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Client is admitted to the intensive care unit for treatment of pericarditis. Client has a history of heart failure and a recent myocardial infarction requiring coronary artery bypass grafts (CABG). Client reports some discomfort at left chest on inspiration. Physical Examination: General: Awake and alert, appears uncomfortable Cardiovascular: heart rate 82/min, S1, S2 noted Respiratory: respiratory rate 20/min, breath sounds clear bilaterally, no crackles Extremities: skin warm and dry, 2+ pulses throughout, no edema Client returned from echocardiogram and chest x-ray. Today, 0800: Client reports “chest tightness and shortness of breath.” Appears restless. Physical Examination: General: anxious, agitated Cardiovascular: tachycardic, muffled heart sounds, 3+ jugular vein distention (JVD) Respiratory: dyspneic, breath sounds clear bilaterally, no crackles, tachypnea Extremities: skin warm and dry, 2+ pulses throughout, no edema]
SCIENCE
HEALTH SCIENCE
NURSING

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