As you remove the digoxin tablet from the automated medication dispensing machine, you note that the dose on the tablet label is 250 mcg.
How many tablets would you give?
Question 2When you go to remove the medications from the automated dispensing machine, you see that carvedilol (Coreg CR) is stocked.
Will you give it to J.M.? Explain.
Question 3The physician confirms your suspicions and indicates that J.M. is experiencing symptoms of early leftsided heart failure. A two-dimensional (2D) echocardiogram is ordered. Medication orders are written.
Medication Orders
Enalapril (Vasotec) 10 mg PO twice a day
Furosemide (Lasix) 20 mg PO every morning
Carvedilol (Coreg) 6.25 mg PO twice a day
Digoxin (Lanoxin) 0.5 mg PO now, then 0.125 mg PO daily
Potassium chloride (K-Dur) 10 mEq tablet PO once a day
For each medication listed, identify its class and describe its purpose for the treatment of HF.
Question 4J.M. tells you he becomes exhausted and has shortness of breath climbing the stairs to his bedroom and has to lie down and rest (put my feet up) at least an hour twice a day.
He has been sleeping on two
pillows for the past 2 weeks. He has not salted his food since the physician told him not to because of
his high blood pressure, but he admits having had ham and a small bag of salted peanuts 3 days ago.
He states that he stopped smoking 10 years ago. He denies having palpitations but has had a constant,
irritating, nonproductive cough lately.
You think it's likely that J.M. has heart failure (HF). From his history, what do you identify as
probable causes for his HF?
Question 5You are now ready to do your physical assessment. For each potential assessment finding for HF, indicate whether the finding indicates left-sided HF (L) or right-sided HF (R).
1. Fatigue, weakness, especially with activity
2. Jugular (neck) vein distention
3. Dependent edema (legs and sacrum)
4. Hacking cough, worse at night
5. Enlarged liver and spleen
6. Exertional dyspnea
7. Distended abdomen
8. Weight gain
9. S3/S4 gallop
10. Crackles and wheezes in lungs
Question 6Knowing his history and seeing his condition this morning, what further questions are you going to ask J.M. and his daughter?
What would be an ideal response?
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