Chronic congestive heart failure (CHF), atrial fibrillation, and hypertension.

Ms. Josephine is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.
Ms. Josephine is recently widowed and lives alone. She has a daughter, Silvia Cooper, who lives in town but works full time and has family issues of her own. Therefore, family support is limited.
Hospital Discharge Instructions
1) Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.
2) Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN.
3) Prescriptions given at discharge:
o Digoxin 0.25 mg once a day
o Lasix 80 mg twice a day
o Calan 240 mg once a day
4) Order written to continue other home meds.

Josephine’s Home Medication List
5) Zocar 50 mg once a day
6) Minipres 1 mg once a day
7) Vasotec 10 mg twice a day
8) Prilosec 20 mg once a day
9) Furosemide 40 mg once a day
10) Effexor 37.5 mg at bedtime
11) Lanoxin 0.125 mg every other day
12) Multivitamin once a day
13) Potassium 40 mEq once a day
14) Ibuprofen 400 mg q 4 hours as needed for pain
15) Darvocet N 100 mg q 4 hours as needed for pain
16) Nitroglycerin ointment, apply 1 inch every day

1. Identify, prioritize, and describe at least four problems.
2. Provide substantiating evidence (assessment data) for each problem identified.
3. Identify and describe at least four medical and/or nursing interventions.
4. Discuss your rationale for the interventions identified.

 

 

 

Sample Solution

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