Question

A 74-year-old woman was admitted to the hospital with heart failure. She had been growing progressively weaker and also had ankle edema, dyspnea on exertion, and three pillow orthopnea. On admission, she is severely dyspneic and can answer questions only with one-word phrases. She is diaphoretic, with a respiratory rate of 28/min, heart rate of 132 beats/min, and BP 98/70. Her oral temperature is 36.7 C and her SaO2 89%. She is extremely anxious. The nurse applies immediately oxygen at 2 L via NC as per unit protocol. The physician orders: Insert PIV then start Dobutamine 3 mcg/kg/hr Furosemide 40 mg IV stat, Digoxin 0.5 mg orally stat, then 0.125 mg every 6 h for three does with ECG before doses 3 and 4; morphine 2 mg IV stat, and then 2 mg IV every 1-2 h prn, increase O2 to 4 L/min. Schedule patient for an echocardiogram, no added salt diet, weigh patient daily and record: Strict I&O. Answer the questions below and give rationales for your answer. 5. What should the nurse include in the discharge instructions for self-care for patients with heart failure?

Answer 1

Answer: Nurse should instruct the patient for self care that she should take her medicines on time. She should avoid high cholesterol foods and junk foods. She should avoid caffeinated drinks and shouldn't pull heavy weight.

She needs to takecare of herself and should include a little exercise such as slow walk or physical activities etc. She should drink sufficient amount of water. She should regularly check up her blood pressure.