Answer

Heart Failure/ Acute Renal Failure: Fundamental Reasoning Case Study

Answer the following questions in a Word document

1. Think or reason; which comes first?

My Response

In clinical reasoning, thinking-in-action precedes reasoning (KeithRN, 2015).

1. When you filter the data presented, you should recognize which is ……………

My Response

Which is most and least important and right so that the nurse can recognize if an actual problem is present (KeithRN, 2015).

1. In the case study what was the main symptom that prompted the patient to enter the ED?

My Response

            The main symptom was shortness of breath for the past three days (KeithRN, 2015).

1. Which lab values are not within the normal range?

My Response

            Normal ejection fraction ranges from 55% to 70% (Cleveland Clinic, 2021). The patient’s ejection fraction of 15% is considered as severe (<20%) and not within the normal range (Cleveland Clinic, 2021; KeithRN, 2015).

1. What lab value relates to the kidney function? Is it affected here in this case?

My Response

Lab values that relate to kidney function include sodium 133 mEq/L (133-145 mEq/L); potassium 5.5 mEq/L (3.5-5.0 mEq/L); and creatinine 2.7 mEq/dL (0.6-1.2mg/dL). The lab value that are affected in this case include an elevated potassium levels of 5.5 mEq/L (3.5-5.0 mEq/L); and elevated creatinine levels of 2.7 mEq/dL (0.6-1.2mg/dL) (KeithRN, 2015).

1. What is the name of the hormone that is released by the left ventricle and seen to be high here?

My Response

B-natriuretic peptide level is high at 1855ng/L compared with the normal reference range, which is less than 100ng/L (KeithRN, 2015).

1. Which vital sign(s) in this patient show any relevance to the health problem?

My Response

            Elevated respiratory rate of 26 breaths per minute (normal: 12-30 breaths per minute), elevated blood pressure of 162/54, and low oxygen saturation (90%) under six-liters of oxygen per minute.

1. Which autonomic nervous system is more dominant here; sympathetic or parasympathetic?

My Response

            Sympathetic nervous system is more dominant here due to elevated blood pressure and respiratory rate (KeithRN, 2015).

1. What are the medications prescribed to the patient?

My Response

            Current medications include carvidilol, hydralazine, torsemide, patossium chloride, and warfarin.  The primary care provider then orders oxygen, Lasix, and nitroglycerin drip (KeithRN, 2015).

1. Which electrolytes need to be reassessed?

My Response

            Electrolytes that need to be reassessed after four hours include creatinine and potassium levels (KeithRN, 2015)

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