Reference no: EM133842758

Question

1. Identify the rhythm (regular or irregular); 2 - Identify the heart rate; 3 - Identify the EKG reading; 4 - Provide two (2) nursing interventions SPECIFIC to the interpreted EKG reading

A)

B)

C)

D)

E)

F)

Part 2 - Ch. 35 (Cardiomyopathy)

The nurse is performing an admission assessment for Mr. Parrott, a 78-year-old man with a history of cardiovascular disease and hypertension. He takes 20 mg of furosemide and 5 mg of Zestril daily. He was seen in the physician's office today reporting swelling in his feet, shortness of breath while playing golf, awakening at night unable to catch his breath, and "feeling" his heart beating in his chest.

Mr. Parrott's blood pressure is elevated, and there is no auscultatory gap. A third heart sound is present. His chest x-ray shows cardiac hypertrophy. There are adventitious sounds in both lower bases. He has gained 10 pounds in the past 2 weeks. A urinalysis is normal. His ECG is normal with evidence of slight cardiomyopathy.

Which assessment finding would the nurse determine to be of the highest priority for intervention? Explain your answer.

Glenn is admitted to the hospital, where his condition continues to decline and progresses to pulmonary edema. The patient asks the nurse, "Am I going to die?"

How should the nurse respond?

What approaches should the nurse utilize when discussing end of life?

The conversation between Mr. Glenn and the nurse continues; Mr. Glenn states, "My doctor said that I only have about 2 months to live."

Should the nurse discuss advance directives with the patient? If so, what approaches should the nurse utilize when discussing his wishes?

What members of the interprofessional team could be consulted for transition management? Explain how will EACH discipline will assist the patient.

Part 3 - Ch. 36 (Hypertension & PAD)

Mr. Logan, a 71-year-old male, arrives in the ED with a headache and lightheadedness. He states, "I just don't feel right." The nurse notes Mr. Logan's blood pressure is 204/162 mm Hg in the right arm and 202/160 mm Hg in the left arm. His cheeks are flushed and he has ankle edema.

What other assessments should the nurse perform?

Mr. Logan is diagnosed with hypertension. He is treated with medications and discharged from the ED with instructions to follow-up with his primary health care provider. When Mr. Logan meets with the nurse at his follow-up appointment, the nurse and Mr. Logan discuss his daily routine, as follows:

He gets 6 to 7 hours of sleep every night, drinks 4 cups of coffee each day, smokes 1 pack daily, and has a glass of wine before dinner every night. He works 8 to 10 hours per day on weekdays, but infrequently works on the weekends. He and his wife walk at a leisurely pace in the evenings when the weather is good. He enjoys reading before he goes to bed. He eats oatmeal for breakfast, fast food for lunch, and a "wholesome" dinner that his wife makes every night.

What lifestyle changes would help Mr. Logan in managing his blood pressure? Explain your answer.

What members of the interprofessional team could be consulted to assist Mr. Logan? Discuss how EACH discipline will assist the patient.

Mr. Logan returns to his provider's office for a follow-up assessment 3 months later. He states that he has been taking his blood pressure every day and that most days it is within the normal range. He also states he doesn't take his blood pressure medication every day. Mr. Logan asks the nurse, "What will happen if I don't take the medication?"

How should the nurse respond to Mr. Logan?

Part 4 - Ch. 45 (Stroke)

Develop a teaching plan about risk factors for stroke. Include primary and secondary prevention measures for stroke.

Discuss the neurologic assessment of patients who are experiencing acute neurologic events of stroke.

What assessment findings would indicate the need for fibrinolytic therapy for ischemic stroke? Include potential adverse effects.

Discuss priority collaborative care and nursing interventions for patients with a stroke to ensure optimal functioning and quality of life.

Identify community resources to help patients with stroke achieve or maintain independence.