Observe rhythm for increased ventricular rate with atrial fib and deterioration in cardiac status with ectopy or onset of chest pain.
Heart Failure Treatments and Drugs”,
Nursing interventions that would be appropriate for Ms J during her admission to the ICU would include the following:
Continuous monitoring of VS and oxygen saturation after nasal O2 is applied – if saturations do not improve change to mask and do not rule out possible intubation – elevate HOB to a semi-fowlers position to facilitate easier effort of breathing
Assess for changes in her alertness or signs of confusion or hypoxia
Observe rhythm for increased ventricular rate with atrial fib and deterioration in cardiac status with ectopy or onset of chest pain.
Provide an environment that allows for rest and decreased anxiety – organize nursing care to facilitate rest periods
Monitor intake and output for cardiac stability as well as dehydration from the onset of the flu
Auscultate chest more frequently for breath sounds to determine improvement or deterioration in status
Administer medications as ordered and assess for prn meds to facilitate reduction in fever, generalized achiness from flu, decrease anxiety and promote rest
Rationale for the following meds (“Heart Failure Treatments and Drugs”, 2017):
LASIX IV – Produces diuresis in the kidneys and dilation in the venous system to promote a preload reducing effect that is seen within minutes once administered. Promotes excretion of water from the body and decreases fluid in the lungs to improve breathing
VASOTEC – an Angiotensin-Converting Enzyme (ACE) inhibitor is a vasodilator that increases the blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart.
LOPRESSOR – A beta blocker that reduces the symptoms of oxygen demand and myocardial ischemia of heart failure, improves the pumping action, and lowers the heart rate and blood pressure. Also increases diastolic relaxation to allow for the heart to fill properly due to wall motion stiffness.
MORPHINE IV – Induces vasodilation and increases venous return to the heart, acts as a mild arterial dilator, decreases myocardial oxygen consumption, centrally suppresses symptoms of breathlessness, decreases anxiety and reduces pain.
Four CV conditions that may lead to heart failure; what medical/nursing interventions can prevent the development of heart failure in each condition:
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