- 0Sep 21, '10 by Fatmah JabrHi every one,I have a case study that I need to write aboutbut initially I have to diagnose the casecan any one help me to find the accurate diagnosissince am very confused about it
Mrs. Edwards, a 70-year-old woman, was admitted to the medical unit with complaints of increasing dyspnoea on exertion.
• 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
• 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
• Pulse full and bounding: 68 bpm, blood pressure: 122/76 mmHg
• General strength of 4/5 (80% of normal)
• 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%
• 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
- 2Sep 21, '10 by rn/writer GuideIt 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?