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A 62-year-old retired elementary school teacher presents to the emergency room with complaints of shortness of...

A 62-year-old retired elementary school teacher presents to the emergency room with complaints of shortness of breath, swelling, and generally not feeling well.

Related Question #1

What physical assessments are priorities given her symptoms?

Related Question #2

What diagnostic tests should be ordered immediately? Explain the purpose(s) of each.

Part 2

Vital signs are obtained and recorded as BP 90/48, R24, HR 100 irregular and varying pulse quality, T 97.8°F, pulse oximetry at 92%. Cardiac monitor reveals atrial fibrillation with variable ventricular response. The following laboratory values are returned: troponin 0.02 ng/ml, BNP 400, Hb 10.6, Hct 31.8, BUN 44 Cr 2.

Related Question #3

Which of the laboratory tests are abnormal?

Related Question #4

What do the abnormal tests indicate?

Part 3

Physical examination reveals obese white female in acute distress with frequent deep sighing breaths. HEENT unremarkable, CN I to CN XII grossly intact. Responds slowly but accurately and appropriately. Negative jugular vein distention. Chest: crackles lower lobes bilaterally. Pansystolic murmur, irregular rhythm. Abdomen: mildly distended, soft with bowel sounds present all quadrants. No organomegaly. Genitalia: deferred. Extremities: moves all extremities on command. 2+ pitting edema bilaterally.

Related Question #5

Which physical signs and symptoms are indicative of congestive heart failure?

Related Question #6

What are the expected interventions?

Related Question #7

What is the purpose of each of these medications in the treatment of CHF?

Part 4

The patient is admitted with the following diagnoses:

Mitral valve regurgitation

CHF secondary to mitral valve disease

Renal failure secondary to CHF

Atrial fibrillation

Anemia

Related Question #8

Explain the development of congestive heart failure in this patient.

Related Question #9

Explain the relationship between the CHF, renal failure, and anemia.

Related Question #10

What is the significance of the atrial fibrillation?

Solutions

Expert Solution

Part 4

The patient is admitted with the following diagnoses:

Mitral valve regurgitation

CHF secondary to mitral valve disease

Renal failure secondary to CHF

Atrial fibrillation

Anemia

Related Question #8

Explain the development of congestive heart failure in this patient.

Heart's role is to pump the blood which is non-oxygenated from the body to the lungs so that it can be oxygenated and sent to the body, cells and tissues.

If there is any etiological factors causing inability of the heart to pump the blood from left side of the heart resulting in pooling or congested of blood and fluids in lungs named congestive heart failure manifests with shortness of breath.

Related Question #9

Explain the relationship between the CHF, renal failure, and anemia.

A chronic anaemia resulting in left ventricular hypertrophy by causing cell death and worsens the condition of congestive cardiac failure. In consequence to CHF, patient gets anemic and in turn anemia worsens CHF. All ends in renal damage and in turn further worsens CHF and anemia.

Related Question #10

What is the significance of the atrial fibrillation?

It is the most common arrhythmia generally seen in hypertrophy and cardiomyopathy. It is associated with clinical outcomes of patients by deteriorating clinical condition, having more complications,increased mortality leading to poor prognosis and increased length of hospitalization stay for patients

Nightingale answered 1 year ago

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