Case Study # 2: Managing Fluid Overload with Diuretic Drugs
Instructions
Complete the following case study. Students must handwrite their responses and upload to Canvas as a word doc or pdf file. Students must use resources and cite them in APA 7th edition format- click on link or go to the writing center for further assistance (APA Formatting and Style Guide (7th Edition) – Purdue OWL® – Purdue University. Answers must include in-text citations to back up the responses.
The APA citation page is the ONLY thing that can be typed. Do NOT use a citation machine as it can be incorrect formatting.
Sources must be within 5 years of the current date (evidence-based practice). Earliest date that is allowed = 2019
View the rubric below to know how the case studies will be graded. Assignment
Mr. Thompson is a 70-year-old Caucasian male who is admitted to the hospital with a diagnosis of congestive heart failure (CHF). He has a history of hypertension and was recently diagnosed with systolic heart failure. Mr. Thompson reports progressive dyspnea on exertion, orthopnea, and lower extremity edema for the past two weeks. His blood pressure (BP) readings are elevated, ranging from 160/100 mmHg to 180/110 mmHg.
Medical History:
Systolic heart failure diagnosed recently
Hypertension
Progressive dyspnea, orthopnea, and lower extremity edema
Current Medications:
Lisinopril 20 mg once daily for hypertension
Physical Examination:
Blood pressure: 175/102 mmHg
Heart rate: 90 bpm
Respiratory rate: 24 breaths per minute
Bilateral crackles on lung auscultation
Lower extremity edema
Laboratory Results:
Elevated B-type natriuretic peptide (BNP): 800 pg/mL
Serum creatinine: 1.2 mg/dL
Electrolytes within normal limits
Assessment: Mr. Thompson is diagnosed with systolic heart failure exacerbation, and his hypertension needs to be managed to improve his symptoms and reduce fluid overload.
Plan:
Diuretic Medication Adjustment: The physician decides to adjust Mr. Thompson’s diuretic regimen to address fluid overload.
Selection of Diuretic Agent: Considering his clinical presentation, the physician chooses a loop diuretic for its potent diuretic effect.
Monitoring and Symptom Management: Close monitoring of fluid balance, electrolytes, and symptom improvement is crucial. Adjustments to the diuretic dose may be necessary.
Prescription: Furosemide (Lasix) 40 mg IV push, followed by 20 mg IV every 12 hours
Questions for Students to Answer:
Pathophysiology Understanding:Explain how systolic heart failure contributes to fluid retention and the development of symptoms such as dyspnea and edema.
Diuretic Medication Knowledge:Describe the mechanism of action of furosemide (Lasix).
What distinguishes loop diuretics from other diuretic classes, and why are they often preferred in heart failure management?
Patient Assessment and Monitoring:Identify at least 3 key assessments and monitoring parameters to evaluate the effectiveness and potential complications of furosemide in Mr. Thompson.
Patient Education:What information will you provide to Mr. Thompson regarding his new diuretic medication, furosemide?
How will you educate him on signs of worsening heart failure and the importance of medication adherence?
Collaborative Care:What other interventions or therapies might be considered in the collaborative care plan for Mr. Thompson?
For all of the questions, make sure you include a rationale for your answers and use in-text citations to backup your response. This helps build critical thinking skills. Rubric
Case Study Rubric
Case Study Rubric
CriteriaRatingsPts
This criterion is linked to a Learning OutcomePosting Timeframe
5 ptsFull Marks
Postings are made according to the assigned timeframe.
0 ptsNo Marks
Postings are not made within the assigned time, if at all.
5 pts
This criterion is linked to a Learning OutcomeEvidence of Critical Thinking
45 ptsFull Marks
Relates new content from readings and poses new possibilities based on current information and evidence in nursing practice
40 ptsPartial
Relates content from readings based on current information and evidence in nursing practice
34 ptsMinimal
Minimal content from readings. Minimal evidence and information relating to nursing practice
0 ptsNo Marks
No new connections are identified.
45 pts
This criterion is linked to a Learning OutcomeApplication of knowledge – Pharmacology
45 ptsFull Marks
Full, detailed explanation of the pharmacology related to the questions in an understandable and organized manner.
40 ptsPartial
Good explanation of the pharmacology. Well-developed description that is organized and understandable.
29 ptsMinimal
Minimally detailed description and explanation of the pharmacology containing several minor or one major error.
0 ptsNo Marks
Explanation of pharmacology is brief, lacks clarity and organization, contains multiple errors. Lacks substance and relevance to the assignment.
45 pts
This criterion is linked to a Learning OutcomeAPA Citation
5 ptsFull Marks
No errors in APA cover page, citations and reference list
4 ptsPartial
Less than 3 errors in APA cover page citations and reference list.
2 ptsMinimal
3-6 errors in APA citations and reference list
0 ptsNo Marks
More than 6 errors in APA citations and reference list
5 pts
Total Points: 100
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Instructions
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