Case Discussion: Echocardiogram

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Case Discussion: Echocardiogram

Case Discussion: Echocardiogram

Case Discussion: Echocardiogram

Question 372 pts A patient has heart failure. A recent echocardiogram reveals decreased compliance of the left ventricle and poor ventricular filling. The patient takes low-dose furosemide and an ACE inhibitor. The primary care NP sees the patient for a routine physical examination and notes a heart rate of 92 beats per minute and a blood pressure of 100/60 mm Hg. The NP should: order serum electrolytes. obtain renal function tests. consider prescribing a ?-blocker. call the patient’s cardiologist to discuss adding digoxin to the patient’s regimen. Question 382 pts A patient takes an antispasmodic and an occasional antidiarrheal medication to treat IBS. The patient comes to the clinic and reports having dry mouth, difficulty urinating, and more frequent constipation. The primary care NP notes a heart rate of 92 beats per minute. The NP should: prescribe a TCA. discontinue the antidiarrheal medication. encourage the patient to increase water intake. lower the dose of the antispasmodic medication. Question 392 pts A patient who has had four to five liquid stools per day for 4 days is seen by the primary care NP. The patient asks about medications to stop the diarrhea. The NP tells the patient that antidiarrheal medications are: not curative and may prolong the illness. useful in cases of acute infection with elevated temperature. most beneficial when symptoms persist longer than 2 weeks. useful when other symptoms, such as hematochezia, develop. Question 402 pts A patient who has angina is taking nitroglycerin and long-acting nifedipine. The primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits. The patient reports lightheadedness associated with standing up. The NP should consult with the patient’s cardiologist about changing the medication to: amlodipine (Norvasc). isradipine (DynaCirc). verapamil HCl (Calan). short-acting nifedipine (Procardia). Question 412 pts A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not working as well as it did initially. The primary care NP should: recommend a reduced potassium intake. increase the dose of digoxin to 0.5 mg daily. hold the next dose of digoxin and obtain a serum digoxin level. contact the patient’s pharmacy to ask if generic digoxin was dispensed.

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