Topic : Mandatory Discussion Question

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

Upon admission Mrs. J. needs supplemental O2, preferably via Bipap, before anything else. However, Mrs. J. is also anxious due to her respiratory distress and Afib with RVR so she might not be able to handle wearing Bipap until her other symptoms are more controlled. Mrs. J. needs PIV x2 inserted. She will need further testing done, such as a CXR and labs.

A CMP, Mag, Phos, and BNP would be beneficial to see if she has any renal damage, her electrolyte status, and also to see the extent of her fluid overload. Insertion of a foley catheter is necessary also. Mrs. J. is unable to ambulate since any form of exertion should be avoided at this time.

Once Lasix IV is given she will need to urinate frequently and will benefit from the use of a foley. Also, this will help keep a strict accounting of her I&O's so that the nurses and doctors are able to track her I&O status. Mrs. J. will need to have her electrolytes closely monitored while receiving IV Lasix. Mrs. J. also needs Metoprolol and Morphine, and possibly vasotec.