J., a 58-year-old retired bus driver, has been in the hospital for 1 week for treatment...

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J., a 58-year-old retired bus driver, has been in the hospital for 1 week for treatment of heart failure. He had a myocardial infarction 1 year earlier and tells the nurse that he "hasn't felt well for weeks." He is currently receiving carvedilol, lisinopril, furosemide, and potassium supplements (all orally), but he has had little improvement. Today during morning rounds, the nurse notes that J. is having increased difficulty with breathing. and his heart rate is up to 120 beats/min. His weight has increased from 72 to 76 kg overnight, and his lower legs and ankles show edema rated as 3+. Crackles are heard over both lungs, and his pulse oximetry reading is 91% (down from 98% earlier). In addition, J. is very restless. Oxygen is started, a Foley catheter is inserted, and J. is transferred to the intensive care unit for treatment of severe heart failure. After examining J., Dr. H. revises J's medication orders as follows: The next morning, J's breathing is better, his lungs are clearer, and his peripheral edema is now evaluated as trace edema. However, he complains of feeling his heart "skip" more than usual. Is there a concern? What will the nurse need to do at this point? J., a 58-year-old retired bus driver, has been in the hospital for 1 week for treatment of heart failure. He had a myocardial infarction 1 year earlier and tells the nurse that he "hasn't felt well for weeks." He is currently receiving carvedilol, lisinopril, furosemide, and potassium supplements (all orally), but he has had little improvement. Today during morning rounds, the nurse notes that J. is having increased difficulty with breathing. and his heart rate is up to 120 beats/min. His weight has increased from 72 to 76 kg overnight, and his lower legs and ankles show edema rated as 3+. Crackles are heard over both lungs, and his pulse oximetry reading is 91% (down from 98% earlier). In addition, J. is very restless. Oxygen is started, a Foley catheter is inserted, and J. is transferred to the intensive care unit for treatment of severe heart failure. After examining J., Dr. H. revises J's medication orders as follows: The next morning, J's breathing is better, his lungs are clearer, and his peripheral edema is now evaluated as trace edema. However, he complains of feeling his heart "skip" more than usual. Is there a concern? What will the nurse need to do at this point?

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Ar rh ythm ias are abnormal heart rhythms that can be caused by a variety of factors Heart failure is one of the most common causes of arr h ythm ias ... View the full answer