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1. anna
DQ 1. Discuss a discharge teaching plan for a patient who has experienced heart failure. Anticipate that the
discharge order will include drugs affecting blood pressure; agents to treat heart failure; and potentially
antiarrhythmic agents. Please provide an example of each medication; nursing considerations for each; and
pertinent patient teaching (rationales) (Students with last name beginning with A – M).
When gathering information to present to my patient that has experienced heart failure, I would first explain to
them what heart failure is. Heart failure is when the heart muscle fails to pump blood around in the body
adequately which then leads to back of blood in the cardiac system. A cardiac glycoside medication that could
be used for treatment of heart failure or arrhythmias would be digoxin. Some patient teaching, I would do for
this drug is to inform them that this drug helps the heartbeat more slowly and efficiently and it can help reduce
swelling in the body. I would educate the patient to check their pulse when on this medication every morning so
they can identify anything out of the normal for them and notify their provider. I would educate them also on
some possible side effects to be aware of like dizziness, nausea, and vision changes and that they should
contact their provider if experiencing any of these (Karch, 2017).
A drug that would help with treatment in blood pressure for a patient with history of heart failure could be
lisinopril. This medication is an ACE inhibitor and should be taken the same time every day. If a dose is missed
just skip that dose and take the next scheduled dose. I would educate them to check their blood pressure
routinely so they can see if it is helping and report any side effects to their provider like cough, dizziness, or
headache (Karch, 2017). When being treated with these medications it is always important to inform your
provider of all medications that they currently take to avoid any drug-drug interactions. I would teach my patient
to keep a list of current medications on them at all times so this information would be easily available when
needed.
References
Karch, A. M. (2017). Focus on nursing pharmacology. Philadelphia: Wolters Kluwer.
2. lydia
DQ 1. Discuss a discharge teaching plan for a patient who has experienced heart failure. Anticipate that the
discharge order will include drugs affecting blood pressure; agents to treat heart failure; and potentially
antiarrhythmic agents. Please provide an example of each medication; nursing considerations for each; and
pertinent patient teaching (rationales) (Students with last name beginning with A – M).
As a nurse on a cardiac/telemetry floor education regarding heart failure is a common type of teaching I am
required to do. For a patient newly diagnosed with heart failure it is important to first explain what heart failure
is. Heart failure is the dysfunction of the cardiac muscle that can occur from conditions such as coronary artery
disease (CAD), cardiomyopathy, hypertension (high blood pressure), or valvular heart disease (Karch, 2016).
With this diagnosis of heart failure, the patient will then be put on medications to help control the disease.
Some of these medications include medications that affect blood pressure, ones that work to aid the heart in
strengthening, and antiarrhythmics. Patients will also need teaching on this diagnosis and there are aspects
that nurses should keep in mind when treating these patients, lets investigate all those things.
To begin, one medication that is commonly seen with heart failure patients on my unit is Lasix (furosemide)
which is used to prevent fluid retention that is seen in these patients with heart failure and decreasing edema
(Mayo Clinic Staff, 2021). Lasix can aide in decreasing blood pressure simply because fluid volume is being
decreased. In addition to Lasix decreasing blood pressure ACE inhibitor medications such as Lisinopril that
works to prevent the body from producing Angiotensin II which helps to relax blood vessels that takes the work
off your heart (Mayo Clinic Staff, 2019). The process of relaxing the blood vessels will also lower the blood
pressure. Another common medication that is see which works to treat heart failure is Lanoxin (digoxin). What
digoxin does is to increase the force of contraction of the heart (David, & Shetty, 2020). Digoxin also has
antiarrhythmic properties as well.
When it comes to nursing considerations for each medication there are assessments the nurse must make 
before administration of each of these drugs. For Lasix, an important assessment is the patient’s labs, if their
potassium is low or if their kidney function has declined the diuretic may need to be held until both values
improve. With lisinopril the patient’s blood pressure must be taken prior to administration to ensure it is not too
low to administer. In the case of digoxin, it is essential the patient’s pulse be taken prior to the patient taking the
drug. Just for the fact that digoxin lowers the patient’s heart rate.
Patients newly diagnosed with heart failure may be overwhelmed and anxious considering the name of the
disease is heart failure. The best education you can provide is that the disease is treatable. In relation to
medications, ensure they are taking them when they are prescribed at the frequency directed. Also, to check
their heart rate before taking a medication such as digoxin. Digoxin can be toxic if lab values of the drug in the
patient’s system are not checked regularly. With lisinopril take their blood pressure before taking and to get
their blood work done regularly to measure lab values. The teaching provided by the nurse can educate the
patient feel more empowered and in control of their own health.
References
David, M. N. V., & Shetty, M. (2020). Digoxin. National Center for Biotechnology Information. Retrieved on April
5th, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK556025/ (Links to an external site.)
Karch, A. M. (2016). Agents for treating heart failure. Focus on Nursing Pharmacology. Lippincott Williams &
Wilkins.
Mayo Clinic Staff. (2019). Angiotensin-converting enzyme (ACE) inhibitors. Mayo Clinic. Retrieved on April 5th,
2021 from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/ace-inhibitors/art20047480 (Links to an external site.)
Mayo Clinic Staff. (2021). Furosemide (Lasix). Mayo Clinic. Retrieved on April 5th, 2021 from
https://www.mayoclinic.org/drugs-supplements/furosemide-oral-route/precautions/drg-20071281?
p=1#:~:text=Furosemide%20is%20given%20to%20help,increase%20the%20flow%20of%20urine (Links to an
external site.).
3. tia
DQ 1. After reading your assigned chapters, please discuss healthcare in the US related to the Patient
Protection and Affordable Care Act (2010) and its repeal. Include your thoughts on the effects the repeal may
have on the nursing profession. (Students with last name beginning with A – M).
The Patient Protection and Affordable Care Act (2010) provided rights and benefits that made healthcare fairer
and more affordable. It also expanded Medicaid, making it more accessible to cover more lower income
individuals (Rosenbaum, 2011). There were many goals with the establishment of The Affordable Care Act.
One was to improve the affordability, quality, and equality of health insurance coverage. Another was to
enhance the value, efficiency, and quality of healthcare given to all patients. With this, the objective was to
reduce careless spending and make the health-care system more responsible to a diverse patient population
(Rosenbaum, 201  1).
Although the Affordable Care Act did not benefit all, as I seen many patients that applied get denied, I think it
still helped more people than not. Being that I have worked with many uninsured patients over the years, this
law came to be a good thing for a lot of people. Previously uninsured female patients were able to get their
mammograms, patient with abnormal chest x-rays, were finally able to get the CT that was needed, without
having to go through the ER. We were able to get needed labs and more patients in for follow-up and
preventive care. Witnessing the benefits of the Patient Protection and Affordable Care Act (2010) has made me
feel more optimistic, as I have seen it help others firsthand.
References
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy
and practice. Public health reports (Washington, D.C.: 1974).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001814/.
4. brittany
After reading your assigned chapters, please discuss healthcare in the US related to the Patient Protection and
Affordable Care Act (2010) and its repeal. Include your thoughts on the effects the repeal may have on the
nursing profession.
Ms. Mohan and Class,
The Patient Protection and Affordable Care Act (PPACA) was signed into legislation by President Barack
Obama on March 23, 2010. Citing a need for health insurance reform and a need to insure the millions of
uninsured Americans. The act preserves private insurance and private health care providers while instituting
more subsidies to enable all individuals to purchase health care insurance (Guido,2014). Repealing the Patient
Protection Affordable Care Act will change the face of the U.S. healthcare system, especially for medically
disadvantaged individuals. A lack of affordable healthcare has greatly contributed to chronic health issues in
lower socioeconomic communities and repealing the Affordable Care Act, a law that served to subsidize the
cost of medicine in the U.S. will further exacerbate that issue. As the law also served to expand Medicaid,
primary care will become costlier and less accessible to low-income Americans across the country, if repealed.
This change will affect the nursing profession in its entirety, primarily in hospital systems. Emergency rooms
will become inundated with patients seeking primary care since many patients will be unable to obtain a
general practitioner without insurance. With many ERs already short-staffed, nurses will experience a higher
rate of burnout and altogether more stress. Nurses on hospital floors will also see an increase in patients, as
chronic illness will go undiagnosed and untreated in affected patient groups. Higher hospital census will lead to
a slower rate of care, as patients will be kept in the Emergency Room longer as they wait for rooms to open up,
limiting the ability of ER staff to care for incoming critical patients.

