1. Mr. Hampton asks you to explain to him what CHF means.

How would
you describe the condition in terms the patient can understand?
Congestive Heart Failure is a condition where the heart is unable
to pump sufficient blood to meet the needs of the tissue for
oxygen and nutrients.

2. The nurse recalls that both right and left sided heart failure are
potential diagnoses for patients. Compare the two in table.
Left Sided Heart Failure
The inability of the left side of
the heart to pump into the
systemic circulation. Back-up
behind the left ventricle
causes accumulation of fluid in
the lungs.

Right Sided Heart Failure

-The inability of the right side
of the heart to adequately
pump venous blood into the
pulmonary circulation. This
causes a back-up of fluid in
the body, resulting in swelling
and edema.

3. What is the best way to evaluate a patients fluid volume status?

What is your rationale for this answer?
Monitoring Intake and output
Rationale
recognize significant lossesto monitor amount of fluid a
client puts out through that the health care team can
plan for the client
to help evaluate clients fluid and electrolyte imbalance
4. Mr. Hampton had the following intake and output amounts during your
shift:
Breakfast 6 oz. glass of orange juice, one carton of milk (240mL), and
one cup of coffe (280mL)
Lunch 6oz. of cranberry juice and one cartopn of milk (240mL)
You note that he drank an estimated 400 mL from his bedside water
pitcher.
Output voided 400mL at 8:45, voided 250 mL at 10:30, voided 300
mL at 1400
Using the information above to calculate Mr. Hamptons intake and
output for your shift.
Input

Output

Glass of orange juice

Breakf
177mL
ast
One carton of milk
240 mL
One cup coffee 280
mL
Cranberry juice 177
Lunch
mL
One carton of milk
240mL
Water pitcher 400
mL
Total: 1514 mL

8:45 am - 400 mL
10:30 am - 250 mL
12:30 am - 400 mL
2:00 pm - 300 mL

Total: 1350 mL

5. As you auscultate Mr. Hamptons lung sounds, you hear crackles.

Describe what crackles indicate and what other important information
to consider as a result of this finding.
Lung crackles indicates that there is a vasoconstriction in the
pulmonary airway. In the condition of Mr. Hampton lung cra ckles
indicate pulmonary edema.

6. What is primary action of Synthroid? Explain a rationale for why it is

scheduled to be administered 6:30.
Mr. Hampton questions why he is in this simulation are indicated to
reduce blood pressure. Answer the following questions related to Mr.
Hamptons hypertension.
Action used to treat patient who do not produce enough thyroid
hormone ion their own; helps to reduce the symptoms of low
thyroid hormone (weight gain, sensitivity to cold, lack of energy
and dry skin)

7. Which of the medications in this simulation are indicated to reduce

blood pressure? Why might multiple medications be ordered?
Coreg and Zestril. We need 2 or more combination of medicine to
reduce level of blood pressure to a target level and to
compensate the work of the other medicine.

8. Is Mr. Hamptons blood pressure effectively controlled? What is your

rationale for this answer?

 Strict compliance of medication: the nurse administered the

medication using 12 Rights of Patients on giving medications

9. In report, you learned that Mr. Hamptons BNP is 2300, his potassium is
4.2, and his WBC is 16.2. why was this information important for the
night nurse to report?
We need to report his BNp and WBC because it is greater than
the normal value. An increased BNP means that heart failure
worsens while increased WBC indicates inflammation of the heart
or other part that may affect by CHF.

Case Study
in

CAN II
Submitted by:

Espiritu, Veda Joy M.

Mampurok, Atedja U.
Pablo, Laurenze A.
Pananggulon, Shailame S.
Ramojal, Wenna May S.

Submitted to:

Mark Ryan Y. Contaoi, RN, MAN

December 8, 2014