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This preview shows page 143 - 145 out of 181 pages. <p>A patient who has just undergone heart transplant surgery reports feeling lightheaded whenchanging positions. What action should the nurse take <b>first</b>?</p>Order a stat 12-lead ECGAdminister isoproterenolContact the health care providerCheck orthostatic blood pressuresRationaleIt is important to assess orthostatic blood pressures for abnormalities, which are a commonfinding in patients after heart transplant. A 12-lead ECG is not the first nursing intervention.Isoproterenol is not indicated. The nurse should not contact the health care provider without firstchecking the patient's blood pressure.p. 716A patient who has undergone heart transplant surgery has developed shortness of breath. Vitalsigns are blood pressure 85/48, pulse 52, and oxygen saturation 92% on 2 L O2via nasalcannula. What action should the nurse takefirst?<p>A patient who has undergone heart transplant surgery has developed shortness of breath.Vital signs are blood pressure 85/48, pulse 52, and oxygen saturation 92% on 2 L O <sub>2</sub>via nasal cannula. What action should the nurse take <b>first</b>?</p>Contact the health care providerAdminister immunosuppressantsIncrease the oxygen concentrationPlace the patient in supine positionRationaleIt is important to contact the health care provider because blood pressure 85/48, pulse 52, andoxygen saturation 92% on 2 L O2via nasal cannula are signs oftransplant rejection.Administering immunosuppressants is not going to stop the rejection. Increasing oxygenconcentration may be done after the health care provider is contacted but is not priority. Supineposition is not indicated for this patient. p. 716What type of medication is prescribed for a patient who has undergone heart transplant surgery?<p>What type of medication is prescribed for a patient who has undergone heart transplantsurgery?</p>AtropineAdenosineCorticosteroidsImmunosuppressantsRationaleImmunosuppressants are used to reduce the chance of rejection after a patient has hearttransplant surgery. Atropine, adenosine, and corticosteroids are not indicated.p. 716What types of cardiomyopathy can be treated with heart transplantation?Select all thatapply.<p>What types of cardiomyopathy can be treated with heart transplantation? <b>Select all thatapply.</b> </p>Dilated cardiomyopathyRestrictive cardiomyopathyObstructed hypertrophic cardiomyopathyNonobstructed hypertrophic cardiomyopathyArrhythmogenic right ventricular cardiomyopathyRationaleDilated cardiomyopathy and sometimes restrictive cardiomyopathy are treated with hearttransplantation. Obstructed and nonobstructed hypertrophic cardiomyopathies are not treatedwith heart transplantation. Arrhythmogenic right ventricular cardiomyopathy is not treated withheart transplantation. Upload your study docs or become a Course Hero member to access this document Upload your study docs or become a Course Hero member to access this document End of preview. Want to read all 181 pages? Upload your study docs or become a Course Hero member to access this document
Case Reports doi: 10.1345/aph.1D440. Epub 2004 Feb 24. Affiliations
Case Reports Terbutaline for chronotropic support in heart transplantationJames C Coons et al. Ann Pharmacother. 2004 Apr. AbstractObjective: To report the use of oral terbutaline for chronotropic support in a patient who had undergone heart transplantation. Case summary: A 54-year-old white man received a heart transplant secondary to ischemic dilated cardiomyopathy. His clinical course was uncomplicated until postoperative day 10, when he became hemodynamically compromised despite inotropic therapy (BP 88/53 mm Hg, mean HR 80 beats/min) secondary to stage IIIa rejection. Although a continuous intravenous infusion of dobutamine was maintained, therapy with oral terbutaline 2.5 mg every 6 hours was initiated. Because the patient remained bradycardic on postoperative day 11 (HR 64 beats/min; mean 75), terbutaline was titrated to a dosage of 5 mg every 8 hours. Subsequently, an improvement in the hemodynamic profile (BP 140/78 mm Hg, mean HR 91 beats/min) was noted. Treatment with terbutaline was continued for 13 days and was well tolerated. Discussion: As of February 11, 2004, this is the first case, to our knowledge, to describe the use of oral terbutaline therapy for chronotropic support in the setting of acute rejection after heart transplantation. Terbutaline is a beta2-adrenergic agonist that may mediate its effects via direct beta2-receptor stimulation, baroreceptor-mediated increases in sympathetic tone, or via presynaptic beta2-stimulation. Although isoproterenol has been the mainstay of therapy for chronotropic support in this setting, its availability has been an issue in recent years. Terbutaline, therefore, may represent a useful alternative for chronotropic support in the setting of heart transplantation. Conclusions: Terbutaline therapy did not appear to be associated with any significant adverse effects and warrants further application and study in this setting. Similar articles
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What type of medication is prescribed for a patient who has undergone heart transplant surgery?
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