Consider Mrs Banks history and describe;

a. Two signs that the nurse may have noted when performing a cardiopulmonary

assessment on Mrs Banks.

b. Two symptoms that Mrs Banks may complain of (aside from dyspnoea).

2. Explain what heart failure is and identify the two main types.

3. Describe the pathophysiology of chronic heart failure.

4. Biventricular pacemakers (BIV) can be used in some patients with heart failure.

a. List the indications for insertion of an biventricular pacemeaker in heart failure

b. Discuss five (5) nursing actions related to the pre-operative preparation of a patient for

insertion of a BIV

5. Consider the current medications that Mrs Banks is on, list the rationale (why are they given) for

these medications in her case

a. Captopril

b. Bisoprolol

c. Spironolactone

6. Consider the above rhythm strip

a. What is the rate of this rhythm?

b. Explain how you determined this rate

c. Identify the rhythm

d. What nursing actions if any are needed?

7. Following medical review on the ward, Mrs Banks is commenced on Frusemide 20 mg BD and

Slow K, 2 tabs, BD.

a. Describe the rationale for commencing these medications for Mrs Banks

b. Describe three parameters that you would use to assess/monitor the effectiveness of

these medications for Mrs Banks

c. Describe the education/patient teaching that you need to communicate to Mrs Banks to

ensure she is adequately informed about her heart failure AND the medications she is

now on

The following morning, you are once again allocated the care of Mrs Banks. You note the following

observations and laboratory results.

0600 Observations Laboratory Results

Weight: 90.8kg

BP: 108/58mmHg

HR: 109 beats per minute (irregular)

RR: 15bpm

Temp: 36.6

SpO2: 95% on 1L via NP

Pain score: 0/10

Sodium: 142

Potassium: 3.2

Urea: 6.2

Creatinine: 89

Chloride: 91

Bicarbonate: 19

Magnesium: 0.63

8. Consider the above 0600 hr vital signs.

a. List the vital signs that are a concern to you (if any) and why.?

b. Outline what action you should take next?


9. Consider the above laboratory results.

a. List the values that are a concern to you and why?

b. Outline what (if any) action you should take next.

Lead II


10. Consider the above observations and rhythm strip.

a. What rhythm is Mrs Banks in now (describe the rate and rhythm) and how have you arrived at

this decision?

b. Outline your immediate nursing priorities and actions based on this rhythm and the patients


c. Discuss the impact this rhythms has on a the haemodynamic status of a patient and why.

d. Consider the patients vital signs and laboratory results above, outline other replacement

therapies that should be given in this case.

11. Choose any research article that you feel is relevant to the nursing care of a patient with heart failure.

a. Upload the FULL TEXT article in the link provided when you submit your written work

b. Critically evaluate this article and present a summary of the paper in 150 – 300 words

c. Identify HOW the chosen article relates to the nursing care in this case study

12. Reflect back on the case study and give examples that support 2 of the NMBA standards.

13. Describe 1 legal responsibility of the nurse in relation to this case.

14. Describe 1 ethical responsibility of the nurse in relation to this case.