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CHF

New treatments

Foley Catheter

A urinary tract catheter with a balloon attachment at one end. After the catheter is inserted, the balloon is inflated. Thus the catheter is prevented from leaving the bladder until the balloon is emptied (Vallerand et. al, 2015)

Non-rebreather

An oxygen administration device with one-way valves for inspiration and expiration and a reservoir bag, used to attain high concentrations of oxygen (Vallerand et. al, 2015)

Generic: Amiodarone Trade: Nexterone, antiarrhythmic

For “Life-threatening ventricular arrhythmias unresponsive to less toxic agents” (Vallerand et al., 2015).

Assessment: Monitor ECG, heart rate and rhythm, assess pacing and defibrillation threshold, assess for signs of pulmonary toxicity (rales/crackles, wheezes, hypoxia, decreased breath sounds), monitor BP, neurotoxicity, thyroid dysfunction, liver dysfunction, and weight gain (Vallerand et al., 2015).

Generic: Spironalactone Trade: Aldactone Diuretic

For management of edema from HF (Vallerand et. al, 2015)

Assessment: Monitor I&O, assess BP before admin, assess for hyperkalemia s/s and labs, periodic ECGs, assess skin for rash, SJ-syndrome, or toxic epidermal necrolysis (Vallerand et al., 2015).

Generic: carvedilol Trade: Coreg Beta Blocker

Assessment: Monitor BP and pulse frequently, weight and assess for fluid overload (edema, rales/crackles, dyspnea, JVD), monitor BUN, creatinine, and electrolyte levels. Assess for orthostatic hypotension (Vallerand et al., 2015).

Antihypertensive, for HF

Generic: Lisinopril Trade: Prinivil ACE Inhibitor

Antihypertensive, for management of HF (Vallerand et. al, 2015)

Assessment: Monitor BP and pulse frequently, weight and assess for fluid overload (edema, rales/crackles, dyspnea, JVD), monitor BUN, creatinine, and electrolyte levels (Vallerand et al., 2015).

Original Medications

Ondanstetron (Zofran) Antiemetic

Prevention of nausea and vomiting associated with highly or moderately emetogenic chemotherapy (Vallerand et al., 2015).

Assessment: Assess for N/V, abdominal distention, and bowel sounds prior to admin. Assess for extrapyramidal effects, monitor ECG, and for s/s of serotonin syndrome (Vallerand et al., 2015).

Digoxin (Lanoxin) Inotropic

For "Heart failure. Atrial fibrillation and atrial flutter (slows ventricular rate). Paroxysmal atrial tachycardia". (Vallerand et al., 2015).

Assessment: Monitor apical pulse for full minute before admin, withhold if <60bmp, monitor BP in IV admin, monitor ECG throughout admin, observe IV site. Monitor I&O, auscultate lung sounds (Vallerand et al., 2015).

New Medication

Generic: Nesiritide Trade: Natrecor 2 mcg/kg bolus Vasodilators

Was Discontinued 11/2/16, @ 1430, TO,RB, per nurse Sara, per Doctor Smith

For Acutely decompensated HF in hospitalized patients who have dyspnea at rest or with minimal activity (Vallerand et al., 2015).

Assessment: Monitor BP, pulse, ECG, respiratory rate, cardiac index, central venous pressure, hypotension, I&O, assess for signs of HF, assess for s/s of allergic reaction (Vallerand et al., 2015).

Generic: warfarin Trade: Coumadin Anticoagulant

Assessment: Assess for s/s of bleeding, bruising, tarry stools, BP, guaiac-positive stools, urine, and fall of hematocrit, assess for thrombosis, monitor labs for PT, INR (Vallerand et al., 2015).

Prophylaxis treatment for atrial fibrillation

Generic: hydralazine/ isosorbide dinitrate Trade: BiDil Vasodilators

"Management of HF in black patients" (Vallerand et. al, 2015)

Monitor BP, monitor for hypotension, assess for s/s of peripheral neuritis (Vallerand et al., 2015).