1. anna
DQ 1. Discuss a discharge teaching plan for a patient who has experienced heart failure. Anticipate that the
discharge order will include drugs affecting blood pressure; agents to treat heart failure; and potentially
antiarrhythmic agents. Please provide an example of each medication; nursing considerations for each; and
pertinent patient teaching (rationales) (Students with last name beginning with A – M).
When gathering information to present to my patient that has experienced heart failure, I would first explain to
them what heart failure is. Heart failure is when the heart muscle fails to pump blood around in the body
adequately which then leads to back of blood in the cardiac system. A cardiac glycoside medication that could
be used for treatment of heart failure or arrhythmias would be digoxin. Some patient teaching, I would do for
this drug is to inform them that this drug helps the heartbeat more slowly and efficiently and it can help reduce
swelling in the body. I would educate the patient to check their pulse when on this medication every morning so
they can identify anything out of the normal for them and notify their provider. I would educate them also on
some possible side effects to be aware of like dizziness, nausea, and vision changes and that they should
contact their provider if experiencing any of these (Karch, 2017).
A drug that would help with treatment in blood pressure for a patient with history of heart failure could be
lisinopril. This medication is an ACE inhibitor and should be taken the same time every day. If a dose is missed
just skip that dose and take the next scheduled dose. I would educate them to check their blood pressure
routinely so they can see if it is helping and report any side effects to their provider like cough, dizziness, or
headache (Karch, 2017). When being treated with these medications it is always important to inform your
provider of all medications that they currently take to avoid any drug-drug interactions. I would teach my patient
to keep a list of current medications on them at all times so this information would be easily available when
needed.
References
Karch, A. M. (2017). Focus on nursing pharmacology. Philadelphia: Wolters Kluwer.
2. lydia
DQ 1. Discuss a discharge teaching plan for a patient who has experienced heart failure. Anticipate that the
discharge order will include drugs affecting blood pressure; agents to treat heart failure; and potentially
antiarrhythmic agents. Please provide an example of each medication; nursing considerations for each; and
pertinent patient teaching (rationales) (Students with last name beginning with A – M).
As a nurse on a cardiac/telemetry floor education regarding heart failure is a common type of teaching I am
required to do. For a patient newly diagnosed with heart failure it is important to first explain what heart failure
is. Heart failure is the dysfunction of the cardiac muscle that can occur from conditions such as coronary artery
disease (CAD), cardiomyopathy, hypertension (high blood pressure), or valvular heart disease (Karch, 2016).
With this diagnosis of heart failure, the patient will then be put on medications to help control the disease.
Some of these medications include medications that affect blood pressure, ones that work to aid the heart in
strengthening, and antiarrhythmics. Patients will also need teaching on this diagnosis and there are aspects
that nurses should keep in mind when treating these patients, lets investigate all those things.
To begin, one medication that is commonly seen with heart failure patients on my unit is Lasix (furosemide)
which is used to prevent fluid retention that is seen in these patients with heart failure and decreasing edema
(Mayo Clinic Staff, 2021). Lasix can aide in decreasing blood pressure simply because fluid volume is being
decreased. In addition to Lasix decreasing blood pressure ACE inhibitor medications such as Lisinopril that
works to prevent the body from producing Angiotensin II which helps to relax blood vessels that takes the work
off your heart (Mayo Clinic Staff, 2019). The process of relaxing the blood vessels will also lower the blood
pressure. Another common medication that is see which works to treat heart failure is Lanoxin (digoxin). What
digoxin does is to increase the force of contraction of the heart (David, & Shetty, 2020). Digoxin also has
antiarrhythmic properties as well.
When it comes to nursing considerations for each medication there are assessments the nurse must make 
before administration of each of these drugs. For Lasix, an important assessment is the patient’s labs, if their
potassium is low or if their kidney function has declined the diuretic may need to be held until both values
improve. With lisinopril the patient’s blood pressure must be taken prior to administration to ensure it is not too
low to administer. In the case of digoxin, it is essential the patient’s pulse be taken prior to the patient taking the
drug. Just for the fact that digoxin lowers the patient’s heart rate.
