Mrs. A, 78 years old, reports to her health care provider (HCP) that she has been...

Mrs. A, 78 years old, reports to her health care provider (HCP) that she has been waking up in the middle of the night feeling like she was going to suffocate. She has also noticed that her legs are tight, and it takes every bit of energy she has to walk to the mailbox.

What additional information would be helpful?

Expert Solution

The patient might be experiencing warning signs of heart failure. It will be helpful if the patient can tell you if she is experiencing confusion sometimes?

Disorientation may be cause by some changes on certain substances in the blood like low sodium level or hyponatremia. Hyponatremia is a result of fluid overload in the body. The patients leg tightness might also be associated with hyponatremia if the blood flow out of the heart slows down, the blood returning through the veins backs up producing the fluid to build up in the tissues.

The kidney less likely to remove sodium and water causing fluid retention in the tissues. It is also important to know if the patient is having consistent coughing, her lungs might have a fluid build up. Because the lungs cannot supply enough oxygen and the heart cannot adequately pump oxygen-rich blood to the body the patient is experiencing shortness of breath, and the body also divert the blood away from less vital organs like muscles and limb and send it to the heart and brain which causes feeling of tiredness and fatigue.

If the patient is experiencing all this warning signs she should immediately get an appointment to her doctor for an immediate treatment to avoid further more life threatening incident.

Nightingale answered 2 years ago

Mrs Schmidt is a 65 years old woman who has been staying at an acute care...

Mrs Schmidt is a 65 years old woman who has been staying at an acute care facility for over 30 months now. She has been suffering for several years from chronic obstructive pulmonary disease and was placed on mechanical ventilation last fall. She was initially admitted to your facility for a weaning .Last night ,the physician informed her that she was to leave the acute facility, connected to the mechanical ventilation ,and that no further trials will be initiated. This...

Mrs. Fatima is 65 years old , celebrating her birthday . She is widow , lost...

Mrs. Fatima is 65 years old , celebrating her birthday . She is widow , lost her husband 6 month back . She lives alone but she has grandchildren who sometimes visit her She works as a school teacher . Everyone in the school was thanking her for her good work . Ali is a teacher working in the same school , he commented telling her that you are supposed to be at home by this age , you don't...

CASE 1. Mrs McMclelland is 43 years old and has two children. She has been receiving...

CASE 1. Mrs McMclelland is 43 years old and has two children. She has been receiving chemotherapy treatment for a year due to breast cancer. Her hair was lost as a result of chemotherapy treatment. In the night shift, nurse hears crying sound from Mrs. McClelland’s room and goes to her room. Nurse: What's wrong with you Mrs. McMclelland? What happened? Why are you crying? Look… you burn yourself out. Mrs McMclelland: Nothing. Nurse: Ohh..poor…did you miss your children? Mrs...

Rosalie is now 20-years old and has been compliant with her treatment regimens. She approaches her...

Rosalie is now 20-years old and has been compliant with her treatment regimens. She approaches her doctor because of a swollen and painful leg, and the doctor fears that a venous thrombosis has formed due to her oral contraceptive. After confirmation thereof, he prescribes warfarin as treatment and ensures the dose is tapered correctly. Three weeks after starting her warfarin treatment, she decides to also start using a new multivitamin containing vitamin B12, vitamin C and vitamin K, something her...

A 40-year-old man reports to his health care provider complaining of heartburn that occurs after eating...

A 40-year-old man reports to his health care provider complaining of heartburn that occurs after eating and also wakes him up at night. He is overweight and admits to enjoying fatty foods and lying down on the sofa and watching TV in the evening. He also complains that lately he has been having a cough and some wheezing. He is negative for peptic ulcerations. What is causing this man’s heartburn? Why does it get worse at night or after he...

Mrs. Gibbs, 72 years-old, has senile cataracts and has been instilling mydriatic eye drops. Her vision...

Mrs. Gibbs, 72 years-old, has senile cataracts and has been instilling mydriatic eye drops. Her vision has progressively worsened and she is scheduled today for a right cataract extraction in the outpatient clinic. The MD orders the following pre-op preparation: NPO; instill mydriatric and cycloplegic eye drops 1 hours before surgery; Valium 5 mg po 1 hour before surgery. Mrs. Gibbs arrives at the outpatient clinic at 0800 and she is scheduled for surgery at 1000. One-hour post-op you assess...

Mrs Smith is 75 years old when she goes for her physical checkup. The doctor notices...

Mrs Smith is 75 years old when she goes for her physical checkup. The doctor notices her height has went from 5’3” to 5’1” over the past few years. She reports she is lactose intolerant, cannot have dairy and does not like green vegetables. She also states that while she has no contraindications to exercise, she does not get much physical activity. The doctor decides to send her for a DXA scan. What mineral deficiency or toxicity may she have?...

You are the primary care provider for Mrs. Z, a 70-year-old female patient who has suffered...

You are the primary care provider for Mrs. Z, a 70-year-old female patient who has suffered from chronic back pain for a number of years. You are well acquainted with this patient, and due to recent changes in prescription regulations you now see her once a month to renew her narcotic prescription. Three months ago Mrs. Z’s 17-year-old granddaughter moved in with her, after a fight with her mother. Z’s granddaughter was a straight-A student prior to a car accident...

E.G. is a 73-year-old woman whose daughter brings her to see the health care provider because...

E.G. is a 73-year-old woman whose daughter brings her to see the health care provider because she has had a case of the “stomach flu,” with vomiting and diarrhea for the past three to four days and is now experiencing occasional light-headedness and dizziness. Her past medical history includes hypertension, hypercholesterolemia, and mild heart failure. She is taking: Digoxin 0.125 mg po daily. Captopril 25 mg po BID. Furosemide 40 mg po daily. Potassium chloride 20 mEq po daily. Atorvastatin...

Mrs. Jacks is a 78-year-old woman who is a resident of a long term care home....

Mrs. Jacks is a 78-year-old woman who is a resident of a long term care home. When you are administering Mrs. Jacks her medication at 0830am she states, “I feel like I need to go to the bathroom constantly and it hurts when I go.” Mrs. Jacks’ urine is cloudy and has a foul odor. Her temperature is 38.1 degrees Celsius. You call the physician and she orders a specimen for C&S and you advise Mrs. Jacks to increase her...

Question