SOLVED469

Mrs. Cooper is a 78-year-old American Indian female who presented to your clinic with dyspnea on exertion, fatigue, and recent weight gain of 8 pounds in the last 3 days. She has a history of heart failure, hyperlipidemia, coronary artery disease (CAD) (CABG X 2 – 3 years prior), Hypertension (HTN), Hyperlipidemia and Type II Diabetes. She lives a sedentary lifestyle and does not exercise. Her medications include Lisinopril 10mg, Metoprolol 25mg, Spironolactone 25mg, Atorvastatin 40mg Daily and Metformin 1000mg twice daily. Her physical examination revealed: Vital signs: BP: 178/98, HR 111, RR 23, T 98.7, O2 of 89% on Room Air so the patient is placed on 2 L of oxygen via nasal cannula increases her O2 to 94%. The patient is alert, oriented x4, anxious, PERRLA, with facial symmetry and reflexes intact. The EKG shows sinus tachycardia and no new ischemic changes. Cardiac assessment revealed S3 heart sounds, bilateral pitting pedal edema 3 , and 2 pulses in all extremities. Auscultation of the lungs revealed bilateral basilar pulmonary rales. There was also use of accessory muscles and pursed lip breathing. All other assessment findings were unremarkable. Discuss what patient education is essential for management of CHF in this
SCIENCE
HEALTH SCIENCE
NURSING

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