Case #1:  Rapid Atrial fibrillation     75 yo M admitted yesterday with 3 days of progressive SOB

Question
Answered step-by-step
Asked by ProfessorPencil765

Case #1: Rapid Atrial fibrillation

75 yo M admitted yesterday with 3 days of progressive SOB, cough, and fever. Physicial exam shows right sided crackles and hypoxia. CXR confirms RML infiltrate. Patient placed on O2 and admitted to the floor. This evening develops sudden increased SOB and palpatations, while returning from a smoke. No chest pain, no fevers, no chills.  Now admitted to ICU as he develops Rapid A-fib.

Past Medical History:

CAD
NSTEMI 2003 with RCA stent,
NSTEMI 2010 with LAD stent x 2
CHF – secondary to ischemic cardiomyopathy, EF 45%
Dyslipidemia
HTN
COPD 

Social History:

Married with 2 children, lives at home with wife, worked as a mechanic, no alcohol or drugs. > 50 pack year smoking history

Medications:

Metoprolol 25mg po BID
Ramipril 10 mg po Daily
ASA 81 mg po Daily
Plavix 75mg po Daily
Lipitor 40 mg po Daily
Spiriva 18mcg 1 puff inh Daily

Initial Parameters:

Patient: Patient uncomfortable, SOB, but able to answer questions.

Vitals: HR 146    BP 95/50 (and dropping)    RR 22    Temp 36.7 C     O2 sat 93% on 3L

Neuro: Eyes open, pupils equal and reactive

Lungs: Crackles at bases R > L

Cardiac: Normal S1, S2, no murmur, mild peripheral edema, elevated JVP

Abdo: Soft, not tender, no masses

Labs: AM Bloodwork  (K Normal at 3.6, WBC 14.2, Glucose 8.9)

CXR: RML infiltrate 

ECG: Rapid Atrial Fib (rate 143-168)-average HR is 146bpm

Q. what are your nursing considerations ( consider both current event and previous medical history )  (5 marks).

SCIENCE
HEALTH SCIENCE
NURSING
CNC 108

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."