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Drugs Treating Heart Failure

South Florida Community College Pharmacology Case Study

Case Study, Chapter 29, Drugs Treating Heart Failure

Jerry Stein, 65 years old, has been diagnosed with chronic heart failure (CHF). He is started on multidrug therapy and discharged. He returns to the outpatient clinic 10 days later complaining of blurry, yellowed vision, anorexia, nausea, and “just not feeling right.” Data obtained from the nursing assessment include the following:


• Mild, peripheral edema


• Heart sounds normal, no S3


• Lung sounds have a few scattered crackles but are otherwise clear.


• Vital signs: temperature, 97.8°F; pulse, 56; respirations, 12; blood pressure, 140/90


The patient’s current medication therapy includes digoxin, 0.25 mg PO qd; hydrochlorothiazide, 25 mg PO qd; and captopril, 25 mg PO tid. (Learning Objectives 2, 3, 4, 6, 7)


1. Why is Mr. Stein on these drugs?


2. Are there any contraindications or precautions that would eliminate the use of these drugs for Mr. Stein?


 3. Are there any aspects of digoxin’s core drug knowledge that are especially relevant to consider because they may interact with the core patient variables?


4. Which findings from the nursing assessment demonstrate the effectiveness or possible adverse effects from drug therapy?


5. Which findings from the nursing assessment demonstrate possible adverse effects from drug therapy?


6. What teaching is required for Mr. Stein regarding his drug therapy? Do you need any additional data to determine appropriate teaching?


a. Identify the teaching needs and readiness to learn for this client. b. Identify any cultural factors that influence the care for this client. 


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