Medication Categories: Concepts/Content:
Antidysrhythmics Assessment
ACE Inhibitors Drug-drug interactions
Beta Blockers Evaluation of desired outcomes
Statins Monitoring for adverse effects
Oral Anticoagulants Emergency treatment of dysrhythmias
Diuretics Client education
Electrolytes Psychosocial support
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
• Management of Care 17-23% X
• Safety and Infection Control 9-15% X
Health Promotion and Maintenance 6-12% X
Psychosocial Integrity 6-12% X
Physiological Integrity
• Basic Care and Comfort 6-12%
• Pharmacological and Parenteral Therapies 12-18% X
• Reduction of Risk Potential 9-15% X
• Physiological Adaptation 11-17% X
, I. Initial Presentation:
Marilyn Fitch is a 78-year-old Caucasian woman with a history of hypercholesteremia, hypertension, and heart
failure and has NKDA. She was brought in by her daughter after Marilyn complained of feeling dizzy several
times this morning and then almost passed out at home. Marilyn has a six-month history of paroxysmal atrial
fibrillation. Her heart rate has been regular and she has had no episodic dizziness since she had a synchronized
cardioversion one week prior to this visit. Her initial VS in triage were: T: 98.9 F/37.2 C (oral) P: 52 R: 16 BP:
94/52 and O2 sat: 98% room air.
Personal/Social History:
Marilyn is a widow and lives alone in her own home. She denies smoking and admits to drinking one glass of
wine with her dinner.
1. What data from the histories are RELEVANT and must be NOTICED as clinically significant
by the nurse? (NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential)
RELEVANT Data from Present Clinical Significance:
Problem:
• Hypercholesterolemia • All of these are risk factors (especially when
Hypertension combined) for heart attack and stroke
Heart failure • Concerning signs of heart rhythm changes
• Dizziness/ almost passing out • Vitals of low HR and Low BP, usually if one of
• 6-month paroxysmal A fib these two vitals changes, the other will increase to
• Synchronized cardioversion compensate.
• Pulse of 52, BP 94/52
RELEVANT Data from Social History: Clinical Significance:
• Widow and lives alone • Shows the pt doesn’t have much of a support
system, and there could be psychosocial aspects to
• Drinking wine with dinner include in
her care
• Drinking 1 glass of wine with dinner is usually ok, in a
healthy individual. Since she has heart problems,
cholesterol issues and hypertension, she should restrict
alcohol use.
As the nurse responsible for this patient, you promptly review the medical
history and current home medications in the medical record:
2. What is the RELATIONSHIP of the past medical history and current medications? Why is your
patient receiving these medications? (Which medication treats which condition? Draw lines to connect)
Medical History (PMH): Home Medications:
Hypercholesteremia Apixaban 2.5 mg po bid
Hypertension Captopril 100 mg po BID daily
Heart failure Amiodarone 100 mg po bid
Atrial fibrillation Hydrochlorothiazide 50 mg po daily
Atorvastatin 10 mg po daily
Carvedilol 6.25 mg po bid
Applying your knowledge of pharmacology, to provide safe
patient care, answer the following essential information:
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