Overview
Use this book Chapters 22-29 chapter 36 & 37
Instructions:
• Please review Canvas PowerPoints, audios, and read the textbook.
• Read the questions/scenarios and answer the following questions.
• Watch for grammar and sentence structure. There must be a minimum of ONE (1) paragraph (five to ten complete sentences) per question.
• Please cite your source(s) and include your reference(s). Reference(s) must be from a credible source (i.e textbook, peer-reviewed articles, etc.).
Assignment:
Scenario #1
Jake is a 50-year-old male patient who is admitted to the emergency department (ED) with the following symptoms: lightheadedness, shortness of breath, and feeling “weak all over.” He also complains that his heart is racing. His wife is present, and she tells the nurse that she and him were walking outside when Jake said he did not feel well and that he was going to “pass out.” She relates that Jake sat down on the sidewalk and vomited.
In the ED, the nurse initiates the ordered intravenous (IV) therapy and places Jake on a heart monitor. A 12-lead electrocardiogram and blood work are also ordered. The bedside monitor shows rapid atrial fibrillation. Jake’s heart rate is 185 beats/min, and his respiratory rate is 35 breaths/min. The nurse asks Jake if these symptoms have occurred previously, and he shakes his head, no.
• What is medication would be administered to treat a new onset of atrial fibrillation? Explain your answer.
• How should the nurse administer this medication?
• What should the nurse assess for during administration? Explain your answer.
• What drug class does the nurse expect will be considered for the long-term treatment of Jake?
Scenario #2
Carl is a 70-year-old male patient with a history of atrial fibrillation that is controlled with medication. His medication regimen also includes warfarin (Coumadin). His daughter has taken him to the Coumadin Clinic today, and she has several questions for the nurse. Carl's daughter says, “I understand why my father takes a medication for his heart rhythm problems, but why does he need a blood thinner?”
• How will the nurse answer the daughter’s question?
Carl's daughter also asks about her father’s clotting times. The nurse states that the prothrombin time (PT) is 19 seconds, and the INR is 2.8.
• Are these values therapeutic? Explain your rationale.
• If the INR was 3.5 and Carl showed signs of hemorrhage, what treatment would the nurse expect to be ordered? Explain your answer.
Scenario #3
Suzy is seeing her nurse practitioner today for a follow-up appointment. Two weeks ago, Suzy was seen for complaints of occasional headaches. On that visit, Suzy'sblood pressure was 160/110 mm Hg. S.W. has been monitoring her blood pressure for the past 2 weeks, and it has remained at 150/100 mm Hg or higher. She is not overweight, does not smoke, and walks for exercise at least three times per week. The nurse practitioner decides to start Suzy on therapy with hydrochlorothiazide daily to control Suzy ’s hypertension.
• What is the role of hydrochlorothiazide in the treatment of hypertension?
The patient asks the nurse what diet changes, if any, she will need to make.
• How will the nurse respond?
The patient calls into the clinic the following week and tells the nurse she is often thirsty, and her legs are so weak that she is having trouble putting one foot in front of the other. She’s been so weak that her husband insisted she call in.
• What would the nurse suspect is occurring? Explain your answer.
Scenario #4
You are the nurse assigned to the following patients:
• Room 1: 15-year-old male with acute asthma exacerbation
• Room 2: 78-year-old female with COPD but is currently stable
• Room 3: 45-year-old female with pneumonia and is having difficulty coughing up the sputum
• Room 4: 63-year-old male recovering from influenza, who is complaining of a nagging, dry cough
• Based on the medications listed from the Lesson Plan for Ch. 36 & 37, which medication(s) would the nurse administer for each patient? Include the mechanism of action, adverse effects, nursing assessment, nursing interventions, and therapeutic monitoring for each medication.
• What will the nurse teach their patient about the respiratory drug(s)? Be specific