Question

Patient is 72 year old. patient has a problem are CHF, COPD, Sob, and history with PTSD, MDD, Anxiety, HTN, CA kidney

Base on patient problem, Please help me question below

1. Primary Medical Diagnosis:

2. Patient specific pathophysiology and nursing considerations:

3. Contributing Secondary Diagnosis/diagnoses:

4. Patient specific pathophysiology and nursing considerations:

Citations are expected. Provide citations for any resourced data.

Answer 1

1.The Primary Medical Diagnosis are

• CHF (Congestive Heart Failure )
• COPD (Chronic Obstructive Pulmonary Disease)

2.The causative factors (MI,poor contractility,CAD,Over load) triggers the alteration in qrdiac functions >>systolic dysfunction >> Decreased ejaculation fraction >> but diastolic fraction is preserbed >>simultaneous action of the compensatory mechanisms >> helps heart to maintain its function>>Over time This mechanism is reverse psychology due to work liad>>it increases te systemic vascular resistance >>the work load on left ventricle is increased >>reduces cardiac output >>signs and symptoms

This is correlated with COPD.At rest the heart doesn't want to pump harder but during activity it has pump hardly to supply blood adequately to the lungs>>but alterations in contraction >> leads to back up of blood in lungs>> an increase in arterial pressure is activated to remove this>>leads to pulmonary hypertension >>congestion in the lungs >>accumulation in the left side heart >>breathlessness and other symptoms

The nursing considerations are

• Administration oxygen to meet the demand
• Provide propped up position to increase lung capacity
• Administer medication to regain the basic function of heart and lungs
• Nebulize the patient to ease breathing difficulties
• Maintain a strict intake and output chart to rule out and prevent complications
• Teach simple breathing exercises like purpose lip breathing to enhance breathing

3.The secondary medical diagnosis are

• PTSD
• MDD
• ANXIETY
• HTN
• CA Kidney

4.The patients meducal conditions (CHF,COPD,.CA Kidney) forms the factors for depression >>overtime the patient experiences anxiety towards the prognosis >>increased blood pressure,alteration in the metabolism >>changes in though process,low self esteem ,isolated, depressed,fear etc.,

The nursing considerations are

• Provide psychological support
• Encourage patient to verbalize their feelings
• Diversional therapy to comfort the patient
• Support therapy, psychotherapy
• Administer medication to relieve anxiety
• Encourage patient to do mild activities which can divert them from sad or feeling low.