Reference no: EM132284214 , Length: word count:600
Assignment 1 -
One year ago, Arthur Jackson, 67 years old, had a large anterior wall MI and underwent subsequent coronary artery bypass surgery. On discharge, he was started on a regimen of enalapril (Vasotec), digoxin, furosemide (Lasix), warfarin (Coumadin), and a potassium chloride supplement. He is now in the cardiac unit complaining of severe shortness of breath, hemoptysis, and poor appetite for 1 week. He is diagnosed with acute heart failure.
ASSESSMENT - Mr. Jackson refuses to settle in bed, preferring to sit in the bedside recliner in high-Fowler's position. He states, "Lately, this is the only way I can breathe." Mr. Jackson states that he has not been able to work in his garden without getting short of breath. He complains of his shoes and belt being too tight. When Mr. Jackson's nurse, Ms. Takashi, RN, obtains his nursing history, Mr. Jackson insists that he takes his medications regularly. He states that he normally works in his garden or light exercise. In his diet history, Mr. Jackson admits a fondness for bacon and Chinese food and sheepishly admits to snacking between meals "even though I need to lose weight."Mr. Jackson's vital signs are BP 95/72 mmHg, HR 124 bpm and irregular, R 28/min and labored, and T 97.5oF (36.5oC). The cardiac monitor shows atrial fibrillation. An S3 s noted on auscultation; the cardiac impulse is left of the midclavicular line. He has crackles and diminished breath sounds in the bases of both lungs. Significant jugular venous distention, 3+pitting edema of feet and ankles, and abdominal distention are noted. Liver size is within normal limits by percussion. Skin cool and diaphoretic. Chest x-ray shows cardio-megaly and pulmonary infiltrates.
Questions:
1. Provide 3 nursing diagnosis for Mr. Jackson.
2. Provide 3 Expected Outcomes of nursing care.
3. The crackles on the exam indicate left or right side heart failure?
4. The pitting edema is indicative of left or right side heart failure?
5. Atrial fibrillation puts Mr. Jackson at risk for what other pathologies to occur? And Why? (name 2).
6. What about Mr. Jackson's diet can further his cardiovascular disease and why?
Assignment 2 - Read the article about nephrology nursing.
Article - A Day in the Life of a Nephrology Nurse.
What are some ways to increase patient compliance in care of patients on hemodialysis?
What does this nurse mean by crossing boundaries in patient care? Can you give some examples of crossing personal boundaries? Do you feel we should have restrictions in place to protect these boundaries, and why?
Instructions - Need 600+ words.
Attachment:- Assignment File.rar