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A nurse is caring for a client who has heart failure.

<div id="exhibits">Exhibits</div>

For each potential provider's prescription, click to specify if the prescription is essential (high priority) non-essential (low priority) or contraindicated(unrelated) for the client.

A.

Furosemide

B.

Echocardiogram

C.

Aspirin

D.

Losartan

E.

Cardiac catheterization

F.

Chest X-ray

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"}}

Furosemide: Furosemide is a diuretic that is commonly used to manage fluid overload in patients with heart failure. The patient has significant pitting edema, increasing dyspnea, and elevated BNP levels, indicating worsening heart failure. Administering furosemide is a high priority to reduce fluid overload and relieve symptoms.

Echocardiogram: An echocardiogram can provide valuable information about heart function.

Aspirin: Aspirin is typically used for its antiplatelet effects in conditions like coronary artery disease. It is not essential for managing acute symptoms of heart failure. The patient’s primary issue is fluid overload rather than a clotting concern.

Losartan: Losartan, an angiotensin II receptor blocker (ARB), is commonly used in the management of chronic heart failure to reduce afterload and prevent further cardiac remodeling. It is essential as part of the long-term management plan for heart failure.

Cardiac catheterization: Cardiac catheterization is an invasive procedure typically used to assess coronary artery disease or for interventional procedures. It is not indicated for the acute management of heart failure symptoms and could pose unnecessary risks in this context.

Chest X-ray: A chest X-ray is essential to assess the extent of pulmonary congestion and rule out other causes of respiratory distress, such as pneumonia or pleural effusion, which are important in managing a patient with worsening heart failure.


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Related Questions

Correct Answer is C

Explanation

A. Secondary hypertension is high blood pressure due to an identifiable cause, such as renal disease, but it does not describe an acute situation with target organ damage.

B. Hypertensive urgency is a situation where the blood pressure is severely elevated but without evidence of target organ damage.

C. Hypertensive emergency is characterized by severely elevated blood pressure with evidence of acute target organ damage, such as encephalopathy, myocardial infarction, or renal failure, requiring immediate medical intervention.

D. Primary hypertension, also known as essential hypertension, is high blood pressure without a known secondary cause and does not describe an acute emergency.

Correct Answer is B

Explanation

A. Obtaining a stat chest x-ray is important if catheter misplacement is suspected, but in this situation, ensuring the accuracy of the pressure reading through proper leveling and zeroing is the priority.
B. Zero referencing and leveling the catheter at the phlebostatic axis is essential to ensure accurate readings of the pulmonary artery pressure, which is critical for patient assessment and management.
C. Increasing supplemental oxygen is unnecessary given the patient’s stable oxygen saturation and normal respiratory status.
D. While notifying the provider is important, ensuring the accuracy of the pressure reading by leveling and zeroing the catheter should be done first.

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