 

 

 

Sample Solution

Heart failure

Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. Heart failure can occur due to an injury to the heart or from natural processes. When a patient who has experienced heart failure is being discharged from the hospital, a guide is given on how to control symptoms of heart failure with some lifestyle changes. The patient should rest as needed. Stop activity if you develop symptoms such as chest pain, lightheadedness, or significant shortness of breath. Find activities that you enjoy, such as brisk walking, dancing, swimming, or gardening. These will help you stay active and strengthen your heart. Weigh yourself every day, check your pulse, and follow a healthy diet (limit canned, dried, packaged, and fast foods). Angiotensin-converting enzyme (ACE) drugs help people with heart failure feel better. ACE inhibitors widens blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart.

 

 

From the earliest starting point of time, authority has been the center in executing our day by day life. Initiative is a procedure of where an individual alludes as pioneer controls, oversee or teach someone else or a gathering so as to accomplish the objective while executing their assignments. Authority exists in an association, relative and furthermore during learning process. A decent pioneer as a rule delivers a decent result. For instance in an association, a great chief consistently guarantees that their representatives finish their deals with plan and get all the help they require to finish their undertaking. Pioneer is the focal point of gathering power structure that keeps the gathering firm together and keeps them pushing ahead at a relentless energy. Administration attributes might be classified as an individual example that reflects in the manner they lead a gathering or an association. Moreover, administration style can likewise be characterized in a few styles. Among them are vote based and totalitarian authorities. The meaning of equitable administration is somebody who hears their colleague’s voice, engage representatives and somebody who has the power to settle on a ultimate conclusion. While dictatorial initiative is somebody who exceptionally unequivocal individual, control their representatives and somebody who has utilize their expert in settling on a ultimate conclusion without hear their worker’s voice. Both of law based and totalitarian initiative make amazing job, however there additionally exist the extraordinary and likenesses between them in their points of interest, burdens and furthermore the best time to utilize the majority rule and absolutist authority.

