Mrs. Jones recovered from her recent hospitalization for treatment of AKI secondary to pyelonephritis. During her hospitalization, it was discovered that Mrs. Jones has developed early signs of Congestive Heart Failure (CHF) evident by her increasing fatigue and difficulty controlling her high blood pressure over the years. During her hospitalization, an echocardiogram (ECG) was performed which showed that she currently has a 40% ejection fraction as well as mild left ventricular hypertrophy. Upon discharge, her antihypertensive regimen was changed to the following: Discontinue
Lisinopril 10mg PO daily
Start
Metoprolol (Lopressor) 25mg PO BID
Furosemide (Lasix) 20mg PO daily

Continue the following
Ibuprofen 800mg PO q 6 hrs for moderate pain (4-6 verbal scale)
Hydrocodone/acetaminophen 5/325mg PO q 4 hrs for severe pain (7-10)
Aspirin 81mg PO q day
Vitamin D 800IU q HS
Calcium 600mg q HS
Hydroxychloroquine 400mg q day

Required:
a. Which of the listed medications are prescribed to address Mrs. Jones new diagnosis of CHF?
b. Briefly describe how each of these medications help with CHF (ex: inotrope, reduce peripheral vascular resistance, etc.) BE SPECIFIC and use your drug book as a guide.
c. Are there safety concerns the patient needs to be aware of with these medications (Hint: synergistic effects? Self-assessments prior to administration?) If so, what are they?
d. What precautions/assessments need to be taken as the nurse when administering these medications to Mrs. Jones?
e. What important educational points does the nurse need to give Mrs. Jones regarding the newly prescribed medications?