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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 B

Explanation

A. There is no time to wait for a DNR order in an emergency; immediate action is needed.

B. Without a written DNR order, the nurse is legally and ethically obligated to initiate CPR and call the emergency response team to attempt to save the client’s life.

C. Contacting the risk manager is not an immediate action that would benefit the patient in this emergency situation.

D. The family’s wishes cannot be respected in this scenario without a formal DNR order in place; thus, the nurse must perform CPR.

Correct Answer is A

Explanation

A. Sudden weight gain can indicate fluid retention, a common early sign of heart failure exacerbation. Prompt reporting allows for early intervention.

B. Nitroglycerin is used to treat chest pain, not specifically to prevent heart failure exacerbations.

C. Assessment of the apical pulse is important, but monitoring weight is more directly related to managing heart failure.

D. Compliance with diuretic therapy is important, but recognizing early signs of fluid retention, such as rapid weight gain, is crucial for preventing exacerbations.

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