R. S. is a 75-year-old woman presented to the emergency department.  She is dia

R. S. is a 75-year-old woman presented to the emergency department.  She is diagnosed with atrial fibrillation. She has a history of hypothyroidism and hypertension but no history of atrial fibrillation. Currently R. S. is taking levothyroxine (Synthroid) 0.125 mg PO daily and enalapril (Vasotec) 5 mg PO bid. Subjective data: She complains of palpitations, dizziness, shortness of breath, and mild chest pressure. Objective data: physical exam reveals an alert and anxious older woman; dizzy upon standing; increase in respiratory rate upon transfers; use of accessory muscles, sitting up in bed.  She relates a time 2 weeks ago that she experienced temporary weakness in her right arm and leg that lasted for about 1 hour then resolved and she was able to move without difficulty. Vital signs: BP 100/70, HR 150 bpm, RR 32 breaths/min, Oxygen saturation is 93% on room air.   Lungs sounds present with bibasilar crackles and she has S1 and S2 heart sounds with an irregular heartbeat. Her 12-lead ECG shows atrial fibrillation with an uncontrolled ventricular response, heart rate 150.   Medications orders include:Discontinue enalapril (Vasotec)IV diltiazem (Cardizem) bolus and then IV dripDigoxin 0.25 mg PO daily Enoxaparin (Lovenox) 1mg/kg subcutaneous BID Warfarin (Coumadin) 5 mg PO daily Clinical Decision-Making sWhat priority nursing interventions do you anticipate when she is admitted? List 4 in order of priority.  17.   A. What is the immediate goal of antidysrhythmic drug therapy for R. S.?B. Explain the rationale for the enoxaparin and warfarin prescribed for R. S. What nursing interventions do you anticipate with the prescribed medications? 18. Explain the pathophysiology of her symptoms: palpitations, dizziness, shortness of breath, and mild chest pressure.    R. S. is admitted to the unit.  Describe the characteristics of her ECG waveform using 5 step method.  Upon discharge home, what education will she require related to her discharge medications of digoxin and coumadin?     R. S. did not understand her discharge instructions and 3 weeks later presented to the ED with R. S. did R. S. presents to the ED 3 weeks later with neurologically deficits: right flaccid arm, right facial drooping.  She was brought to the ED by a neighbor who found her in the front yard. 21. You anticipate that she will be diagnosed with a stroke. a. Based on her previous history (see above case study), what were her risk factors that lead to the stroke?   b. Is she a candidate for thrombolytic therapy? c. Identify 3 priority criteria to meet the eligibility criteria for R. S. to receive tPA? (hint see Chart 67-3)Differentiate between the types of ischemic strokes, embolic and thrombotic.   What are the risk factors associated with each type?  Can they be prevented?  What is the treatment?  Ischemic strokeThrombotic strokePathophysiology(cause)  Signs and symptoms  Risk factors  Prevention  Treatment   What type of stroke was R. S. diagnosed with due to her risk factors? Why is she experiencing neurologically deficits only on the right side? Describe hemorrhagic stroke completing the chart.  What are the signs and symptoms? What are the risk factors associated with hemorrhagic stroke?   Prevention? Treatment?  Hemorrhagic strokePathophysiology (cause) Signs and symptoms Risk factors Prevention Treatment   Describe the Glasgow Coma Scale and a focused neuro assessment.   Health Science Science Nursing NURSING NUR 114 Share EmailCopy link Comments (0)

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.