Following an acute myocardial infarction, a previously healthy ...

[javeds]

Following an acute myocardial infarction, a previously healthy 63-year-old develops clinical manifestations of heart failure. The nurse anticipates discharge teaching will include information about
 
  a. digitalis preparations.
  b. -adrenergic blockers.
  c. calcium channel blockers.
  d. angiotensin-converting enzyme (ACE) inhibitors.

Question 2

While admitting an 82-year-old with acute decompensated heart failure to the hospital, the nurse learns that the patient lives alone and sometimes confuses the water pill with the heart pill.
 
  When planning for the patient's discharge the nurse will facilitate a
  a. consult with a psychologist.
  b. transfer to a long-term care facility.
  c. referral to a home health care agency.
  d. arrangements for around-the-clock care.

[laurnthompson]

Answer to Question 1

ANS: D
ACE inhibitor therapy is currently recommended to prevent the development of heart failure in patients who have had a myocardial infarction and as a first-line therapy for patients with chronic heart failure. Digoxin therapy for heart failure is no longer considered a first-line measure, and digoxin is added to the treatment protocol when therapy with other medications such as ACE-inhibitors, diuretics, and -adrenergic blockers is insufficient. Calcium channel blockers are not generally used in the treatment of heart failure. The -adrenergic blockers are not used as initial therapy for new onset heart failure.

Answer to Question 2

ANS: C
The data about the patient suggest that assistance in developing a system for taking medications correctly at home is needed. A home health nurse will assess the patient's home situation and help the patient develop a method for taking the two medications as directed. There is no evidence that the patient requires services such as a psychologist consult, long-term care, or around-the-clock home care.

[javeds]

TYSM

[upturnedfurball]

Excellent