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Author Question: The nurse suspects that a patient is experiencing a neuroendocrine response from low cardiac output ... (Read 64 times)

xroflmao

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on: Jun 25, 2018
The nurse suspects that a patient is experiencing a neuroendocrine response from low cardiac output in heart failure. What manifestations did the nurse assess to make this clinical decision?
 
  Select all that apply.
 
  1. irregular heart rhythm
  2. gastrointestinal bleeding
  3. blood pressure 188/94 mmHg
  4. nausea, vomiting, and diarrhea
  5. heart rate 112 beats per minute

Question 2

A patient newly diagnosed with heart failure is prescribed 40 mg of furosemide (Lasix) to be given IV push. Knowing that the patient is also prescribed digoxin (Lanoxin), the nurse should review which laboratory result?
 
  1. sodium level
  2. digoxin level
  3. creatinine level
  4. potassium level


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raenoj

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Reply #1 on: Jun 25, 2018
Answer to Question 1

Correct Answer: 3, 5
A neuroendocrine response to low cardiac output is stimulation of the sympathetic nervous system and catecholamine release, leading to an increase in heart rate or tachycardia. A neuroendocrine response to low cardiac output and decreased renal perfusion is the stimulation of the reninangiotensin system, which leads to vasoconstriction and increased blood pressure. Dysrhythmias, gastrointestinal bleeding, nausea, vomiting, and diarrhea are not neuroendocrine responses to low cardiac output.

Answer to Question 2

Correct Answer: 4
Serum potassium level is measured in the patient receiving digoxin and furosemide. Heightened digoxin effect can occur in the patient with hypokalemia. Hypokalemia also predisposes the patient to ventricular dysrhythmias. There is no data indicating renal insufficiency; therefore creatinine level is not relevant. Furosemide can cause hyponatremia, but the risk of hypokalemia has more severe consequences in this situation.


xroflmao

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Reply #2 on: Jun 25, 2018
Thank you :)


raenoj

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Reply #3 on: Jun 25, 2018
Happy to help you


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