The long-term care client with a history of heart failure has ...

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The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND).
 
  The nurse reviews the client's medication record and determines that which of the following medications has been prescribed to treat the PND? 1. Bumetanide (Bumex)
  2. Propranolol (Inderal)
  3. Warfarin (Coumadin)
  4. Acetylsalicylic acid (aspirin)

Question 2

The nurse is assisting in developing a postoperative plan of care for a 40-year-old male Filipino-American client scheduled for an appendectomy. The nurse includes which of the fol-lowing in the plan of care?
 
  1. Offer pain medication on a regular basis as prescribed.
  2. Offer pain medication when nonverbal signs of discomfort are identified.
  3. Inform the client that he will need to ask for pain medication when needed.
  4. Allow the client to maintain control and request pain medication on his own.

[pami445]

Answer to Question 1

1

Rationale: Bumex is a diuretic that should increase urine output and lower the risk of episodes of PND. PND is most likely to occur because of increased venous return when lying in bed. Because of increased venous return and inability of the heart to effectively pump, the consequence is pulmonary congestion. Inderal is a beta blocker. Coumadin is an anticoagulant. Aspirin in low doses is an antiplatelet agent and is also an analgesic at routine doses.

Answer to Question 2

1

Rationale: Filipino-Americans view pain as part of living an honorable life. The client may appear stoic and be tolerant of a high degree of pain. Health care providers need to offer, and in fact encourage, pain relief interventions for the Filipino-American client who does not complain of pain, despite physiological indicators. Offer pain medication on a regular basis as prescribed is the most appropriate intervention to include in the plan of care.

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Gracias!

[rachel]

TYSM