CHF/COPD and Runny Nose?

[Seliah]

Hello,

I work in an NH as a CNA. In my 'off duty' time, I have something of a private case I take care of. The gentleman who lives upstairs from me - for about a year and a half now I've been taking care of him (he does have a visiting RN but only after hospital stays). He's 70 - definitely geriatric.

And.. I have a question, but I'm going to give a basic care history just in case its needed.

He has the following DX's :

COPD

CHF

Diabetes (adult onset)

Triple abdominal hernia (90lbs in hernia weight, multiple surgical fixes done in the past to no avail)

Peripheral arterial disease

Some basic medical history :

He had one major heart attack about a year ago, and had a second, minor one a week after being released from the hospital from the major one. He's had a bypass of some sort done in LLE due to poor circulation that led to loss of the great toe on the left foot. He has perfectly good bowel function and no problems voiding. Still fairly independant for the most part. Poor appetite (eats just a little bit here and there, sometimes won't eat for two or three days despite encouragement - can sometimes solve it if I bring him homemade soup or stew), but does take in a lot of fluid without a problem (yay for marines and their love of coffee and water!).

I can provide a med list w/dosages and frequencies if it's needed (it's lengthy), as I'm the one passing him his meds (his eyes are poor and he can't read the labels, so I fill the weekly pill boxes and do the afternoon pass/nebulizer setup.) I suppose this is basically a home-care sort of case, when you get right down to it.

I know that during summer and spring CHF and COPD symptoms will frequently flare up - however, can such a flare up present as simply a runny nose? This poor man's had for about a week now, an excessively runny nose, an excessive cough. Cough is productive, but I'm just not sure if it's mucus buildup due to the COPD/etc, or not. No fever. No wheezing of any kind. No SOB outside of what's "normal for him." (he's on 2 liters of O2 WIB w/PRN usage, rarely needs the PRN usage). His BP, pulse, temp, respirations are all within his usual normal ranges, nothing out of ordinary there. O2's are running about 95-98 as well. Will dip down to high 80's w/exertion, and then raise back up to the mid-to-high 90's once he's been sedentary for a few minutes.

Is there anything I can do to help the runny nose or does he honestly just have a spring cold? He does not have allergies, he is completely cognisant and mentally competent. He can go through 1-2 entire ROLLS of paper towels in about two days on it. Mucus is clear or a little yellowish. No swelling observed in his extremeties so far this spring, no weight gain or loss or noticeable outward sign of fluid buildup.

I'm just trying to handle this as best I can. Am I reading too much into the runny nose, is it possibly just a flareup symptom, or is it more likely to just be a spring cold?

Thanks in advance - and I apologize for the lengthy post...

~ Seliah

[mamamerlee, LPN]

We are not allowed to give medical advice on this board according to the TOS.

That being said, please have someone contact his primary care physician about his runny nose - he may be fluid overloaded.

[SuesquatchRN, BSN, RN]

He's gotta see the doc, selilah.

[Seliah]

He's got an apptt with the primary tomorrow morning. Thanks.

[CapeCodMermaid, RN]

70? That's not all that old these days! Get him to the doc.

[Nurse_Tricia, LPN]

I had a 99 yr. old patient in the hospital (during clinicals) who could probably run circles around 1/2 the staff. She loved romance novels and had no problems sharing her ...???well, romantic thoughts while reading them..

"70 - definitely geriatric" LOL

So, technically what age does geriatric start????? Just so I know when I may be there

[SuesquatchRN, BSN, RN]

65. My husband'll be there in October!

[Nurse_Tricia, LPN]

Ok, so I was interested in when exactly Geriatrics started.. Funny thing is I found sites where they say a dog is geriatric at 7, so I best take care of my Henry as he is now a geriatric dog. But, for the human species, it seems like much of the information is leaning towards not so much age as it is the aging process combined with multiple diagnosis and numerous medications. Interesting...

65? Oh Lord, I won't break the news to dear Mother that she has been living geriatric yrs.. She would croak..