Health
Sixty-three-year-old Jonathan Stevens visits the healthcare clinic complaining of increasingfatigue and difficulty breathing. Physical assessment findings include a rapid, irregular heart rateof 138 beats/min, BP of 140/86 mm Hg, and a respiratory rate of 28 breaths/min. His breathsounds are clear with fine crackles in the bases bilaterally. He has positive jugular veindistention (JDV) bilaterally and 1+ pitting edema of his ankles bilaterally. His initial medicaldiagnosis is heart failure (HF). Jonathan is immediately admitted to the acute care facility forfurther evaluation and treatment.Risk factorsHeart failure occurs most commonly in clients over the age of 60 and occurs more commonly inmales than females.Question 1: In addition to these two risk factors, what other risk factors will provide the nursewith the best data for the heart?Clinical ManifestationsQuestion 2: Name one assessment finding indicating that Jonathan is experiencing right-sidedheart failure.Cardiac DysrhythmiasLeft-sided heart failure results in pulmonary fluid overload, and right-sided heart failure results inperipheral fluid overload. Left-sided heart failure usually occurs first and can trigger right-sidedheart failure.Upon admission to the Cardiac Nursing Unit, Jonathans dyspnea continues. He reports fatiguebut denies chest pain. The nurse places Jonathan on oxygen via a nasal cannula at 3L/min anda cardiac telemetry monitor. The ECG recording shows no discernible P waves, and a rapid,irregular ventricular response (QRS complexes). This corresponds with Jonathans pulse rate,which is 136 and irregular.Question 3: What cardiac dysrhythmia is Jonathan most likely experiencing?Question 4: Based on Jonathans cardiac dysrhythmia, what would the nurse implement first?Diagnostic StudiesJonathan is scheduled for a chest-x-ray and 12 lead electrocardiograph (ECG). Additionaldiagnostic studies that may be performed include echocardiography and pulmonary arterycatheterization.Question 5: Name the diagnostic test used to measure the pressure within the right atrium?Medication AdministrationThe HCP prescribes the following medications for Jonathan: Digoxin (Lanoxin) 0. 125 mg IV every 6 hours x 4 doses, then 0.25 mg orally, daily Furosemide (Lasix) 40 mg IV push, daily. Captopril (Capoten) 12.5 mg orally, three times a day Docusate sodium (Colace) 100 mg orally, twice a day. Carvedilol (Coreg) 3.125 mg orally, twice a day. Warfarin (Coumadin) 5 mg orally, daily.Question 6: The nurse prepares a dose of digoxin )Lanoxin) 0.125 mg via IV push. Themedication is supplied as 0.25 mg in 2 mL. How many mL should the nurse prepare to give?(Enter numeric value only. If rounding is necessary, round to the whole number).Question 7: What assessment is the most important prior to the administration of captopril(Capoten)?Question 8: What is the expected outcome of digoxin (Lanoxin) therapy?Nursing Diagnoses and InterventionsQuestion 9: List one priority nursing diagnosis to be included in the plan of care.Question 10: List one intervention that should be implemented based on the diagnosis of activityintolerance