Use Nursing Central to complete the following case study.

Use Nursing Central to complete the following case study.

1. Read the scenario carefully before and during completion of the case study.
2. Read all questions before starting the case study.
3. Only associate each question with the information included in the scenario.
4. Look up each unfamiliar term, do not guess at meanings.
5. Briefly and concisely answer each question as if the individual reading the responses knows nothing about the subject matter. Type these into a word document, which you will then upload for instructor review.

Scenario

A 58-year-old white female presents to the emergency department complaining of a “racing heartbeat” with chest pain “on and off”.  She is overweight and has a history of angina and myocardial infraction 5 years ago with 2 vessel coronary artery by-pass graft. She is admitted to the hospital to rule out Congestive Heart Failure.

The nursing assessment reveals the following:

• decreasing appetite for past 2-3 weeks
• 3+ edema in feet and ankles extending to mid-calf x 3 weeks
• sleeping on 2-3 pillows at night after waking up short of breath
• admission v/s- B/P 158/92, P-110, R-24, T-98.8F[unique_solution]
• 9-year history of (h/o) hypercholesterolemia
• h/o osteoarthritis and gout
• Family history- positive for atherosclerosis, father died at age 66 yrs. of heart attack, mother living with several CVA’s, one sibling with h/o HTN, one sibling with h/o MI
• Allergies- hydralazine, almonds, shellfish and strawberries
• Medication Reconciliation- celecoxib, allopurinol, atorvastatin, amlodipine, aspirin and clopidogrel.

Provider admission orders:

• Continue homes meds- celecoxib 200 mg QD, allopurinol 100 mg po BID, atorvastatin 100 mg BID, amlodipine 5 mg daily, aspirin 81 mg daily, clopidogrel 75mg PO daily
• Furosemide 10 mg PO stat and daily
• v/s Q4H
• CB, electrolytes, Troponin and CK-MB today
• Stat EKG
• Bedrest (BR) with Bathroom privileges (BRP)
• Schedule cardiac cath. for a.m.
• IV to KVO

Answer the following questions as related to this scenario.

1. Which of the following types of heart failure should the professional nurse assigned to this client suspect in this client- right heart failure, left heart failure or both right and left heart failure?  State information found in the scenario to support your answer with the accompanying physiology/pathophysiology.
2. State three risk factors related to the client developing heart failure and briefly explain how each factor relates to heart failure occurring.
3. Following the collection of the data presented in the scenario, the RN identifies three nursing care diagnoses. State three-part priority nursing diagnosis for this client.
4. The professional nurse must anticipate post cardiac cath complications and identify interventions to decrease the opportunity for the client developing a complication.  State two complications of cardiac cath and one intervention for each.
5. Which lab data ordered for this client must the nurse check prior to the administration of Furosemide?  Why should this lab be checked?
6. While reading the provider medication orders, the RN notices that one medication dosage seems to be well beyond the recommended dose.  Which medication is the RN concerned about and what two things should be done to protect the client’s safety?
7. What is the significance of a client admitted with signs of congestive heart failure needing to have a Troponin and CK-MB level drawn?
8. Why is this client with heart failure receiving Amlodipine?
9. Why is this client receiving aspirin and clopidogrel?
10. Why is this client receiving celecoxib and allopurinol?