Chapter 24, Problem 1CS

(1)

Summary Introduction

To describe:

The drug effects of medications Mr. J is receiving for heart failure.

Case summary:

A 58-year-old retired bus driver Mr. J, who had a myocardial infarction, has been admitted recently in the hospital for heart failure. Mr. J tells the nurse that he had not been feeling good for a week. During the morning rounds, the nurse finds Mr. J had difficulty in breathing, his weight increased from 72 to 76kg overnight, heart rate of 120 beats/min, and 3 + edema in his lower legs, and crackles heard in both lungs. Mr. J is shifted to intensive care unit and the physician told to administer furosemide to 60mg intravenous twice a day and to continue Carvedilol and Lisinopril. The prescriber told to start an infusion of milrinone 50mcg/kg over 10 minutes and followed by another infusion of 0.5mcg/kg/min.

(2)

Summary Introduction

To answer:

The laboratory values to be monitored while Mr.J receiving heart failure drugs.

Case summary:

A 58-year-old retired bus driver Mr.J, who had a myocardial infarction, has been admitted recently in the hospital for heart failure. Mr. J tells the nurse that he had not been feeling good for a week. During the morning rounds, the nurse finds Mr.J had difficulty in breathing, his weight increased from 72 to 76kg overnight, heart rate of 120beats/min, and 3 + edema in his lower legs, and crackles heard in both lungs. Mr.J is shifted to intensive care unit and the physician told to administer furosemide to 60mg intravenous twice a day and to continue Carvedilol and Lisinopril. The prescriber told to start an infusion of milrinone 50mcg/kg over 10 minutes and followed by another infusion of 0.5mcg/kg/min.

(3)

Summary Introduction

To answer:

The potential problem of administering milrinone with furosemide.

Case summary:

A 58-year-old retired bus driver Mr.J, who had a myocardial infarction, has been admitted recently in the hospital for heart failure. Mr. J tells the nurse that he had not been feeling good for a week. During the morning rounds, the nurse finds Mr.J had difficulty in breathing, his weight increased from 72 to 76kg overnight, heart rate of 120beats/min, and 3 + edema in his lower legs, and crackles heard in both lungs. Mr.J is shifted to intensive care unit and the physician told to administer furosemide to 60mg intravenous twice a day and to continue Carvedilol and Lisinopril. The prescriber told to start an infusion of milrinone 50mcg/kg over 10 minutes and followed by another infusion of 0.5mcg/kg/min.

(4)

Summary Introduction

To answer:

What the nurse must do and is there a concern regarding query of Mr.J’s skipping of his heartbeat more than usual.

Case summary:

A 58-year-old retired bus driver Mr.J, who had a myocardial infarction, has been admitted recently in the hospital for heart failure. Mr. J tells the nurse that he had not been feeling good for a week. During the morning rounds, the nurse finds Mr.J had difficulty in breathing, his weight increased from 72 to 76kg overnight, heart rate of 120beats/min, and 3 + edema in his lower legs, and crackles heard in both lungs. Mr.J is shifted to intensive care unit and the physician told to administer furosemide to 60mg intravenous twice a day and to continue Carvedilol and Lisinopril. The prescriber told to start an infusion of milrinone 50mcg/kg over 10 minutes and followed by another infusion of 0.5mcg/kg/min.

(5)

Summary Introduction

To answer:

The teaching was given by the nurse to Mr.J to monitor himself at home.

Case summary:

A 58-year-old retired bus driver Mr.J, who had a myocardial infarction, has been admitted recently in the hospital for heart failure. Mr. J tells the nurse that he had not been feeling good for a week. During the morning rounds, the nurse finds Mr.J had difficulty in breathing, his weight increased from 72 to 76kg overnight, heart rate of 120beats/min, and 3 + edema in his lower legs, and crackles heard in both lungs. Mr.J is shifted to intensive care unit and the physician told to administer furosemide to 60mg intravenous twice a day and to continue Carvedilol and Lisinopril. The prescriber told to start an infusion of milrinone 50mcg/kg over 10 minutes and followed by another infusion of 0.5mcg/kg/min.