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tionna98 tionna98
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3 years ago
The 2D echocardiogram shows that J.M.'s left ventricular ejection fraction (EF) is 49.
  Explain what this test results mean with regard to J.M.'s heart function.

Question 2

This is J.M.'s first episode of significant HF. Before he leaves the clinic, you want to teach him about lifestyle modifications he can make and monitoring techniques he can use to prevent or minimize future problems.
  List five suggestions you might make and the rationale for each.

Question 3

Based on the new medication orders, which blood test or tests should be monitored carefully?
  Explain your answer.

Question 4

When you give J.M. his medications, he looks at the potassium tablet, wrinkles his nose, and tells you he hates those horse pills. He tells you a friend of his said he could eat bananas instead.
  He says he would rather eat a banana every day than take one of those pills. How will you respond ?
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3 years ago
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The answer to question 1  The ejection fraction refers to the amount of blood that is pumped out of the heart's ventricle with
each heartbeat and is measured as a percentage. EF is generally measured only in the left ventricle
(LV). An LV EF of 55 or higher is considered within normal range. J.M.'s EF is decreased and reflects
the weakening of his heart muscle as a result of the HF.

The answer to question 2   Gradually increase and pace your activities to decrease the work requirements and oxygen
demand of the heart.
 Minimize stress to reduce sympathetic nervous system response to increased workload of the
 Avoid hot or cold environments; both increase cardiac demand.
 Learn to take your pulse, and call your physician if your pulse is less than 50 beats/min, greater
than 100 beats/min, or very irregular. Very slow, very rapid, or irregular heart rates can
exacerbate HF.

The answer to question 3  Potassium levels need to be monitored, for several reasons. The diuretic causes potassium to be
excreted along with sodium and water, thus the potassium supplement is ordered. However, the ACE
inhibitor causes retention of potassium and can lead to hyperkalemia. Last, patients who are taking
digoxin need to have potassium levels monitored as well as periodic digoxin levels. If potassium
levels get low, the hypokalemia can make the patient more susceptible to digoxin toxicity. Digoxin
levels must be monitored carefully because digoxin toxicity can lead to serious complications.

The answer to question 4   Use empathy and humor. Tell him that sounds good, but to get as much potassium from a banana
as he would from the potassium tablet, he would have to eat a 4-foot long banana every day
 Tell him there are other ways the physician can order the potassium, such as in a liquid form or
a powder form that is dissolved in liquid. If J.M. would prefer, ask the physician for an order of a
different formulation.
This verified answer contains over 400 words.

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