Your patient, 58-year-old K.Z., has a significant cardiac history….

Question Answered step-by-step Your patient, 58-year-old K.Z., has a significant cardiac history…. Your patient, 58-year-old K.Z., has a significant cardiac history. He was admitted to your telemetry unit this am for a same-day cardiac catheterization. Patient history includes long-standing coronary artery disease (CAD) with occasional episodes of heart failure (HF). One year ago, he had an anterior wall myocardial infarction (MI). In addition, he has chronic anemia, hypertension, chronic renal insufficiency, and a recently diagnosed 4-cm suprarenal abdominal aortic aneurysm. Because of his severe CAD, he had to retire from his job as a railroad engineer about 6 months ago. His wife died a year ago (about the same time that he had his MI) and he does not have any children. He is a current cigarette smoker with a 50-pack-year smoking history. Preop baseline vital signs (VS) were 158/94, 88, 20, and 97.2° F (36.2° C).Several hours later, K.Z. returns from his catheterization. The catheterization report shows 90% occlusion of the proximal left anterior descending (LAD) coronary artery, 90% occlusion of the distal LAD, 70% to 80% occlusion of the distal right coronary artery (RCA), an old apical infarct, and an ejection fraction (EF) of 37%.About an hour after the procedure was finished, you perform a brief physical assessment and note a grade III/VI systolic ejection murmur at the cardiac apex, crackles bilaterally in the lung bases, and trace pitting edema of his feet and ankles. Except for the soft systolic murmur, these findings were not present before the catheterization. VS 160/96, 94, 24, 98.8. After assessing K.Z., the healthcare provider admits him with a diagnosis of CAD and HF for CABG surgery. Significant laboratory results at this time are Hct 25.3%, Hgb 8.8 g/dL, BUN 33 mg/dL, and creatinine 3.1 mg/dL. K.Z. is given furosemide (Lasix) and 2 units of packed RBCs (PRBCs). After the CABG you will likely be administering nitroprusside and dobutamine to K.Z..Explain the significance of having an ejection fraction of 37%.List at least three nursing interventions and include a rationale for each. Don’t list monitor VS, labs, and administer meds as prescribed it is assumed as the nurse you will do these basic interventions. Be specific.Why will K.Z. be receiving nitroprusside and dobutamine?What is your responsibility as a nurse when caring for patients receiving these meds?List at least three general areas related to his CABG surgery in which he should receive instruction before he goes home. Health Science Science Nursing 265 NUR 265 Share QuestionEmailCopy link Comments (0)

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