Mr. P is a 76-year-old male who admitted for congestive heart failure (CHF), and cardiomyopathy. Mr. P is despondent and a poor historian regarding his health. The patient does not demonstrate any concern to improve his current acute health issues. The patient presents with 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. Mr. P’s wife has stated that he does not adhere to any diet restrictions and cannot keep track of medications. Mrs. P is distressed over her husband’s lack of concern for his well-being and is also under a great deal of stress with the declining health of her husband and increasing medical debts. The first priority is to stabilize Mr. P’s acute symptoms and then formulate a plan of care that
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Such as labored breathing, crackles throughout his lungs, and 4+ pitting edema. Continuous monitoring of his oxygen saturation will be necessary to assess the amount of fluid in his lungs. Due to his labored breathing an oxy mask will be applied as well as telemetry monitoring. Labs will be drawn immediately to identify and measure deficit blood gases and electrolyte imbalances. Other initial protocols that may be implemented would be to administer morphine, diuretics, vasodilators, and inotropes. Morphine is useful to reduce anxiety, labored breathing and reduce the heart’s pre load. Administering a diuretic, such as, Lasix will aid in the patient eliminating excess fluid from his lungs and generalized 4+ pitting edema. In conjunction, administering a vasodilator, Apresoline, which works by relaxing the muscles in the blood vessels therefore creates dilation, thus allows blood to flow more easily, which can lower the patient’s blood pressure and reduce the heart’s workload. Since the patient suffers from cardiomyopathy, he is in need of an inotrope, such as, Digoxin; which increases contractility of the heart muscle wall, to be more efficient with contracting strongly enough to empty the ventricle of blood (Drugs.com, …show more content…
Attempting to correct or improve the patient’s symptoms can adversely cause extremes is lowering his blood pressure too much. It is a fine line to reach a therapeutic level for each patient (healthgrades.com, 2015). Another objective data that must be monitored to insure that drug therapies are at therapeutic levels, for instance, Mr. P’s fluid status. His recorded intake and output will be crucial. If his output is too high, the patient may be wasting too much potassium and could further complicate his health (American Heart Association,
Such as labored breathing, crackles throughout his lungs, and 4+ pitting edema. Continuous monitoring of his oxygen saturation will be necessary to assess the amount of fluid in his lungs. Due to his labored breathing an oxy mask will be applied as well as telemetry monitoring. Labs will be drawn immediately to identify and measure deficit blood gases and electrolyte imbalances. Other initial protocols that may be implemented would be to administer morphine, diuretics, vasodilators, and inotropes. Morphine is useful to reduce anxiety, labored breathing and reduce the heart’s pre load. Administering a diuretic, such as, Lasix will aid in the patient eliminating excess fluid from his lungs and generalized 4+ pitting edema. In conjunction, administering a vasodilator, Apresoline, which works by relaxing the muscles in the blood vessels therefore creates dilation, thus allows blood to flow more easily, which can lower the patient’s blood pressure and reduce the heart’s workload. Since the patient suffers from cardiomyopathy, he is in need of an inotrope, such as, Digoxin; which increases contractility of the heart muscle wall, to be more efficient with contracting strongly enough to empty the ventricle of blood (Drugs.com, …show more content…
Attempting to correct or improve the patient’s symptoms can adversely cause extremes is lowering his blood pressure too much. It is a fine line to reach a therapeutic level for each patient (healthgrades.com, 2015). Another objective data that must be monitored to insure that drug therapies are at therapeutic levels, for instance, Mr. P’s fluid status. His recorded intake and output will be crucial. If his output is too high, the patient may be wasting too much potassium and could further complicate his health (American Heart Association,