provide a care plan Celine Adams is
provide a care plan Celine Adams is a 79-year old African American female with a past medical history of atrial fibrillation, hypertension, diastolic heart failure, pulmonary cancer, cardiomyopathy, hyperlipidemia and hypothyroidism. She presents to the emergency department from Ashland Nursing home and Rehab with increased shortness of breath that has been ongoing for 4 days. She also endorses light headedness, fatigue, and chest pain. Medications in the nursing home include levothyroxine50mcg, amlodipine 5mg, vitamin D 5000units/weekly, lisinopril 40mg, lasix 40mg daily and digoxin (0.25 mg oral daily). On exam, she is alert and oriented with increased work of breathing. Physical exam was notable for heart rate 40, blood pressure 110/50, and a grade II systolic ejection murmur, and 2 + bilateral extremity edema, pale, faint pulses in lower extremities. She reports falling 1 year ago. She also reports constipation that is “ongoing.” Prior to entering the nursing home, she lived at home alone but became confused at night and was unable to be on her own. Her only daughter lives 5 hours away. The patient is a retired history teacher and well known in her community for feeding the homeless. She has been in the nursing home for 4 months. The nursing home charge nurse reports that she is having difficulty adjusting to her new home. Right now, the patient has been admitted to the medical-surgical unit and placed on telemetry. Heart rhythm is normal sinus. She is on a bed alarm and appears anxious. You are responsible for developing a plan of care for her. Your plan of care should prioritize her needs and assess for ongoing care. Her labs are Hgb 8.2g/dl Platelet 150 Sodium 123meq Potassium 3meq BUN 18 Creatinine 1.1mg/dl WBC 11,000 Troponin I 6.3ng/ml Troponin T 34ng/l. Vit d 104ng/m SCIENCE HEALTH SCIENCE NURSING NURSING NU451
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