Docmoates: Created page with "{{Daily Eight |date=January 01, 0000 |day_number=1 |theme=Cardiovascular |moc_scenario=Delegation |moc_setting=Med-surg unit, RN with 1 LPN and 1 UAP, 6 patients |moc_question=Which task can the RN delegate to the UAP for a patient with heart failure? |moc_rationale=UAP can obtain vital signs and daily weights. Cannot assess, teach, or administer medications. Daily weights are critical for HF monitoring but are data collection, not assessment. |safety_topic=Fall Preven..."

2026-01-11T08:10:54Z

Created page with "{{Daily Eight |date=January 01, 0000 |day_number=1 |theme=Cardiovascular |moc_scenario=Delegation |moc_setting=Med-surg unit, RN with 1 LPN and 1 UAP, 6 patients |moc_question=Which task can the RN delegate to the UAP for a patient with heart failure? |moc_rationale=UAP can obtain vital signs and daily weights. Cannot assess, teach, or administer medications. Daily weights are critical for HF monitoring but are data collection, not assessment. |safety_topic=Fall Preven..."

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{{Daily Eight
|date=January 01, 0000
|day_number=1
|theme=Cardiovascular

|moc_scenario=Delegation
|moc_setting=Med-surg unit, RN with 1 LPN and 1 UAP, 6 patients
|moc_question=Which task can the RN delegate to the UAP for a patient with heart failure?
|moc_rationale=UAP can obtain vital signs and daily weights. Cannot assess, teach, or administer medications. Daily weights are critical for HF monitoring but are data collection, not assessment.

|safety_topic=Fall Prevention – Cardiac Patients
|safety_key_points=Orthostatic hypotension common with cardiac meds (beta-blockers, diuretics, ACE inhibitors). Dizziness increases fall risk.
|safety_action=Teach patient to rise slowly, dangle feet before standing, call for assistance. Ensure call light within reach. Non-skid footwear.
|safety_trap=Don't choose "keep all side rails up" – this is considered a restraint and can increase injury risk.

|health_focus=Cardiovascular Risk Screening
|health_population=Adults 40-75 years
|health_teaching=Know your numbers: BP <120/80, LDL <100, fasting glucose <100, BMI 18.5-24.9. Lifestyle modifications first.
|health_expected_vs_concern=Expected: BP slight increase with age. Concern: BP consistently >130/80, requires follow-up.

|psych_topic=Therapeutic Communication – Anxiety about Diagnosis
|psych_scenario=Patient just diagnosed with heart failure says: "I can't believe this is happening to me. My life is over."
|psych_response="This diagnosis is overwhelming. Tell me more about what concerns you most." (Open-ended, acknowledges feelings)
|psych_avoid="Don't worry, lots of people live with heart failure" (minimizes feelings), "You should be grateful it's not cancer" (dismissive comparison)

|basic_topic=Positioning – Heart Failure
|basic_intervention=High Fowler's position (60-90°) or orthopneic position (leaning forward on overbed table)
|basic_consideration=Reduces venous return, decreases preload, improves lung expansion. Monitor for skin breakdown at sacrum.
|basic_teaching=Sleep with head elevated on 2-3 pillows. Report worsening orthopnea or PND (paroxysmal nocturnal dyspnea).

|pharm_drug=Furosemide (Lasix)
|pharm_class=Loop diuretic
|pharm_mechanism=Inhibits sodium/chloride reabsorption in Loop of Henle → increased urine output → decreased fluid volume and preload
|pharm_side_effects=Hypokalemia, hypotension, ototoxicity (especially with rapid IV push), dehydration, hyponatremia
|pharm_nursing=Monitor K+ (give with K+ supplement or K+-sparing diuretic), daily weights, I&O, assess for hearing changes. IV push over 1-2 minutes.
|pharm_teaching=Take in morning to avoid nocturia. Eat potassium-rich foods (bananas, oranges, potatoes). Report muscle cramps, weakness, irregular heartbeat.

|risk_lab=BNP (B-type Natriuretic Peptide)
|risk_normal=<100 pg/mL
|risk_critical=>500 pg/mL indicates heart failure
|risk_significance=Released by ventricles in response to stretching/volume overload. Higher = worse heart failure. Used to diagnose and monitor HF severity.
|risk_response=Elevated BNP: assess for fluid overload (edema, JVD, crackles, weight gain). Anticipate diuretics, oxygen, possible medication adjustment.

|physio_diagnosis=Heart Failure (HF)
|physio_pathophys=Heart cannot pump effectively → decreased cardiac output → backup of blood → pulmonary congestion (left-sided) or peripheral edema (right-sided). Triggers compensatory mechanisms that worsen condition over time.
|physio_signs=Left-sided: dyspnea, orthopnea, crackles, cough, fatigue. Right-sided: JVD, peripheral edema, hepatomegaly, weight gain. Both: decreased urine output, activity intolerance.
|physio_interventions=Oxygen, position (high Fowler's), diuretics, daily weights, I&O, sodium/fluid restriction, monitor BNP and electrolytes. Medications: ACE inhibitors, beta-blockers, diuretics.
|physio_complications=Pulmonary edema, cardiogenic shock, renal failure, dysrhythmias, thromboembolism
}}

[[Category:The Daily Eight]]

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