Author Question: A patient has heart failure. A recent echocardiogram reveals decreased compliance of the left ... (Read 93 times)

Mr3Hunna · **on:** Jul 24, 2018

A patient has heart failure. A recent echocardiogram reveals decreased compliance of the left ventricle and poor ventricular filling. The patient takes low-dose furosemide and an ACE inhibitor.

The primary care NP sees the patient for a routine physical examination and notes a heart rate of 92 beats per minute and a blood pressure of 100/60 mm Hg. The NP should: a. order serum electrolytes.
b. obtain renal function tests.
c. consider prescribing a B-blocker.
d. call the patient's cardiologist to discuss adding digoxin to the patient's regimen.

Question 2

The neighbor of a primary care NP asks the NP to write a prescription for an antibiotic. The NP should tell the neighbor:

a. a prescription will be written one time only.
b. she will ask a colleague to write the prescription.
c. that it is illegal to write prescriptions for friends.
d. that it is best if the neighbor sees a health care provider before obtaining a prescription.

l.stuut · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
Patients with diastolic heart failure are sensitive to fluid depletion, which can cause decreased preload and stroke volume. This patient has a rapid heart rate and a low blood pressure, which can indicate dehydration, so serum electrolytes should be obtained. Renal function tests are not indicated. B-Blockers are used in patients who are stable. Digoxin should not be used in patients with diastolic failure.

Answer to Question 2

D
It is not illegal to prescribe antibiotics for friends, but it is unethical. It is better if patients are seen and diagnosed appropriately before antibiotics are prescribed. The NP should recommend that the neighbor see a health care provider.