I'm working on my caremap for my patient last week. He is an 81 y/o black male admitted for acute systolic heart failure and urinary obstruction after being seen in the office for acute swelling in his legs, ankles, & member.
(He has no known allergies, is MRSA positive. On contact precautions. Past medical history: cardiomyopathy with pacemaker induced with systolic heart failure, HTN, & hyperlipidemia. Ascending aortic aneurysm, 2:1 AV block with pacemaker implanted. Aortic aneurysm repaired with ascending aortic graft. Aortic valve replacement (prosthetic).)
Ok, my gut is telling me (& I could be wrong, I am only a third semester nursing student) that the #1 nursing diagnosis would be decreased cardiac output. Would that apply, however, considering that he is 100% paced? I am stressing over this BAD because I have the most awful clinical instructor on the face of the earth. *sigh*...#just another hurdle to get over.
If I can get over the hurdle of this primary nursing diagnosis for him, I know that I will be fine from there.
Thank you!!