Question

A 64 year-old man compliants of pain in is lower legs when his dog. Pain is releived with rest . His past medical history includes hypertension and hyperlipidemia. he smokes one pack of cigarettes per day . o physical examination , his vital signs are temperature 99.2,respiratory rate 20, heart rate 94, and blood pressure 148/86. His feet are pale and coolto touch. He has diminished pedal and posterior tibial pulses 1+/4 and decreased sensation. he has a quater size open area on the lateral side of his left ankle. Nomalodor or drainage observed. 1. What are subjective data in the scenario.? 2. what are the objective data in the scenario? 4. Provide two medications that would anticipate the ED physicians orderd for the client? 5. Identify the classification and side effects of the medication ? 6.What diagnostic and/or laboratory test would the nurse anticipate the ED physician order for this patient? 3. What is the most likelymedical diagnosis would the nurse expect the physician diagnose the client with?

Answer 1

1. Subjective data in this scenario are :-

- complain of pain

- pain is relieved by rest

- past history of hypertension and hyperlipidemia

- smokes one packet of cigarettes per day

- decreased sensation in the edema site

2. Objective data in this scenario are :-

- temperature of 99.2 degree Fahrenheit

- respiratory rate of 20 breaths per minute

- heart rate of 94 beats per minute

- blood pressure of 148/ 86 mmhg

- pedal edema in the posterior tibial area with grade of 1/4

- open area on the lateral side of left ankle , normal odour and drainage.

3. The most likely medical diagnosis the nurse expect the physician will diagnose is chronic renal failure .

4. Two medications that should be prescribed for the client are :-

- diuretics like lasix as the BP is high and there is pedal edema sign of kidney damage .

- dressing of the open area to avoid infection and providing prophylactic antibiotics .

- assess for hyperkalemia as a result of kidney damage and then provide calcium gluconate ,asthalin nebulization , 25%dextrose and k -bind sachet if hyperkalemia is there .

5. Lasix is a Loop Diuretics ,are the drugs given to flush out extra fluid volume from the body . Lasix acts at the ascending loop of henele and excretes out excess fluid and also decreases blood pressure . Side effects are hypokalemia , dehydration , hypovolemia , shock , dizziness ,low blood pressure , confusion , tachycardia ,etc .

6. The nurse should anticipate the doctor to do a kidney function test to assess the levels of main ions like sodium, potassium , then urea , creatinine etc as the kidneys are damaged here . Main is to check potassium ,because low and high levels of potassium both causes cardiac arthymias .