Respond to the following post in two different replies. Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource that is different than the one you used for the initial post. Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation. APA format, Cites three or more references, using at least one new scholarly resource . 1st POST ( PLEASE RESPOND) The purpose of this discussion post is to review ML’s new diagnosis and potential treatment options. For ML, her new diagnosis of stage A heart failure does not mean she has any structural abnormality with her heart. The pathophysiology of this condition includes the fact that ML has preexisting conditions that increase her risk of developing heart failure in the future, if left untreated. The conditions that would cause ML to be diagnosed with stage A heart failure and potentially lead to further heart failure staging if left untreated include hypertension, coronary artery disease, or diabetes mellitus (Woo & Robinson, 2020). The main goal with stage A heart failure includes managing comorbidities to prevent heart failure development (Tanaka, 2018). The main goal of this belongs with consistent blood pressure management. For ML, the main goal in her treatment therapy will include good blood pressure control. According to Woo and Robinson (2020), ACE inhibitors are typically the first line of treatment, as research has displayed these medications to improve patient symptoms, decrease mortality, and increase life expectancy. As these medications are typically shown to reduce the mechanisms that lead to heart failure, this would be the recommended drug of choice for ML to prevent her progression of stage A heart failure. Due to the fact that digoxin has not been shown to present a mortality benefit, although it may improve quality of life in patients with congestive heart failure, this would not be the first choice of treatment for ML. If, however, this was chosen for ML to treat her stage A heart failure and she was experiencing halos, this would be a sign of digoxin toxicity (Cummings & Swoboda, 2020). If ML has any renal impairment, she would be at increased risk for developing digoxin toxicity. To evaluate for toxicity, a random digoxin level should be checked as well as confirming when the last dose was taken by ML. Once an EKG and basic lab values are obtained, Digibind is an antidote that will assist with eliminating the toxicity, especially in life-threatening instances (Cummings & Swoboda, 2020). If digoxin is chosen to be the treatment for ML, special consideration should be taken if ML is an older adult or has renal impairment (Woo & Robinson, 2020). Along with this, digoxin was associated with increased risk of death and worsening heart failure in women compared to men (Jackson, 2015). Due to these risks and potential complications, ACE inhibitors will remain to be the drug class of choice for ML. Due to the risk of hypotension, a low-dose ACE inhibitor should be initiated, with a gradual increase in dose occurring to improve exercise tolerance and to relieve any potential symptoms. While doing this, BP and renal function should be closely monitored. Along with this, due to the risk of increased potassium levels, serum electrolyte levels should be regularly monitored. Lastly, one potential side effect that is typically the primary cause for discontinuation amongst patients is the risk of a persistent dry cough (Woo & Robinson, 2020). Ideally, with proper treatment and close monitoring, ML’s stage A heart failure will not progress to additional stages. 2ND POST (PLEASE RESPOND) The purpose of this post is to discuss heart failure and the implications of using digoxin as a treatment option Pathophysiology of Stage A heart failure. According to Cleveland Clinic (2021), Stage A heart failure is where though one is not having heart failure, the risks are high due to family history or other health medical conditions such as diabetes, hypertension, alcohol use, cardiomyopathy, drug use, coronary artery diseases, metabolic syndrome, rheumatic fever, and others. This means that the patient has a high risk for heart failure, but they do not have symptoms or structural heart diseases Digoxin is the rational drug choice for treatment of this individual because it does not affect contractility. In addition to that is for maintenance as it does not cure heart failure. As stage A is just a risk and not fully heart failure, there is no need to alter the function of the heart. According to American Heart Association (2021) women need to get low dose digoxin, the advantage to this is, the low doses are beneficial hemodynamic, neurohormonal, and in clinical effect (Gheorghiade, 2017). The patient’s concern about halos should digoxin be prescribed is a legit concern. When a patient has digoxin toxicity, there are a myriad of side effects and some are visual which include the haloes. If that happens, the patient should notify the provider immediately and get blood work to assess the serum level, tapering may be the first option that complete discontinuance of the medication (Pincus, 2016). There are gender considerations related to medication treatment as women have increased mortality rates than men. One of the reasons is due to the hormone interaction and digoxin. Progestin increases the serum digoxin levels as it causes the reduction of digoxin excretion through the kidneys (Rathore, 2018). Digoxin monitoring is very important as it has a very narrow safety range and to ensure therapeutic levels are met. Blood work is done as recommended especially after a few hours from last dose taken. The results will aid in adjusting medications or maintaining the regimen. In addition to that blood work is essential as it will monitor magnesium and potassium levels that can alter digoxin levels. Lastly if there is digoxin toxicity, there is an antidote that can be given to prevent adverse issues (Lab tests, 2020) RESPOND TO EACH POST WITH 300-350 WORDS.
Why Choose Us
Top Quality and Well-Researched Papers
We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.
Professional and Experienced Academic Writers
We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.
Free Unlimited Revisions
If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.
Customer Support 24/7
Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.
No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.
No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.
Admission and Business Papers
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.
Editing and Proofreading
Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.