Management of Patients With Complications From Heart Disease

 

1. George Brown, 72 years of age, is a male patient who is admitted with the diagnosis of acute pulmonary edema secondary to acute left ventricular heart failure. The patient has a history of coronary artery disease that has been treated medically. The patient is anxious, pale, cold, clammy, and dyspneic. The vital signs are: blood pressure, 88/50 mm Hg; heart rate, 110 bpm; respiratory rate, 32 breaths/min; and temperature, 97°F. There are bubbling crackles and wheezing throughout the lung fields and the patient is raising frothy blood-tinged clear sputum. The patient’s admission weight is 100 kg. (Learning Objectives 1 and 6)

a.What first actions should the nurse take and what are the rationales for these actions?

The physician prescribed furosemide (Lasix) 40 mg IVP STAT.

b.What are the actions of furosemide that will help the patient?

c.What nursing actions should be implemented when administering a diuretic?

2. Carl Edwards is a 75-year-old man with congestive heart failure. Having sustained three myocardial infarctions in the last 10 years, he has decreased left ventricular function. Mr. Edwards takes Digoxin, Capoten, Coreg, and Lasix for management of this disease. Today he presents to the emergency department with fatigue, generalized weakness, and feelings of “skipping” heartbeats. Upon arrival, he is placed on the cardiac monitor, his vital signs are assessed, and an IV is inserted. He currently denies chest pain, but is experiencing some shortness of breath, and is placed on 2 L of oxygen via nasal cannula. (Learning Objective 1)

a.Which of his medications might be contributing to his symptoms of generalized weakness and heart irregularities?

b.For what clinical manifestations should you assess to correlate to his left-sided heart failure?

c.How do his medications treat his congestive heart failure?

d.How does the hypokalemia affect the effects of Digitalis?

 

 

 

 

Sample Solution

 

Sex in Movies

Sexual orientation in motion pictures In the present entertainment world, the job of sex is getting progressively significant. The response to this generally distributed inquiry depends vigorously on singular supposition, yet it isn’t the situation. The unbiased development of this movie is straightforwardly identified with the development of that job in current society. The entertainment world has just to adjust to changes in social diversion needs. The entertainment world is the thing that it calls industry. Industry that has objectives with all different ventures that bring in cash.

The film has a watch: Oliver will remain just for about a month and a half, and the motion pictures are apprehensive – like this scene – when do they have intercourse? Guadagnino included this doubt by giving close consideration to this conduct: eyes, motions, disdain and departure, reality and creative mind, everything is under development. This film is shrewd and fascinating, yet his style is easing back down. What’s more, this absence of supportability prompts a more smooth and expressive film than previously. Want is at times engaging, however this is certainly not an unmistakable film – there is a male (and female) exposed glimmer, yet not at all like outsiders on the lake and blue, the name “your name” is really PG It is a level. It is the hottest shading

Sex in motion pictures In the present entertainment world, the job of sex is getting progressively significant. The response to this generally distributed inquiry depends vigorously on singular supposition, yet it isn’t the situation. The unbiased development of this movie is straightforwardly identified with the development of that job in current society. The entertainment world has just to adjust to changes in social amusement needs. The entertainment world is the thing that it calls industry. – In the late eighteenth century, reformers and the political world examined the offer of liquor for different reasons. Issues, for example, prohibiting may free numerous individuals taking an interest in legislative issues and exposure from genuine issues. President Cleveland won the Republican political decision in 1884. It is supposed to be because of the celebrated comment by the Republican minister.

This is a film about sex. Indeed, in the event that you are delegated an old, the film may here and there dress it as a sentimental relationship, however the film isn’t about sex. As 90% of the motion pictures are this way, you ought to get ready for loads of sexual conversations. Truly, this film is alluring. All the scenes are about sex being acceptable, regardless of whether the old ought to have it, how to get it, and whether they should adore somebody when having intercourse. This is a ton of sex. This film has more sexual conversations than American ones. Taking a gander at the four old women resembles taking a gander at four super hares. This is irritating as you are simply burnt out on hearing. Toward the finish of the film, I am worn out on tuning in to sex so I invest a ton of energy talking about why blossoms are set accurately in the lounge.

 

 

 

 

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