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1735 : patient admitted for management of heart failure, awake, alert, oriented x3. reports recent weight gain of 7 lbs and increasing dyspnea on exertion. lung sounds with rales in bilateral bases. heart sounds regular. bowel sounds normoactive in all 4 quadrants. 2+ pitting edema noted to bilateral lower extremities. Telemetry reveals normal sinus rhythm. oxygen at 2 l/min per nasal cannula. Lab drawn for b-type natriuretic peptide. 1955: reports increasing shortness of breath. lung sounds with rales throughout. Head of the bed elevated to fowler’s position. oxygen increased to 4 l/min per nasal cannula. heart sounds diminished. 4+ pitting edema to lower extremities. lab drawn for serum BNP notified.
SCIENCE
HEALTH SCIENCE
NURSING
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