Mrs. R is a 65-year-old client who had suffered a myocardial infarction a year ago.She is scheduled to come to the outpatient cardiac rehabilitation center where you work for follow-up after suffering from fatigue and shortness of breath for the past couple months which is increasing in severity.She complains of a "fluttering" feeling in her chest as well as an occasional productive cough.Mrs. R. states that over the last couple months she has been having to get up to use the bathroom several times at night - this is new for her.She has gained 5 pounds in the past week.

1)Mrs. R's healthcare provider (HCP) believes she has developed heart failure after her MI last year. What is heart failure and why might a myocardial infarction cause this?

2)What tests would most likely be used to confirm the presence of HF?

3)During your physical assessment of Mrs. R you focus on the respiratory assessment. What signs or symptoms of heart failure might you find when assessing Mrs. R's respiratory status?

Part B:After all the diagnostic tests are completed, Mrs. R is diagnosed with heart failure.Her HCP has prescribed furosemide (Lasix) for her to take every day. The HCP also wants her to start her program with cardiac rehabilitation where she can exercise on a regular basis and continue to be monitored by healthcare professionals such as yourself.

4)How does furosemide (Lasix) help with heart failure symptoms?

5)What are patient education priorities regarding taking diuretic medications such as furosemide?

6)In addition to the exercise, what other types of lifestyle changes should Mrs. R implement to control her symptoms

Part C: Mrs. R has started taking the furosemide and continues to come to cardiac rehab.She has lost the weight she had recently gained and is able to walk a little further than she used to when using the treadmill.She also states she is not getting up as often at night to use the bathroom.However, she is still complaining of the fluttering feeling in her chest and her blood pressure has been elevated.Her last BP reading was 140/88.Her HCP orders captopril 50mg PO TID and wants her to come back to the clinic for a re-evaluation in 2 weeks.

7. What type of medication is Captopril?

8. Why might this medication be given for a patient who has heart failure?

9. What information is important for the nurse to given to this patient when they are taking this medication?

10. How would Mrs. R know if her medications are controlling her heart failure?