H.J. arrives to ED with c/o “racing heart”. 79 year old female experiencing sob during past...
H.J. arrives to ED with c/o “racing heart”. 79 year old female experiencing sob during past 2-months and swelling in the ankles. She sleeps with several pillows to keep herself in a sitting up position. 5-years ago she had an anterior wall myocardial infarction and had two-vessel coronary artery bypass surgery. Family history for atherosclerosis, father died MI and mother a stroke. She smoked for 30-years but quit after having the CABG 4 1/2 years ago. She uses alcohol socially. She’s allergic to nuts, shellfish, strawberries and hydralazine. Her medical history includes osteoarthritis, hypercholesterolemia, and gout.
Current medications are; celecoxib, allopurinol, atorvastatin, daily aspirin and clopidogrel. She is admitted to cardiac observation unit in the hospital.
Will the prescribed home medications be therapeutic for H.J’s presenting problem? Explain
How do the medication actions relate to the medical history?
Physical Assessment
Vital Signs
B/P 135/80 (left arm sitting); AP 125 and irregular; peripheral pulses +1, RR 28, SaO2 91%, nonproductive cough, T 97.5F oral; reported weight 215lb, admission weight 102.7 Kilos; Height 5’8”; appropriately anxious
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What do you conclude about the patient’s blood pressure?
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Why is the patient tachycardic? Why is the patient tachypneic?
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Using the reported height and weight what is her BMI?
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Discuss your conclusions about patient’s admission weight, do you have concerns, why?
Homework Answers
Q. No. 1. Answer :
H. J's presenting problem is " Congestive heart failure ".
Because in congestive heart failure we will see the symptoms like
* short ness of breath when the person will lie down,
* swelling or edema in legs due to improper excretion of fluids.
* Rapid and irregular heart beat that is heart racing,
* persistent cough will be there.
* weakness and fatigue.
* can not able to do exercises.
These are all most all symptoms are having Mrs. H. J's.
So she is suffering from congestive heart failure.
Q. No. 3. Answer :
In sitting position left arm blood pressure is 135 / 80 mm of hg. Indicates normal.
If it comes more difference in between two arms it indicates any artery blocking in arms.
Q. No. 4. Answer :
The patient is having tachycardia because during in congestive heart failure the multiple different arrhythmias may occurs, due to that fluids overload may occurs,
Cardiac output may decreases so that the tachycardia may comes.
Tachypnea due to inadequate heart pumping of blood leads to decreased oxygen supply to the all organs, in order to compensate that oxygen levels the patient may take more and more breaths, so patient becomes tachypnic.
Q. No. 5. Answer :
Her BMI = weight in kgs/ height in meter square.
Admission Weight is 102.7 kilos.
Height is 1.47 meters
BMI = 102.7/ 1.47×1.47
= 102.7/2.16
= 47.54 kg per meter square.
It indicates extremely obese.
Because normal BMI is 18 to 24 kg per meter square.
Add Answer to:
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