Diagnosis

  1. 0
    Hi every one,
    I have a case study that I need to write about
    but initially I have to diagnose the case
    can any one help me to find the accurate diagnosis
    since am very confused about it


    Patient profile
    Mrs. Edwards, a 70-year-old woman, was admitted to the medical unit with complaints of increasing dyspnoea on exertion.

    Subjective data
    Had a severe myocardial infarction at 58 years of age
    Has experienced increasing dyspnoea on exertion during the last 2 years
    Recently had a respiratory tract infection, frequent cough, and oedema in legs 2 weeks ago
    Has to sleep with head elevated on three pillows
    Does not always remember to take medication

    Objective data
    In respiratory distress, use of accessory muscles, respiratory rate 36 breaths/min
    Heart murmur
    Cyanotic lips and extremities
    Skin cool and diaphoretic
    Venous leg ulcer on left ankle
    Bloated abdomen

    Physical examination
    Pulse full and bounding: 68 bpm, blood pressure: 122/76 mmHg
    General strength of 4/5 (80% of normal)

    Diagnostic studies
    Increased white cell count (WBC 15 109/L); BNP normal (100pg/mL); troponin I normal (0.01 ng/mL).
    Chest X-ray results: cardiomegaly with right and left ventricular hypertrophy; fluid in lower lung fields
    Ejection fraction 25%

    Collaborative care
    Digoxin 0.25 mg by mouth once daily
    Frusemide 40 mg IV twice daily
    Potassium 40 mmol/L by mouth twice daily
    Enalapril 5 mg by mouth once daily
    Low sodium diet
    Oxygen 6 L/min via Hudson mask
    Daily weights
    Daily 12-lead ECG
    Cardiac enzymes every 8 hrs 3
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  3. 2 Comments so far...

  4. 2
    It helps us experienced nurses to know what you are thinking.

    We don't want to rob students of the opportunity to grapple with the material and make it their own. If you share the progression of your reasoning, we know what kind of help you need. And you get the experience of supporting a rationale and integrating pieces of knowledge.

    So, based on the data you have posted, what possibilities are you considering and why? And which ideas have you ruled out?
    lkwashington and donsterRN like this.
  5. 0
    Honestly? This is an orgy of information. I knew the diagnosis just from the one line patient profile, but each and every thing in your list reiterates the same thing. Think back to what you are studying right now. Look at all the symptoms as one big picture...


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