Nurse case scenerio Health, Medicine, Nursing Essay

Sample of Nurse Case Scenario 
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Nurse Case Scenario
Case Scenario: Keola, who is 70 years old male with a history of heart failure; the patient admitted for assessment and management of medication associated with digoxin toxicity.
Question one: What are the nutritional implications, key assessment findings, and nursing interventions for a patient with hypokalemia?
A patient with hypokalemia has ordinarily low potassium levels; this means that the readings in hypokalemia are below normokalemia of 3.5–5.5 mmol/L and values that are below 2.5 mmol/L are considered life threatening (Formiga et al., 2019, (Mani, 2018). It must be noted that potassium is crucial for nerve and muscle functioning, especially cardiomyocytes. On assessment, low potassium is associated with arrhythmia and muscle weakness, fatigue, muscle cramping, and palpitations, among others. These symptoms are due to impaired function in nerve and muscle cells owing to low levels. Mild hypokalemia may not depict any symptoms until the potassium values are too low. The severe hypokalemia that is characterized by potassium value that is below 2.5 mmol/L leads to equality severe symptoms that include paralysis, muscle breakdown, and respiratory failure.
Hypokalemia can be managed via several approaches. Intravenous potassium can be infused in a patient with a history of congestive heart failure, or myocardial infarction should maintain a serum potassium concentration of at least 4 mEq per L (4 mmol per L) (Goyal et al.,2012). At the time of infusion, ECG should be monitored. Oral potassium can be takin if it is clinically suitable. A patient with hypokalemia must be assessed nutritionally. The nutritional implication would mean that a nurse would encourage the patient to take a potassium-rich diet, for example, tomatoes, bananas, spinach, oranges, and beans, among others.
Question Two: What are the signs and symptoms of digoxin toxicity, and how would the nurse assess for these symptoms?
Digoxin toxicity is a life threatening situation that needs urgent medical attention. When a patient has symptoms of heart arrhythmias, the clinician should also check the history of digoxin use. Patients who are on digoxin can report heart arrhythmias that include atrial or ventricular fibrillation, bradycardia, tachycardia, and premature ventricular contractions. Thus, the nurse is expected to check for atrial or ventricular fibrillation and premature cardiac contractions using an electrocardiogram (ECG) and also take and interpret readings on the heart rate. The nurse should assess whether the patient has nausea, diarrhea, abdominal pain loss of appetite, or vomiting.it is necessary to conduct neurological and ocular examination because digoxin toxicity leads to altered mental status, and the patient may perceive yellow color (Cummings & Swoboda, 2019).
Digoxin works by blocking the sodium/potassium ATPase pump, but the mechanism of AV conduction suppression remains unclear: it is maybe due to increased vagal tone. Intracellular calcium in the cardiomyocytes is elevated by digoxin, which leads to increased contractility (Ziff & Kotecha, 2016). Digoxin toxicity leads to hyperkalemia. The sodium and potassium ATPase pump ordinarily causes sodium to exit from the cells and potassium to enter cells. Thus, the sodium/potassium ATPase pump is blocked; the potassium can no longer enter the cell, leading to higher serum potassium levels.
In the case of hypokalemia, digoxin toxicity is aggravated because digoxin commonly binds to the ATPase pump on a similar site to that of potassium. Thus, in the case of low potassium levels, digoxin will have less competition; hence, it will bind more on the ATPase pump. The results of low potassium and more digoxin binding will lead to the increased entry of calcium into the cells because of the digoxin effect of opening calcium channels. This mechanism of digoxin causing imbalances in electrolytes is what explains the abnormal heart rhythms and associated symptoms. It must be noted that digoxin can cause both hyperkalemia and hypokalemia.
Question Three: How would the nurse provide for family-centered care?
Family-centered care is a collaborative partnership betwee...