Question

Information Gender Male Patient Name: Charles Jones DOB:04/20xx Age: 68 Weight: 82 kg (180 Ibs) Height: 183 cm (72 inches) Religion: Baptist Race: African American Major support: Wife Allergies & Sensitivities No known allergies Social history Mr. Jones lives with wife. Both retired 3 years ago. He worked as a school maintenance Jones has three adult children who are very supportive of their parents. Prior medical history: Mr-Jones has had for hypertension the-last 10 years, and was diagnosed with atrial fib heart failure 5 years ago.Не has hyperlipidemia. He had been smoking 1 pack aday for 20 years, but it-smoking 2 years ago. He is a social-drinker only. No known drug allergies, immunizations current with annual flu vaccine. Recent medical history: Mr. Jones presented to the emergency department two days ago with dyspnea, orthopnea, fatigue, a weight gain of 10 pounds, and ankle edema. His appetite is poor, he complains of slight nausea, no emesis. Patient has received Ⅳ Lasix twice daily and has duresed approximately 2 L (weight down 4 Ibs), Last lung auscultation revealed fine rales in the bases bilaterally, no cough, and 2+ edema in lower extremities. Time: 8.45 a.m Report: Charles Jones is a 68-year-old male with history of congestive heart failure (CHFP) who presented to the emergency department two days ago with shortness of breath, fatigue, and weight gain and ankle edema. An echo performed upon admission showed ejection t or of %. The chest x-ray revealed bilateral congestion to the lower lungs. Mr. Jones was transferred to the medical unit yesterday. Despite ⅣLasix, resulting in a weight loss of 4 lbs, he remains short of breath and requires oxygen 2 L on nasal cannula to maintain a saturation > 92%. He complains of lightheadedness when standing and has required assistance when out of bed. You are preparing his morning medications. Assessment: Follow-Up Questions 1) According to Mr. Jones' prior medical history, please list all of his possible risk factors modifiable & non-modifiable) that could contribute to cardiovascular disease? (10 Points) Please list the signs/symptoms that correlate with Mr. Jones' heart failure (10 Points) 2) 3) According to Mr. Jones's signs/symptoms which type of heart failure would you suspect he is experiencing? (10 Points) Explain the pathogenesis of the following symptoms Mr. Jones is experiencing (20 Points) a) 4) Shortness of breath b) Fatigue c) Weight gain d) Ankle edema

Answer 1

1. Non modifiable risk factors

Age ,race,gender

Modifiable-

Hypertension

Hyperlipidemia

Smoking

2. Symptoms and signs of cardiac failure

Shortness of breadth

Fatigue

Weight gain

Ankle edema

3.Left heart failure due to systemic hypertension

4. Pathogenesis

Dyspnea is due to lack of blood supply to the organs from reduced cardiac output this leads to increased metabolic demand for oxygen and hence increased respiratory effort is triggered to compensate for it and also due to accumulation of fluid in the lungs from pulmonary hypertension

Fatigue

This is due to lack of oxygen supply to the various parts of the body since there is reduced cardiac output

Weight gain is due to edema

Ankle edema is due to movement of fluid from the intravascular space to extravascular space due to increased pressure in the intravascular pressure from hypertension