NURSING > EXAM > Walden University - NURSING 6550iHuman Carter Cardiovascular. 100%. (All)

Walden University - NURSING 6550iHuman Carter Cardiovascular. 100%.

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1. Primary (1) Left-sided Heart Failure (2) Right-sided Heart failure secondary to LV dysfunction (3) Acute Renal Injury (AKI) Differential Dx (1) Hypothyroidism (2) Viral Cardiomyopathy (3) Pulmonary Embolism (4) Lung Neoplasm (5) Hyperthyroidism (6) Pneumonia (7) Interstitial Lung Disease 2. Admit to: Cardiovascular Unit (CVU) , stable, Dr. Moore – Hospitalist, call upon arrival with rm# 3. Vitals: continuous cardiac and pulse oximetry monitoring, Blood pressure checks q2hrs 4. Isolation/Precautions: Standard precautions 5. Allergies: NKDA 6. Diet: Cardiac with 2,000 mg/d Sodium restriction and 1500 ml fluid restriction/24hr 7. Intake/Output: insert foley catheter, strict q4h I&Os, notify physician if urine output is <120 ml in 4 hours. 8. Activity: Bedrest with active and passive range of motion while awake, keep HOB elevated at least 30º or higher 9. IV: Total of 2 - 18 gauge right antecubital; 20g left mid-anterior forearm 10. IVF: none 11. Respiratory: titrate to maintain oxygen saturation >94% by nasal cannula 12. LABS: BMP q4hr 13. AM LABS: BMP, BNP, NT-proBNP 14. RADS/Diagnostic tests: AM CXR PA and lateral, AM EKG, Echocardiogram 15. PT/OT/Nutrition/SW/Pysch: Nutrition, PT, Respiratory 16. Consult: Specialty services: Cardiology, Nephrology 17. Screening (s): PNA vaccine 18. Medications: Lisinopril 2.5 mg oral twice daily, continue as home medication no end date Valsartan mg oral once daily, end date 06/24/18 or discharge date Metoprolol 50 mg oral twice daily, continue as home medication no end date Lasix 80 mg IVP now, one-time schedule dose, end date 06/20/18 Lasix 20 mg IVP twice daily, end date 06/24/18 or discharge date Diovan HCT 80/12.5 mg oral daily, prescription to be given on day of discharge Plan Rationale and Supporting Documentation References Arcangelo, V. & Peterson, A. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins Chung, C. J., & Schulze, P. C. (2011). Exercise in Patients with Heart Failure. The Physician and Sportsmedicine, 39(4), 37–43. Retrieved from http://doi.org/10.3810/psm.2011.11.1937 Cruz, D., Giuliani, A., & Ronco, C. (2015). Acute kidney injury in heart failure. Oxford Textbook of Clinical Nephrology. Oxford, UK: Oxford University Press. Retrieved from http://oxfordmedicine.com/view/10.1093/med/9780199592548.001.0001/med-9780199592548-chapter-248. Doukky, R., Avery, E., Mangla, A., Collado, F. M., Ibrahim, Z., Poulin, M., & ... Powell, L. H. (2016). Impact of Dietary Sodium Restriction on Heart Failure Outcomes. JACC. Heart Failure, 4(1), 24-35. doi:10.1016/j.jchf.2015.08.007 Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2018). Current medical diagnosis & treatment (57th ed.). New York, NY: McGraw Hill.

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