L.J. is a 63-year-old woman who has a history of hypertension, chronicheart failure, and sleep apnea
L.J. is a 63-year-old woman who has a history of hypertension, chronicheart failure, and sleep apnea. He has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, he had an onset of flu with fever, pharyngitis, and malaise. He has not taken his antihypertensive medications or his medications to control his heart failure for 4 days. Today, he has been admitted to the hospital ICU with acute decompensated heart failure. Subjective Data-Is very anxious and asks whether he is going to die.-Denies pain but says he feels like she cannot get enough air.-Says his heart feels like it is “running away.”-Reports that he is so exhausted he cannot eat or drink by himself. Objective Data -Height 5 ft, 10 in (175 cm); Weight 210 lb (95.5 kg)-Vital signs: T 37.6 C/99.6 F, HR 118 and irregular, RR 34, BP 90/58-Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates atrial fibrillation with a ventricular rate of 132.-Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82% on room air-Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin-Laboratory work and diagnostic testing are scheduled Questions:1. What signs and symptoms of right-sided and left-sided heart failure is L.J experiencing?2. What diagnostic procedures and findings would help to establish a diagnosis of acute decompensated heart failure with pulmonary edema?3. What monitoring will be used to evaluate L.J.’s condition?4. what priority nursing interventions are appropriate for L.J. at the time of his admission?5.During L. J.’s hospitalization, basic starndars of evidence-based care for patients with HF are set forth in four core measures.Which two of these measures should be implemented by the nurse?6. The physician mentions the possibility of inserting a pacemaker called cardiac resynehronization therapy (CRT).L.J. asks the nurse what CRT is. What response would be appropriate from the nurse?7. Based on the assessment data presented, what are the priority nursing diagnoses for L.J? Are there any collaborative problems? Health Science Science Nursing NURSING 1343 Share QuestionEmailCopy link Comments (0)
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