Popularity based originated from Greek’s words and call as demos and kratos, Demos signifies “individuals” and Kratos signifies “power” or “authority”. Majority rule initiative is participative, worker focused and worried about the relations with their colleagues. For instance in association setting, when the pioneers have a decent association with their representative, this will make it simpler for the pioneers to comprehend their worker’s concern and unravel it rapidly. These will give a favorable position to the organization since they remain to one another and trust one another. The outcomes will be incredible on the grounds that they have numerous thought and imagination given by the representatives. This sort of initiative can urge individuals to like their contribution and make a lovely workplace for the representatives. All things considered, vote based administrations likewise have their shortcoming or impediments in their prosperity. The basic leadership can be a since quite a while ago drawn one since each colleague should be counseled and the pioneer can here and there being hesitant in settling on choice because of the numerous assessment that originated from all part that take an interest. This initiative style can’t be use when the venture is in a pressing stage. For instance in learning process, the group has given a brief timeframe to complete their last task. With the five individuals and one pioneer in the group, they attempt to complete their undertaking. Be that as it may, because of the absence of time, the group stuck in the advancement of making it achievement. Moreover, the pioneer some of the time turns into a remorseful. This additionally can be a shortcoming of vote based initiative on the grounds that the representatives know the shortcoming of their pioneer. Coincidentally, the best time to utilize this administration is the point at which the quality is a higher priority than effiency or profitability of the task.

Next is about imperious administration that originated from Greek’s words. Call as auto which signifies “self” and Kratos signifies “power” or “authority”. The despotic initiatives have a particular expert connection between the pioneers and the adherents. Dictatorial administrations is unequivocal individual, order initiative and occupation focused. Besides, choice will be made by the pioneers that have the position. It will be offer preferred position to association, for example, the military or aviation based armed forces in light of the fact that the pioneer needs to give choice in sharp and speedy time. For instance, there is circumstances in the class where there are a few understudies are tormented. The class screen needs to settle the contentions between them without the need to ask the colleagues on what should he do on the grounds that despot chief will choose the choice by his self. Also, the totalitarian initiatives give a solid inspiration and fulfillment to the pioneers. Be that as it may, the imperious authorities likewise have its inconveniences. This current administration’s style is regularly ordered as a childish individual. The pioneer couldn’t care less and doesn’t need hear what are been told by their colleague. This sort of connections could raise faculties of disappointment, low resolve, and struggle among colleagues. What’s more, in a long haul impact this can cause the negative considerations toward the pioneer just as ineffective workplace. For instance in political setting, the supporters need to pursue the pioneer’s choice, and yet he additionally needs to tune in to his adherent on their supposition and recommendation in settling on the best choice for everybody. On the off chance that the pioneer neglects to tune in and disregard his supporters, at that point this will make a crack among devotees with isolated conclusion on how their pioneer should act. Besides, trust could be an issue, a few feels that they are not being confided in enough in helping improving an answer.

In work point of view, on the off chance that I as representative were allowed to pick which authority style will be suite me, I for one would like to pick the law based administrations since its suits me more contrast with dictatorial initiative. On the off chance that I were a pioneer as well, I’m additionally will pick vote based initiative. In light of my experience of being a pioneer, I find that my trademark suit law based authority as opposed to totalitarian administration on the grounds that my character would additionally upgrade my capacity of being a pioneer. I likewise have had a lot of being a pioneer while executing despotic style and I didn’t appreciate it. Despite the fact that, I effectively ready to deal with my group, I battle to make it as fruitful when contrast with vote based. Consequently, I would state that I’m significantly more of a sure pioneer when I’m ready to do it as democrat pioneer. I appreciate great association with the individuals who I’m working with. I realize I could rely on them as much as they had put their trust on me. To me, the relations between the individuals are extremely significant.

I can presume that not every person can be a pioneer. Some are destined to be a pioneer, while others need to learn dependent on experience to be a fruitful pioneer. Everybody is diverse consequently their usage would be unique. A few chiefs are severe and others are perhaps a delicate heart, yet paying little mind to whom is it they first need to get themselves and evaluate circumstance they are in to make the best out of what they have. The shortcoming in fair could be a quality in other situation. The individuals who might hurry to stamp their expert in an association or gathering would make some hard memories to be a pioneer. Yet, a pioneer is extremely significant in an association, colleagues, and furthermore assumes an imperative job in family. What’s more, pioneers likewise help to motivate their colleagues to make an accomplishment in accomplishing something. An inability to impact the colleagues is a marker of initiative disappointment. A compelling pioneer is an individual that has a character, capability, fortitude and empathy. These are the parts that enable them to lead their subordinates the correct way.

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