Question

A 74-year-old woman was admitted to the hospital with heart failure. She had been growing progressively weaker and also had ankle edema, dyspnea on exertion, and three pillow orthopnea. On admission, she is severely dyspneic and can answer questions only with one-word phrases. She is diaphoretic, with a respiratory rate of 28/min, heart rate of 132 beats/min, and BP 98/70. Her oral temperature is 36.7 C and her SaO2 89%. She is extremely anxious. The nurse applies immediately oxygen at 2 L via NC as per unit protocol. The physician orders: Insert PIV then start Dobutamine 3 mcg/kg/hr Furosemide 40 mg IV stat, Digoxin 0.5 mg orally stat, then 0.125 mg every 6 h for three does with ECG before doses 3 and 4; morphine 2 mg IV stat, and then 2 mg IV every 1-2 h prn, increase O2 to 4 L/min. Schedule patient for an echocardiogram, no added salt diet, weigh patient daily and record: Strict I&O. Answer the questions below and give rationales for your answer. 2. Considering the process of heart failure, rationalize each of the patient symptoms.

Answer 1

Answer: The symptoms of this Patient is directly related to the severe heart failure. The increase heart rate i.e. 132 beats per minute shows that it is beyond normal heart rate that is 72 beats per minute. Decreased blood pressure shows that the heart is not getting sufficient amount of oxygen as well as blood pressure lowered. Patient is unable to breathe properly.