NURSINGWS MISCWS CSWS SWERSWS BESTWS HEARTWS GRADEDWS A+WS FAILUREWS EXAMWS GUARANTEEDWS QUESTIONSWS ANDWS AN SUCCESSWS ATEWS 2022

NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN
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JoAnn- Smith,- 72- years- old


Primary Concept
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Perfusion
Interrelated Concepts (In order of emphasi
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NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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,NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN
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s)
1. Gas- Exchange

2. Fluid- and- Electrolyte- Balance

3. Clinical- Judgment

4. Patient- Education

5. Communication

6. Collaboration

UNFOLDING-Reasoning-Case-Study:-STUDENT-Heart-Failure-

History-of- Present- Problem:

JoAnn- Smith- is- a- 72-year-
old- woman- who- has- a- history- of- myocardial- infarction- (MI)- four- years- ago- and- systolic- h-
eart- failure- secondary- to- ischemic- cardiomyopathy- with- a-current- ejection- fraction- (EF)-of-
only- 15%.- She- presents- to- the- emergency- department- (ED)- for- shortness- of- breath- (SOB
)- the- past- three- days.- Her- shortness- of- breath- has- progressed- from- SOB- with- activity- to- b-
ecoming- SOB- at- rest.- The- last- two- nights- she- had- to- sleep- in- her- recliner- chair- to- rest- co-
mfortably- upright.- She- is- able- to- speak- only- in- partial- sentences- and- then- has- to- take- a- br-
eath- when- talking- to- the- nurse.She- has- noted- increased- swelling- in- her- lower- legs- and- ha-s-
gained- six- pounds- in- the- last- three- days.- She- is- being- transferred- from- the- ED- to- the- c-
ardiac- step-down- where- you- are- the- nurse- assigned- to- care- for- her.


Personal/Social- History:
JoAnn- is- a- retired- math- teacher- who- is- unable- to- maintain- the- level- of- activity- she- has- be-en-
accustomed- to- because- of- theprogression- of- her- heart- failure- the- past- two- years.- She- h

NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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,NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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as- struggled- with- depression- the- past- two- years- and- has- been- more- withdrawn- since- her- h-
usband- of- 52- years- died- unexpectedly- three- months- ago- from- a- myocardial- infarction.


What- data- from- the- histories- is- RELEVANT- and- has- clinical- significance- to- the- nurse?
RELEVANT Data from Present
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Problem:
MI- four- years- ago, MI- is- significant- because- it- decreases- heart- functi-
increase- shortness- of- breath- at- re- on- due- to- death- ofmyocardial- muscle
st;- can- onlyspeak- in- partial- sent- EF- of- 15%- shows- that- the- heart- is- having- a- hard- time-
ences, pumping- blood- out- torest- of- the- body- therefore- starving-
ischemic- cardiomyopathy- with- it- of- oxygenated- blood.
EF- of- 15%last- two- nights- slept- Weight- gain- and- increased- swelling- signifies- she- is- flui-
in- recliner d- overloaded-and- it can- be- reason- why- she- is- having- a-
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increased- swelling- in- lo- hard- time- talking,- breathing,- being
wer- legsgained- 6- poun active- and- why- she- has- to- sleep- in- a- recliner- the- past- 2
ds- in- last- 3- days nights
RELEVANT Data from Social H Clinical Significance:
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istory:
Retired-math-teacher,-recent-wido- Depression- might- affect- her- enthusiasm- to- recover,- to- st-
w,-history-ofdepression,-decreasin- ick-to- a- therapyregimen
g- activity- level


What- is- the- RELATIONSHIP-of- your- patient’s- past- medical- history- (PMH)- and- current- med-s?


NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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, NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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(Which-medication-treats-which-condition?-Draw-l-
ines-to-connect)
PMH: Home Meds: WS Pharm. Classificatio Expected Outcome
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n: :
• Diabetes mellitus typ 1. ASA- 81- mg- PO- d
WS WS • Antiplatelets • Decrease-chan-
e IIWS
aily • Beta- blocker ce-ofclot-form-
• ACE- inhibitor ation
• Hypertension 2. Carvedilol 3.25 WS WS



• Choleste- •
• Atrial fibrillation
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- mg PO daily
WS WS Decrease-bl-
rolmedic
• Hyperlipidemia 3. Lisinopril 5 m WS WS
oodpressur-
ation
-
e
• Chronic renal insuff WS WS
g PO daily
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• Vasodilator • Decrease-bloo-
- 4. Ezetimide 10 WS WS


• Diuretic d-pressure,-hel-
iciency (baseline cre
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• Electroly ps-withheart- f
-atinine 2.0) WS 5. Hydralazine 25 WS WS

te-
-
ailure,-
• Cerebral- vascular- a
-

mg PO 4x daily replac-
ccident(CVA)-with-
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decrease-chan-
6. Torsemide 20 ement
no- residual- deficits
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ce-ofdeath- fro-
mg PO bid • Anticoagulant
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m- heart- attac-
• Heart failure (systoli-
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• Antidiabetic
7. KCL 20 meq PO WS WS WS WS
k
c)
daily • Decreas-
secondary -to - WS WS


8. Warfarin 5 mg PO WS WS WS
e-choles-
isc-
daily WS
terol
hemic cardiomyo
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9. Glyburide 5 mg WS WS
• Decrease-bl-
-pathy
PO daily ood pressur
• MI with stent x2 to
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- LAD 4 WS




NURSING MISC CS HEART FAILURE EXAM QUESTIONS AND AN-
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