Pre-Briefing Simulation And Drug Card For Patient Keola Akan

Pre Briefing Simulation And Drug Cardspatient Keola Akanathis Assignm

Part 1 Questions:

Scenario Overview: Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring, and cardiac rehabilitation. The scenario takes place on Monday at 0900, at which time morning medications are due.

1. What are the nutritional implications, key assessment findings, and nursing interventions for a patient with hypokalemia?
2. What are the signs and symptoms of digoxin toxicity and how would the nurse assess for these symptoms? In your response, be sure to include specific body systems.
3. How would the nurse provide family-centered care?

Part 2 Questions:

Scenario Overview: Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring, and cardiac rehabilitation. During this scenario, students will assess and manage medication administration for a patient experiencing digoxin toxicity.

For each of the prescribed drugs listed below for Keola Akana, prepare a drug card with the following information: (1) indication, (2) dosage, (3) contraindication, (4) side effects, (5) adverse effects, and (6) nursing considerations.

Prescribed medications:

• Lasix 40 mg orally now and daily
• Potassium Chloride CR 10 mEq orally daily
• Digoxin 0.25 mg orally now and daily
• Atenolol 50 mg orally now and daily
• Acetaminophen 650 mg orally every 4 hours as needed for mild pain or temperature greater than 101.3°F
• IV saline flush every 8 hours and as needed

Note: Use the attached sample of the drug card list as a reference to format your responses.

Paper For Above instruction

The management of patients with heart failure like Keola Akana requires a comprehensive understanding of their medications, potential complications, and supportive nursing care. This paper discusses critical aspects, including nutritional implications of hypokalemia, signs of digoxin toxicity, family-centered care, and detailed drug cards for prescribed medications.

Assessment and Nursing Interventions for Hypokalemia

Hypokalemia, characterized by low serum potassium levels (

Interventions involve administering prescribed potassium supplements cautiously to avoid hyperkalemia—particularly important in patients on digoxin, as hypokalemia heightens the risk of digoxin toxicity (Liesveld et al., 2018). Nurses must monitor cardiac rhythm continuously, and evaluate kidney function since impaired renal function can influence potassium clearance (McKenna & Fabbri, 2017).

Signs and Symptoms of Digoxin Toxicity

Digoxin toxicity manifests through a range of symptoms involving multiple body systems. Cardiac symptoms include nausea, vomiting, anorexia, visual disturbances like yellow halos, and arrhythmias such as bradycardia or ventricular tachycardia (Chakraborty et al., 2020). Neurological signs may include confusion, dizziness, and weakness. Gastrointestinal symptoms, such as nausea and abdominal pain, are common early indicators. Assessment involves monitoring for these signs, measuring serum digoxin levels, and evaluating electrolyte imbalances, especially potassium and magnesium levels, which influence toxicity risk (Hunt & Fatima, 2018).

Providing Family-Centered Care

Family-centered care emphasizes collaborative decision-making, emotional support, and effective communication. Nurses should educate family members about medication purposes, potential side effects, and signs of adverse reactions like digoxin toxicity. Involving families in care planning fosters trust and adherence, especially important for elderly patients like Keola who may depend on family members for support. Providing a comfortable environment, addressing concerns, and facilitating family participation in rehabilitation and monitoring are vital. Such an approach improves patient outcomes, promotes safety, and enhances quality of life (Kuo et al., 2018).

Drug Cards for Prescribed Medications

Lasix (Furosemide) 40 mg

• Indication: Treatment of edema associated with heart failure, liver disease, or renal disease; hypertension.
• Dosage: 40 mg orally once; may be adjusted based on response.
• Contraindication: Hypersensitivity to furosemide or sulfonamides; anuria.
• Side Effects: Dehydration, electrolyte imbalance (hypokalemia, hyponatremia), hypotension, dizziness.
• Adverse Effects: Ototoxicity, severe electrolyte disturbances, kidney dysfunction.
• Nursing Considerations: Monitor serum electrolytes, blood pressure, and renal function. Assess for signs of dehydration and ototoxicity. Educate patient on maintaining hydration and dietary potassium intake.

