sounds, rate and musicality, circulatory strain, weight, edema, respiratory exertion, and customer's face, lip, and nail shading.

What does it indicate? (Don’t forget to address the lab results)

Results show couple of noteworthy contrasts between the appraisals of the constant and screen time medical caretakers. meetings of the elderly patients uncovered a great response to utilizing the telemedicine screen, refering to a snappy association with a medical caretaker and reaction to their worries and inquiries. The two attendants and patients detailed the need genuine medical caretaker home visits alongside telemedicine visits.

What classification is Digoxin? What is the action of Digoxin?

Digoxin is a solution that originates through digitalis plant. It is utilized to treat gentle to direct heart disappointment and also atrial fibrillation. The impacts of digoxin result in expanded quality of the heart withdrawals, improving it pump blood. It likewise keeps up a general heart cadence.

Why is a loading dose given?

To accomplish unfaltering state, you require roughly 5 to 7 1/2 existent of the medication. For drugs with quick disposal esteems, this isn't an issue; anyway sedates with moderate end to accomplish relentless state. In the event that remedial impacts are required rapidly, and the medication has a long half-life, one can utilize a stacking measurements to accomplish helpful levels on the principal dosage. The stacking measurement quickly accomplishes the restorative reaction and ensuing dosages keep up the reaction.

How do you determine if the dosage of Digoxin is right for this patient?

According to American Health Association rules, a stacking dosage to start digoxin treatment in patients with heart disappointment isn't important. Utilize bring down end of dosing in patients with weakened renal capacity or low fit weight.

What are nursing considerations there with giving Digoxin?

Digoxin is a kind of prescription to encounter heart disappointment or irregular heart musicality. Digoxin works by adjusting the mineral substance of heart cells. For instance, it changes the measure of sodium or potassium in the cells. This makes it less demanding for the heart to pump blood and lessens the measure of strain the heart muscle perseveres. Like any solution, digoxin can cause certain reactions.

What are three appropriate nursing diagnoses and patient goals for this patient?

Learning shortage An information shortfall can happen for var-ious reasons, contingent upon the etiol-ogies and characterizing qualities you distinguish.

Absence of compliance for meds - Noncompliance is another diagnosticlabel that can happen when you bargain witha persistent and a predetermined medication regimen.

modification in nourishment - a smaller amount than body necessities, connected to nausea, anorexia.