NUR 440 SIM LAB ADMISSION TICKET Patient name: Malcolm Little Visit # 2 Scenario: CHF

NUR 440 SIM LAB ADMISSION TICKET Patient name: Malcolm Little Visit # 2 Scenario: CHF

SLS: Health Assessment 8.1

Allergies: PENICILLIN

Course Objectives: By the end of the course, the student should be able to:

1.      Identify competent nursing care for clients with chronic conditions utilizing evidence-based practice guidelines (SLO 1, 2, 5).

2.              Differentiate care needs of the elderly adult experiencing alterations in health (SLO 2, 3, 5).

3.                  Acknowledge legal and ethical issues in healthcare (SLO 3).

4.                  Prioritize nursing care for patients with chronic alterations in health (SLO 1, 2, 4, 5).

5.              Develop an individualized teaching plan for the client with the goal of improving and maintaining personal health (SLO 1, 2, 3, 4).

6.                  Correctly calculate medication doses appropriate for the population (SLO 1, 5).

THOROUGHLY ANSWER THE FOLLOWING COMPREHENSIVELY and submit by 0730 the day before Simulation. Incomplete tickets will be returned for redo, and must be returned by the following week’s simulation.

**ANSWERS MUST BE paraphrased AND CITE PROFESSIONAL source (Author, year, page). Textbook and NANDA are preferred sources.

1.       Paraphrase (with reference) the mechanism that occurs when LCHF causes pulmonary edema. A) How does CHF cause pulmonary edema? Pulmonary edema is caused when the left side of the heart/heart valve is unable to eject all of the blood out of the heart so it accumulates in the left atrium and lungs.                                                                                                   B) How does the fluid move from the vessels? By the excessive fluid which causes hydrostatic pressure that causes fluid to move from the pulmonary capillary bed into the interstitial, and then to the alveoli. C) Where exactly is the fluid is within the lungs? The fluid builds in the alveoli in the lungs. (Harding et al., 2020, p. 735).

2.       You receive STAT orders for Furosemide and a Foley for a patient in fulminant pulmonary edema. A) What does fulminant mean? Fulminant means acute onset (Harding et al., 2020, p. 989). B) Based on research, how does each relieve pulmonary edema? Furosemide is a loop diuretic and acts quickly. This diuretic works by preventing the reabsorption of sodium (water follows sodium) at the loop of Henle. It also activates renal prostaglandins which dilates blood vessels in the kidneys, lungs, and the body. This action (hemodynamic effect) decreases water absorption reduces preload and central venous pressures which in turn reduces edema (Lilley et al., 2020, p. 446). A Foley is used to accurately monitor the total output. Low urinary output can lead to edema so accurately monitoring it is important for a patient with HF (Harding et al., 2020, p. 739).