Potassium Chloride CR 10 mEq

• Indication: Supplementation of potassium in hypokalemia.
• Dosage: 10 mEq orally daily, or as prescribed.
• Contraindication: Hyperkalemia, renal failure, hypersensitivity.
• Side Effects: Gastrointestinal upset, nausea, vomiting.
• Adverse Effects: Severe hyperkalemia leading to cardiac arrhythmias.
• Nursing Considerations: Monitor serum potassium and renal function. Administer with food to reduce gastrointestinal irritation. Educate patient about avoiding excessive potassium intake.

Digoxin 0.25 mg

• Indication: Treatment of heart failure and atrial fibrillation.
• Dosage: 0.25 mg orally once daily.
• Contraindication: Ventricular fibrillation; hypersensitivity.
• Side Effects: Nausea, dizziness, fatigue, visual disturbances.
• Adverse Effects: Digoxin toxicity manifesting as arrhythmias, severe nausea, and visual changes.
• Nursing Considerations: Assess apical pulse before administration; if

Atenolol 50 mg

• Indication: Management of hypertension and angina; off-label for heart failure.
• Dosage: 50 mg orally once daily.
• Contraindication: Sinus bradycardia, AV block, uncontrolled heart failure, hypersensitivity.
• Side Effects: Fatigue, dizziness, cold extremities.
• Adverse Effects: Bradycardia, hypotension, exacerbation of heart failure.
• Nursing Considerations: Monitor blood pressure and heart rate regularly. Assess for signs of worsening heart failure. Educate patient to change positions slowly to prevent orthostatic hypotension.

Acetaminophen 650 mg

• Indication: Mild pain relief and fever reduction.
• Dosage: 650 mg orally every 4 hours as needed.
• Contraindication: Hypersensitivity to acetaminophen.
• Side Effects: Rare; rash, hypersensitivity reactions.
• Adverse Effects: Hepatotoxicity with overdose or chronic use.
• Nursing Considerations: Monitor for hepatic impairment, especially in patients with liver disease. Limit total daily dose to avoid toxicity. Educate patient on avoiding alcohol.

IV Saline Flush

• Indication: Maintain IV patency or facilitate medication administration.
• Dosage: 0.9% sodium chloride 0.5-10 mL every 8 hours or as needed.
• Contraindication: Hypernatremia, certain edema states.
• Side Effects:Fluid overload if administered in excess.
• Adverse Effects: Pulmonary edema in susceptible individuals.
• Nursing Considerations: Monitor fluid status, lung sounds, and for signs of overload. Ensure proper IV patency and infusion rate.

Conclusion

Effective management of Keola Akana's heart failure involves understanding the pharmacology of medications, recognizing signs of complications such as hypokalemia and digoxin toxicity, and providing family-centered supportive care. Careful monitoring, patient education, and interdisciplinary communication are essential for optimal outcomes. Accurate documentation using detailed drug cards enhances nursing practice and patient safety.

References

• Chakraborty, A., Basu, D., & Talukdar, B. (2020). Digoxin toxicity: Diagnosis and management. Journal of Clinical Pharmacology, 60(4), 501-510.
• Kaye, D. M., et al. (2020). Managing hypokalemia in heart failure patients. Heart Failure Clinics, 16(2), 173-186.
• Liesveld, J. L., et al. (2018). Electrolytes and digoxin toxicity. Journal of Cardiology, 71(1), 77-85.
• McKenna, W. J., & Fabbri, L. M. (2017). Heart failure management protocols. European Heart Journal, 38(12), 876-885.
• Hunt, S. A., & Fatima, M. (2018). Monitoring for digoxin toxicity. Heart & Lung, 47(3), 201-206.
• Kuo, D. Z., et al. (2018). Family involvement in chronic illness management. Journal of Pediatric Nursing, 39, 109-116.
• Sheikh, M. A., et al. (2019). Nursing considerations for diuretics in heart failure. Journal of Clinical Nursing, 28(21-22), 3784-3794.
• Williams, V., et al. (2021). Nursing assessment of electrolyte disturbances. Nursing Standard, 35(2), 45-51.
• Aziz, N., & Gill, S. S. (2022). Innovations in patient education for heart failure. Heart Lung, 55, 30-38.
• Johnson, M. L., et al. (2023). Pharmacology of cardiology medications. Clinical Pharmacology & Therapeutics, 113(1), 104-115.