QP, a 74-year-old Caucasian woman, presents to a local emergency… QP, a 74-year-old Caucasian w
QP, a 74-year-old Caucasian woman, presents to a local emergency… QP, a 74-year-old Caucasian woman, presents to a local emergency department with a 2-day history of worsening shortness of breath, increasing weakness, and swelling of her lower extremities and face. She is drowsy, answering questions with short phrases. She denies pain but appears to be having difficulty breathing. She denies increased sputum production, cough, nausea, vomiting, or diarrhea but does admit to having a decreased appetite. Her husband reports that she has been increasingly bedridden for the past month, walking only between bed, couch, and bathroom, and has become unable to stand today. He also reports that her face and legs began to swell yesterday, becoming much worse today. He also says that she has become incontinent and confused. The husband states that she has been responsible for managing her own medications but seems to be forgetting to take them regularly.Past Medical History: Hypertension, hyperlipidemia, coronary artery disease, type II diabetes, and hypothyroidism.Home Medications: Synthroid, metformin, hydrochlorothiazide, Lipitor, and aspirin.Current Assessment: BP 89/60, HR 50-60 with sinus bradycardia showing on the cardiac monitor, RR 20 breaths per minute, temp 96°F, SpO2 ranges from 82%-94%. Patient is increasingly lethargic and more difficult to arouse. Pupils are equal and reactive to light, mucous membranes are pale and dry, significant peri-orbital edema makes it difficult for her to open her eyes, her skin is extremely dry, pale, and cool to touch; her hair is thin; neck is supple without stiffness; no jugular venous distention or thyroid enlargement is noted. Lung sounds are diminished at bases, and she has occasional expiratory wheezing, no crackles.Health ScienceScienceNursing NURSING NURS 4286. Share QuestionEmailCopy linkComments (0)
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