Case Studies

Cardiac Rehab Case Study

82-year-old male admitted to Willow Springs after a 16-day hospitalization at Hackensack Meridian Hospital for Acute on Chronic Systolic CHF, Acute Renal Failure with Hyperkalemia, CKD Stage 3 and history of Type 2 Diabetes.
Patient admitted requiring IV Inotropic Therapy with Milrinone.

Nursing Interventions

Monitor Fluid Balance: Diuretic Therapy and Daily Weight Monitoring
Medication Management: Milrinone 0.375mcg/min continuous IV infusion for total dose 11.6ml per shift, Entresto 24-26 tablet QHS, Torsemide 20mg BID, Atorvastatin and Metoprolol
Aspiration Precautions: Patient received on nectar thick and chopped diet
Maintain Adequate Oxygenation: Oxygen therapy at 3 lpm on admission
Reviewed weekly in Cardiopulmonary round table team discussion and seen weekly by our In-center Cardiologist, Dr. Cohen

Therapy

Upon admission, Patient required maximum assistance with all self-care tasks and was able to ambulate 5 feet with maximum assistance and had marked Dyspnea on Exertion. He was receiving occupational and physical therapy 5 times a week for several weeks. Upon discharge, he was independent with all self-care tasks, able to ambulate 200 feet with a rolling walker and ascend/descend 4 stairs independently.

Patient’s weights remained stable throughout his stay, Diet was upgraded to Chopped and thin liquids. His Oxygen was weaned to 2 lpm continuous upon and set up for home upon discharge.

Patient returned home with his 24-home health aide after a 62-day LOS in STR. He is new to oxygen therapy and Milrinone Infusion. He lives in Greenbriar and receives visits from Mended Hearts Organization Volunteer. His Community PCP Dr. Martin Riss and will continue to follow with Dr. Cohen for Cardiology in the community.


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