E.S. is a 92-year-old man diagnosed with

E.S. is a 92-year-old man diagnosed with heart failure at 84 years of age. He has a 50-year history of hypertension that was well managed with spironolactone with hydrochlorothiazide. He has been treated with Simvastatin for 30 years secondary to high cholesterol levels. E.S. lives alone and is independent. He provides for his own ADLs. E.S no longer drives. He uses subsidized bus transportation for shopping, errands, and appointments. For the past 10 days E.S. has been feeling increasingly fatigued, short of breath, and displays marked edema in his ankles. He reports that he has been sleeping on 4-5 pillows at night, has little appetite and when he coughs his “chest rattles”. E.S. has 4 children who live locally (one son with Down Syndrome died at age 53), 16 grandchildren and 4 great-grandchildren. His 2 sons are active in his care but are also busy with their careers. • Upon admission, E.S. is noted to weigh 12 pounds more than his baseline weight and can say four to five words without pausing. His color is pale, and he has a stooped posture. E. S. is receiving oxygen at 2L/min via nasal cannula. Client’s vital signs: T-98.9F HR-96 RR-20 BP-138/84 O2 sat 92%. a. What data in the scenario is important? Subjective: Objective: b. What is missing that you would want to know? c. What assessments are a priority based on ES cues? d. What are your priority interventions or actions for ES? e. What are potential and actual complications to ES condition? f. What additional tests would you anticipate being ordered? g. What are priority medications for ES? h. What education do you think is a priority for ES now and prior to discharge?

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