Reference no: EM133946148

Question 

Congestive Heart Failure

Ms. Smith is admitted to the emergency department with a diagnosis of heart failure. She was recently discharged from the hospital. She complains of being unable to catch her breath. She has +4 swelling to her legs. She states she has been following the fluid and salt diet restriction given to her by her physician. She states she has gained 10 pounds since discharge. Her vital signs are: T- 97.8 F, R - 28, B/P - 168/102, O2 sat - 91% on RA

Ms. Smith has brought the following home medications with her:

Vasotec 5 mg BID PO
Digoxin 0.125mg per day PO
KCL 20meq per day PO
Lasix 40 mg per day PO

The physician writes orders for all the meds but changes the Lasix to 80mg IVP now and then 40mg IVP per day

1. What error in discharge teaching likely occurred?

2. What is the rational for changing the PO Lasix to IV?

3. You administer the Lasix. What there parameters would you use to monitor the effectiveness of the drug?

4. What lab tests should be ordered for Ms. Smith because of the Lasix order?

5. How do ACE inhibitors help in heart failure?

6. What will determine if the oral dose will be adequate to prepare for discharge?

7. What key management concepts will be important to prevent another relapse and admission?