Patients newly diagnosed with heart failure may be overwhelmed and anxious considering the name of the
disease is heart failure. The best education you can provide is that the disease is treatable. In relation to
medications, ensure they are taking them when they are prescribed at the frequency directed. Also, to check
their heart rate before taking a medication such as digoxin. Digoxin can be toxic if lab values of the drug in the
patient’s system are not checked regularly. With lisinopril take their blood pressure before taking and to get
their blood work done regularly to measure lab values. The teaching provided by the nurse can educate the
patient feel more empowered and in control of their own health.
References
David, M. N. V., & Shetty, M. (2020). Digoxin. National Center for Biotechnology Information. Retrieved on April
5th, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK556025/ (Links to an external site.)
Karch, A. M. (2016). Agents for treating heart failure. Focus on Nursing Pharmacology. Lippincott Williams &
Wilkins.
Mayo Clinic Staff. (2019). Angiotensin-converting enzyme (ACE) inhibitors. Mayo Clinic. Retrieved on April 5th,
2021 from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/ace-inhibitors/art20047480 (Links to an external site.)
Mayo Clinic Staff. (2021). Furosemide (Lasix). Mayo Clinic. Retrieved on April 5th, 2021 from
https://www.mayoclinic.org/drugs-supplements/furosemide-oral-route/precautions/drg-20071281?
p=1#:~:text=Furosemide%20is%20given%20to%20help,increase%20the%20flow%20of%20urine (Links to an
external site.).
3. tia
DQ 1. After reading your assigned chapters, please discuss healthcare in the US related to the Patient
Protection and Affordable Care Act (2010) and its repeal. Include your thoughts on the effects the repeal may
have on the nursing profession. (Students with last name beginning with A – M).
The Patient Protection and Affordable Care Act (2010) provided rights and benefits that made healthcare fairer
and more affordable. It also expanded Medicaid, making it more accessible to cover more lower income
individuals (Rosenbaum, 2011). There were many goals with the establishment of The Affordable Care Act.
One was to improve the affordability, quality, and equality of health insurance coverage. Another was to
enhance the value, efficiency, and quality of healthcare given to all patients. With this, the objective was to
reduce careless spending and make the health-care system more responsible to a diverse patient population
(Rosenbaum, 201  1).
Although the Affordable Care Act did not benefit all, as I seen many patients that applied get denied, I think it
still helped more people than not. Being that I have worked with many uninsured patients over the years, this
law came to be a good thing for a lot of people. Previously uninsured female patients were able to get their
mammograms, patient with abnormal chest x-rays, were finally able to get the CT that was needed, without
having to go through the ER. We were able to get needed labs and more patients in for follow-up and
preventive care. Witnessing the benefits of the Patient Protection and Affordable Care Act (2010) has made me
feel more optimistic, as I have seen it help others firsthand.
References
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy
and practice. Public health reports (Washington, D.C.: 1974).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001814/.
4. brittany
After reading your assigned chapters, please discuss healthcare in the US related to the Patient Protection and
Affordable Care Act (2010) and its repeal. Include your thoughts on the effects the repeal may have on the
nursing profession.
Ms. Mohan and Class,
The Patient Protection and Affordable Care Act (PPACA) was signed into legislation by President Barack
Obama on March 23, 2010. Citing a need for health insurance reform and a need to insure the millions of
uninsured Americans. The act preserves private insurance and private health care providers while instituting
more subsidies to enable all individuals to purchase health care insurance (Guido,2014). Repealing the Patient
Protection Affordable Care Act will change the face of the U.S. healthcare system, especially for medically
disadvantaged individuals. A lack of affordable healthcare has greatly contributed to chronic health issues in
lower socioeconomic communities and repealing the Affordable Care Act, a law that served to subsidize the
cost of medicine in the U.S. will further exacerbate that issue. As the law also served to expand Medicaid,
primary care will become costlier and less accessible to low-income Americans across the country, if repealed.
This change will affect the nursing profession in its entirety, primarily in hospital systems. Emergency rooms
will become inundated with patients seeking primary care since many patients will be unable to obtain a
general practitioner without insurance. With many ERs already short-staffed, nurses will experience a higher
rate of burnout and altogether more stress. Nurses on hospital floors will also see an increase in patients, as
chronic illness will go undiagnosed and untreated in affected patient groups. Higher hospital census will lead to
a slower rate of care, as patients will be kept in the Emergency Room longer as they wait for rooms to open up,
limiting the ability of ER staff to care for incoming critical patients.