Marilyn Fitch Pharmacology Reasoning Bradycardia 2021 | NUR 306 Pharmacology Reasoning Bradycardia - COMPLETE

NUR 306 Marilyn Fitch Pharmacology Reasoning Bradycardia 2021 Pharmacology Reasoning Bradycardia Suggested Answer Guidelines Marilyn Fitch, 78 years old Medication Categories: Concepts/Content: Antidysrhythmics Assessment ACE Inhibitors Drug-drug interactions Beta Blockers Evaluation of desired outcomes Statins Monitoring for adverse effects Oral Anticoagulants Emergency treatment of dysrhythmias Diuretics Client education Electrolytes Psychosocial support NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective Care Environment • Management of Care 17-23% X • Safety and Infection Control 9-15% X Health Promotion and Maintenance 6-12% X Psychosocial Integrity 6-12% X Physiological Integrity • Basic Care and Comfort 6-12% • Pharmacological and Parenteral Therapies 12-18% X • Reduction of Risk Potential 9-15% X • Physiological Adaptation 11-17% X I. Initial Presentation: Marilyn Fitch is a 78-year-old Caucasian woman with a history of hypercholesteremia, hypertension, and heart failure and has NKDA. She was brought in by her daughter after Marilyn complained of feeling dizzy several times this morning and then almost passed out at home. Marilyn has a six-month history of paroxysmal atrial fibrillation. Her heart rate has been regular and she has had no episodic dizziness since she had a synchronized cardioversion one week prior to this visit. Her initial VS in triage were: T: 98.9 F/37.2 C (oral) P: 52 R: 16 BP: 94/52 and O2 sat: 98% room air. Personal/Social History: Marilyn is a widow and lives alone in her own home. She denies smoking and admits to drinking one glass of wine with her dinner. 1. What data from the histories are RELEVANT and must be NOTICED as clinically significant by the nurse?(NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential) RELEVANT Data from Present Problem: Clinical Significance: Hx of hypercholesteremia, hypertension, and heart failure Felt dizzy several times this am 6 mo Hx of intermittent A-Fib. Had sync. Cardioversion 1 wk ago, heartbeat regular and no dizziness since until today. Pulse: 52 BP 94/52 Pt already has pre- existing conditions that can implicate heart complications. Would support showing an intermittent A-Fib. Pt is elderly and having dizziness, can be a fall risk and may need help with setting up home for safety measures if this is continuous. Will need to keep eye on this as it seems to be continuing even after treatment for this. Seemed to work short term, but a-fib seems to be appearing again so we may need a longer-term treatment/ and /or a better treatment plan for care. Pulse and BP are sig. low but pt is also on ace inhibitor and beta blocker. Need to keep watch on these values.