Mrs. Jones recovered from her recent hospitalization fortreatment of AKI secondary to pyelonephritis. During herhospitalization, it was discovered that Mrs. Jones has developedearly signs of Congestive Heart Failure (CHF) evident by herincreasing fatigue and difficulty controlling her high bloodpressure over the years. During her hospitalization, anechocardiogram (ECG) was performed which showed that she currentlyhas a 40% ejection fraction as well as mild left ventricularhypertrophy. Upon discharge, her antihypertensive regimen waschanged to the following;
- Discontinue
- Lisinopril 10mg PO daily
- Start
- Metoprolol (Lopressor) 25mg PO BID
- Furosemide (Lasix) 20mg PO daily
- Continue the following
- Ibuprofen 800mg PO q 6 hrs for moderate pain (4-6 verbalscale)
- Hydrocodone/acetaminophen 5/325mg PO q 4 hrs for severe pain(7-10)
- Aspirin 81mg PO q day
- Vitamin D 800IU q HS
- Calcium 600mg q HS
- Hydroxychloroquine 400mg q day
Please answer the following questions about the pharmacologicalmanagement of Mrs. Jones;
- Which of the listed medications are prescribed to address Mrs.Jones new diagnosis of CHF?
- Briefly describe how each of these medications help with CHF(ex: inotrope, reduce peripheral vascular resistance, etc.)BE SPECIFIC and use your drug book as aguide.
- Are there safety concerns the patient needs to be aware of withthese medications (Hint: synergistic effects? Self-assessmentsprior to administration?) If so, what are they?
- What precautions/assessments need to be taken as the nurse whenadministering these medications to Mrs. Jones?
- What important educational points does the nurse need to giveMrs. Jones regarding the newly prescribed medications?
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