Comprehensive Cardiac Medication Case Studies

Case Study 1: Furosemide IV for CHF

Patient: 68-year-old male with acute decompensated heart failure, receiving furosemide (Lasix) 40 mg IV every 8 hours for fluid overload.

Q1. Highlight the assessment findings that are most concerning for a patient on furosemide:

Q2. Which order should the nurse question?

Q3. Select all teaching points for furosemide:

Q4. Place the following nursing actions in order of priority if the patient develops muscle cramps and hypotension:

1. --Select--Assess vital signs and orthostatic BPHold furosemideNotify the providerDocument findings
2. --Select--Assess vital signs and orthostatic BPHold furosemideNotify the providerDocument findings
3. --Select--Assess vital signs and orthostatic BPHold furosemideNotify the providerDocument findings
4. --Select--Assess vital signs and orthostatic BPHold furosemideNotify the providerDocument findings

Q5. Matrix: Indicate if each is a common or serious side effect:

Side Effect	Common	Serious
Hypokalemia
Ototoxicity
Hypotension

Q6. Which finding requires immediate provider notification?

Case Study 2: Digoxin PO for CHF

Patient: 75-year-old female with chronic heart failure, prescribed digoxin 0.125 mg PO daily.

Q7. Highlight assessment findings most concerning for digoxin toxicity:

Q8. Which order should the nurse question?

Q9. Select all teaching points for digoxin:

Q10. Priority actions for bradycardia and vision changes:

1. --Select--Hold digoxinAssess vital signs and cardiac rhythmNotify the providerDocument findings
2. --Select--Hold digoxinAssess vital signs and cardiac rhythmNotify the providerDocument findings
3. --Select--Hold digoxinAssess vital signs and cardiac rhythmNotify the providerDocument findings
4. --Select--Hold digoxinAssess vital signs and cardiac rhythmNotify the providerDocument findings

Q11. Matrix: Digoxin Side Effects:

Side Effect	Common	Serious
Nausea
Vision changes
Bradycardia

Q12. Immediate notification needed for:

Case Study 3: Hydralazine PO for Urgent Hypertension

Patient: 54-year-old male with BP 198/110 mmHg, prescribed hydralazine 25 mg PO every 6 hours.

Q13. Highlight concerning findings for hydralazine:

Q14. Which order should the nurse question?

Q15. Select all teaching points:

Q16. Priority actions for chest pain and hypotension:

1. --Select--Stop hydralazineAssess vital signs and cardiac statusNotify the providerDocument findings
2. --Select--Stop hydralazineAssess vital signs and cardiac statusNotify the providerDocument findings
3. --Select--Stop hydralazineAssess vital signs and cardiac statusNotify the providerDocument findings
4. --Select--Stop hydralazineAssess vital signs and cardiac statusNotify the providerDocument findings

Q17. Matrix: Hydralazine Side Effects:

Side Effect	Common	Serious
Headache
Chest pain
Tachycardia

Q18. Immediate notification needed for:

Case Study 4: Plavix by Mouth after Cardiac Stent

Patient: 59-year-old male, status post cardiac stent placement, prescribed clopidogrel (Plavix) 75 mg PO daily.

Q19. Highlight findings concerning for Plavix:

Q20. Which order should the nurse question?

Q21. Select all teaching points for Plavix:

Q22. Priority actions for black tarry stools and bruising:

1. --Select--Assess vital signs and bleedingHold PlavixNotify providerDocument findings
2. --Select--Assess vital signs and bleedingHold PlavixNotify providerDocument findings
3. --Select--Assess vital signs and bleedingHold PlavixNotify providerDocument findings
4. --Select--Assess vital signs and bleedingHold PlavixNotify providerDocument findings

Q23. Matrix: Plavix Side Effects:

Side Effect	Common	Serious
Bruising
Bleeding (GI, nosebleeds)
Thrombocytopenia

Q24. Finding requiring immediate notification:

Case Study 5: Eliquis PO for Atrial Fibrillation

Patient: 73-year-old female, prescribed apixaban (Eliquis) 5 mg PO twice daily.

Q25. Highlight findings concerning for Eliquis:

Q26. Which order should the nurse question?

Q27. Select all teaching points:

Q28. Priority actions for severe headache and hematuria:

1. --Select--Assess neurological status and bleedingHold EliquisNotify providerDocument findings
2. --Select--Assess neurological status and bleedingHold EliquisNotify providerDocument findings
3. --Select--Assess neurological status and bleedingHold EliquisNotify providerDocument findings
4. --Select--Assess neurological status and bleedingHold EliquisNotify providerDocument findings

Q29. Matrix: Eliquis Side Effects:

Side Effect	Common	Serious
Easy bruising
Major bleeding (GI, intracranial)
Hematuria

Q30. Immediate notification needed for:

Case Study 6: Warfarin PO for DVT

Patient: 66-year-old male with DVT, prescribed warfarin 5 mg PO daily.

Q31. Highlight concerning findings for warfarin:

Q32. Which order should the nurse question?

Q33. Select all teaching points for warfarin:

Q34. Priority actions for INR 5.2 and hematuria:

1. --Select--Hold warfarinAssess for bleedingNotify providerDocument findings
2. --Select--Hold warfarinAssess for bleedingNotify providerDocument findings
3. --Select--Hold warfarinAssess for bleedingNotify providerDocument findings
4. --Select--Hold warfarinAssess for bleedingNotify providerDocument findings

Q35. Matrix: Warfarin Side Effects:

Side Effect	Common	Serious
Bleeding gums
Hematuria
INR > 4.0

Q36. Immediate notification needed for: