Reference no: EM133847655

Question

Ola Swanson, 70 years old, has been a type 2 diabetic for 40 years. She has a history of renal disease and chronic heart failure (CHF). She has been on a low sodium diet for 10 years. She is admitted to the hospital with exacerbation of CHF and chronic renal failure. Nursing assessment information obtained on admission includes the following: - Vital signs: temperature, 97.8; pulse, 102; respiration, 24; blood pressure, 140/88 - Weight: 143 pounds - Height: 5 feet, 3 inches (as reported by the patient) - Alert and oriented - Rhonchi in bases of both lungs - Shortness of breath noted on mild exertion (turning in bed, sitting up for lungs to be auscultated) - S1, S2, and S3 heart sounds on auscultation - + 3 pitting edema in both hands and feet - States urinary output has been scant and dark-colored the last 3 days The patient is prescribed furosemide, 20 mg IVP bid, and digoxin, 0.25 mg PO daily. After the second dose of the furosemide, the patient complains of a ringing in her ears, which goes away. After the second dose of medication, the nursing assessment information includes the following: -Vital signs: temperature, 98.4; pulse, 88; respiration, 18; blood pressure, 130/80 - Weight: 136.4 pounds - Crackels in bases of both lungs - Able to get out of bed to chair, with assistance, without shortness of breath - Some dizziness when first stood up - S1 and S2 heart sounds auscultated - + 1 edema in both hands and feet - Intake, 1,000 cc; output, 2,500 cc (last 24 hours) - Complains of nausea and loss of appetite The patient continues on prescribed furosemide, 20 mg IVP bid, and digoxin, 0.25 mg PO daily.

1. Why is Ms. Swanson on these drugs?

2. How do these drugs work together to address Ms. Swanson's underlying pathologic conditions?

3. What patient variables are most important to consider for Ms. Swanson when assessing her drug therapy?

4. Are there any aspects of core drug knowledge that are especially relevant to consider because they may interact with the core patient variables?

5. Which findings from the nursing assessment demonstrate the effectiveness of drug therapy?

6. Which findings from the nursing assessment demonstrate possible adverse effects from drug therapy?

7. What actions are indicated to maximize therapeutic effects?

8. What actions are indicated to minimize adverse effects?

9. What teaching is required for Ms. Swanson regarding her drug therapy? Do you need any additional data to determine appropriate teaching?