Question

C. Anne is a retired registered nurse (RN) who has been given the diagnosis of Stage B heart failure. She "knows" from her RN education that she will "definitely" be placed on digoxin as a therapy. SHe remembers something about "halos" as something to be attuned to. As a mental health nurse, she admits to not keeping up with medical types of medications and therapies. 1. Describe the classification and treatment guidelines for patients diagnosed with Stage B HF 2. Is Anne correct in her assumption that she will be placed on digoxin? Explain. 3. If she is placed on this medication, does her memory of "halos" apply?

Answer 1

1.AHA stages of heart failure

Stage A: Patients at high risk of developing left ventricular dysfunction because of the presence of conditions that are strongly associated with the development of HF.

Stage By: Patients who developed structural heart disease that is strongly associated with the development of HF but who have never shown signs of HF.

Stage C

Patients who have current or prior symptoms of HF associated with underlying structural heart disease.

Stage D: Patients with advanced structural heart disease and marked symptoms of HF at rest despite maximal medical therapy and who require specislized interventions.

2.Digitalis preparation are particularly useful in the treatment of HF accompanied by attial flutter and or fibrillation with a rapid ventricular rate. They increase the force of cardiac contraction. They also decrease the conduction speed within the myocardium and slow the HR. These actions allow for more complete emptying of the ventricles, thus diminishing the volume remaining in the ventricles during diastole. CO increases because of an increased stroke volume from improved contractility. Because digitalis requires a loading dose and time to accomplish hemodynamic improvement, it is not recommended for the initial treatment of Heart failure.

3.An individual receiving a digitalis preparation is prone to develop digitalis toxicity,. Early symptoms of toxicity include anorexia, nausea and vomiting. Visual disturbances, such as yellow vision can occur with digitalis toxicity. Dysrhythmias are a common but often late indication of digitalis toxicity. Although almost any dysrhythmia can occur, the types most frequently found are premature ventricular beats, atrial fibrillation and first degree heart block.