Answered step-by-step
Question
Answered step-by-step
Asked by DeaconWombat1189
Case #4: Endocarditis
82 year old female, DNR, admitted two days ago in the ER department with Endocarditis, currently awaiting an inpatient bed. She is on day 2 of antibiotics, O2 saturations >92% on 2L NP, up walking in the hall on the day shift. At the beginning of your night shift you notice she is weak, using accessory muscles to breathe, O2 sats are 88% on 2L, and having muscle pain.
Past Medical History:
NIDDM
Hyperlipidemia
Peptic ulcer disease
CHF with EF of 40%
Asthma/COPD
HTN
Social History:
Lives with husband, dwelling is a small bungalow, fully functionally with ADL’s, active within her community, volunteer for the food bank.
Medications:
Metformin 500mg PO BID
Ramipril 5mg PO daily
Lipitor 40mg PO daily
Pantoloc 40mg BID
Norvasc 10mg PO daily
Ventolin 2 puffs PRN (with asthma/COPD symptoms)
Coumadin 1mg PO daily
Initial Parameters:
Patient: No response except to painful stimuli, current GCS 9
Vitals: BP 178/92, HR 74, RR 31, O2 sat 88% on 2L Temp 36.8 C
Eyes: Closed, pupils reactive
Lungs: Inspiratory/Expiratory crackles/wheezes (audible without a stethoscope)
Heart Sounds: Normal S1, S2, systolic murmur
Heart Rhythm: Paced Rhythm at 74
Abdomen: Flat, soft, non-tender
Labs: Bloodwork (WBC 16.2, Fasting Glucose- 7.7, INR 1.6)
CXR: Fluid overload (Pulmonary Edema)
ECG: Ventricular Paced Rhythm (70’s) with an ICD
Cardiac Case Study Outline
Provide the Pathophysiology of the diagnosis as it pertains to your case study (5 marks)
Review the “past medical history”, give a brief overview of what other risk factors could have significance to the current critical situation presented? (5 marks)
Is your client in homeostasis? If not explain why? (4 marks)
Identify which medications your client is on that are important for cardiac health. (4 marks)
Facilitate at least 4 questions that would be pertinent to ask this patient right now? (2 marks)
What are your nursing considerations? (Consider both current event and previous medical history) (5 marks)
Based off of your case study and findings, provide your client with 5 health teaching tips that could change their health for the better? (5 marks)
SCIENCE
HEALTH SCIENCE
NURSING
NURSING CNC 105
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