Excelsior College Health Differences
Across the Lifespan 1: Module 3 Exam
Q&A 100% Solved
Heart Failure Lifestyle Changes - ✔✔1. Smoking cessation.
Counsel patient/family on the benefits of smoking cessation.
2. Diet: Heart healthy or DASH diet. Patient may have sodium and
or fluid restriction as per physician/provider.
3. Exercise/activity instructions. May enroll initially in a supervised
exercise program to increase endurance and improve symptoms.
4. Specific patient instructions in regards to what to do if
symptoms get worse. Written instructions of when to seek
immediate and routine medical attention.
5. Advanced Directives Care plan or surrogate decision plan
discussion and ideally documented. Encourage dialogue about
,decisions relating to end of life issues before urgent or emergent
situations occur.
6. Daily weight is used as a means of reflecting ongoing body fluid
status. Patient/family are told if weight gain is more than 2 pounds
(1 kilogram) in one day or more than 5 pounds (2.3 kilograms) in
one week, further action is required..
7. Immunization is highly encouraged. Influenza and
pneumococcal immunization reduce overall mortality and
morbidity.
8. Medication teaching to improve medication adherence.
Aldosterone antagonist:
Spironolactone (Aldactone) - ✔✔ACTION: ↓myocardial fibrosis
SPECIAL CONSIDERATIONS: Potassium sparing diuretic
Avoid potassium supplements
Angiotensin converting enzyme (ACE) inhibitor:
ACE: lisinopril (Zestril);ramipril (Altace)
,Angiotensin II receptor antagonists (ARB):
ARB: losartan (Cozaar); valsartan (Diovan) - ✔✔ACTION:Dilate
venules & arterioles; improves renal blood flow; ↓blood fluid
volume.
SPECIAL CONSIDERATIONS: ACE inhibitor may cause irritating
cough causing a change to an ARB. May ↑ serum potassium.
Beta Blocker (specific for heart failure):
Bisoprolol (Monocor)
Carvedilol (Coreg)
MetoprololCR/XL (LopressorCR/Toprol XL) - ✔✔ACTION:
↓sympathetic tone; improves cardiac performance; ↓progression
of CHF
, SPECIAL CONSIDERATIONS: Assess for orthostatic
hypotension; may mask signs of hypoglycemia
Vasodilator Nitrate:
Hydralazine (Apresoline)
Isosorbide dinitrate (Isordil) - ✔✔ACTION: vasodilation
SPECIAL CONSIDERATIONS: Used to treat heart failure in
African American patients. May cause tachycardia, orthostatic
hypotension.
Cardiac glycoside:
Lanoxin (digoxin) - ✔✔ACTION: ↑force of contraction; ↓heart rate
SPECIAL CONSIDERATIONS: Needs very close monitoring for
toxic effect. Eliminated by kidney (need good kidney function) Has
many drug interactions.
Required to take apical pulse before administration
Across the Lifespan 1: Module 3 Exam
Q&A 100% Solved
Heart Failure Lifestyle Changes - ✔✔1. Smoking cessation.
Counsel patient/family on the benefits of smoking cessation.
2. Diet: Heart healthy or DASH diet. Patient may have sodium and
or fluid restriction as per physician/provider.
3. Exercise/activity instructions. May enroll initially in a supervised
exercise program to increase endurance and improve symptoms.
4. Specific patient instructions in regards to what to do if
symptoms get worse. Written instructions of when to seek
immediate and routine medical attention.
5. Advanced Directives Care plan or surrogate decision plan
discussion and ideally documented. Encourage dialogue about
,decisions relating to end of life issues before urgent or emergent
situations occur.
6. Daily weight is used as a means of reflecting ongoing body fluid
status. Patient/family are told if weight gain is more than 2 pounds
(1 kilogram) in one day or more than 5 pounds (2.3 kilograms) in
one week, further action is required..
7. Immunization is highly encouraged. Influenza and
pneumococcal immunization reduce overall mortality and
morbidity.
8. Medication teaching to improve medication adherence.
Aldosterone antagonist:
Spironolactone (Aldactone) - ✔✔ACTION: ↓myocardial fibrosis
SPECIAL CONSIDERATIONS: Potassium sparing diuretic
Avoid potassium supplements
Angiotensin converting enzyme (ACE) inhibitor:
ACE: lisinopril (Zestril);ramipril (Altace)
,Angiotensin II receptor antagonists (ARB):
ARB: losartan (Cozaar); valsartan (Diovan) - ✔✔ACTION:Dilate
venules & arterioles; improves renal blood flow; ↓blood fluid
volume.
SPECIAL CONSIDERATIONS: ACE inhibitor may cause irritating
cough causing a change to an ARB. May ↑ serum potassium.
Beta Blocker (specific for heart failure):
Bisoprolol (Monocor)
Carvedilol (Coreg)
MetoprololCR/XL (LopressorCR/Toprol XL) - ✔✔ACTION:
↓sympathetic tone; improves cardiac performance; ↓progression
of CHF
, SPECIAL CONSIDERATIONS: Assess for orthostatic
hypotension; may mask signs of hypoglycemia
Vasodilator Nitrate:
Hydralazine (Apresoline)
Isosorbide dinitrate (Isordil) - ✔✔ACTION: vasodilation
SPECIAL CONSIDERATIONS: Used to treat heart failure in
African American patients. May cause tachycardia, orthostatic
hypotension.
Cardiac glycoside:
Lanoxin (digoxin) - ✔✔ACTION: ↑force of contraction; ↓heart rate
SPECIAL CONSIDERATIONS: Needs very close monitoring for
toxic effect. Eliminated by kidney (need good kidney function) Has
many drug interactions.
Required to take apical pulse before administration
