Case Scenario:
Mr. H, an 82-year-old man who is widened and lives alone,
arrives in the emergency room complaining he has had difficulty
breathing, especially at night, associated with nausea, for the
past week. He states that he must sleep with two pillows to breathe
more easily at night and still does not get a good night’s rest. He
also complains of cough that is worse at night and relieved by
nothing. Mr. H has pneumonia. Assessment of Mr. H reveals the
following;
Vital signs: temperature, 98F; apical heart rate 86 beat s/min
and irregular, respiratory rate, 36 breaths/min and labored; and
blood pressure, 170/96 mmHgSkin – pale, cool, and
diaphoresisInspiratory bibasilar crackles that do not clear with
coughingS3,
heart sound on auscultation
Visible jugular vein distention3+ bilateral pedal edema
A 12-lead ECG and a chest x-ray examination are ordered.
An intravenous line is started at a “keep vein oven” (KVO)
rate.
Oxygen via mask is admitted with a diagnosis of CHF.
1. What are the signs and symptoms of heart failure?
2. Give 7 lifestyle modifications to teach older adults with
heart failure and discuss briefly.
3. Make a drug study on Digoxin including the nursing
consideration.
4. Give 6 objectives with interventions (for each objective)
in the management of CHF.