Question

Jerry Williams is a 62-year old obese (BMI 35.2) Caucasian male with a history of diastolic heart failure and type II diabetes.

Last evening, he began having difficulty breathing with activity. He thought he might be getting a cold because he had a runny nose. He reports more swelling in his lower legs the past couple days. He woke up this morning with increased difficulty breathing when he woke up and his wife called 911.

Paramedics report that his initial VS: HR:92 RR: 28 BP: 172/88 O2 sat: 80% on room air with scattered expiratory wheezing bilat. He was placed on oxygen by facemask and albuterol nebulizer administered with some improvement in his breathing.

His RR is now 24 upon arrival to the emergency department ED). His initial labs have resulted; creatinine of 2.5 (last adm. 1.8), K+ 3.5 (last adm. 3.7) and BNP 944 (last adm. 322). Jerry is given furosemide 40 mg IV in the ED and had 800 mL urine output in the last hour. He is admitted to cardiac telemetry, and you are the nurse responsible for his care.

_{What data is RELEVANT and Why is it clinically significant? ​​​​​​​(}There are 7 criteria, list 4 of them and their clinical significance)

Answer 1

Relevant data:-

Type 2 diabetes

Difficulty in Breathing

Respiratory rate:- 28

Blood pressure:- 172/88

Serum creatinine:- 2.5

Oxygen saturation:- 80% on room air.

Heart rate:- 97

Clinical significance:-

*Increased risk of infection and other physiological condition indicate physical intolerance and decrease respiratory capacity.

*Tachypnea may indicate respiratory distress.

*Increased blood pressure indicate fluid volume excess/hypervolaemia.

*Oxygen saturation is below the expected referance range 95% to 100% this may be indication of oxygen insufficiancy and fluid in the lungs with the increased blood pressure, left side heart failure,

Serum creatinine 2.5 is above the referance range of 0.6 to 1.3 mg/dL. Elevated creatinine level signifies impaired kidney function or kidney disease.