Question

PN 105 Fundamentals of Nursing I Concept Map - Congestive Heart Failure Mable Grant, a "frequent flyer", is admitted to the emergency room with a diagnosis of congestive heart failure. She was discharged from the hospital ten (10) days ago and comes in today stating "I just had to come to the hospital today because I can't catch my breath and my legs are as big as tree trunks". After further questioning you learn she strictly followed the fluid and salt restriction as ordered at her last hospitalization. She reports she has gained 1-2 pounds every day since her discharge. Vital signs are T100.2, P 104 and bounding, R 26 with audible crackles bilateral lower lobes, BP 156/112. O2 sats 88. Height 5'8" Weight 159.5. She is placed on Lasix 20 mg by mouth daily, strict intake and output: O2 at 2L/min; bedrest with bathroom privileges; 2400mg sodium diet; and Toprol 12.5 by mouth daily Now complete your concept map. Revised 9/19

Answer 1

Answering second section.

1. Instruct the patient to avoid use of anti seizure medications. It will cause risk for congenital abnormalities.

2. Avoid GI distress take the drug with food.

3. Carefully floss and brush the teeth and massage gums.

4. Stop the phenytoin therapy immediately

Monitor changes

Albumin therapy according to doctors order

Assess serum phenytoin level.

5. 10 to 20 mcg/ ml