A 58 year-old male with a 10-year history of hypertension presentsto the ER with dyspnea and dry cough that has been progressively worsening over the last 6 months. Initially he experienced dyspnea only after a brisk 1-mile walk. He now has dyspnea climbing up the flight of stairs to his bedroom. Lying down worsens symptoms, and he often needs three or four pillows to fall asleep.On exam, he is afebrile, BP is 170/100 mmHg, respiratory rate is 20 breaths per minute and pulse is 80 beats per minute and regular. Auscultation of the heart reveals an S3, S4 and a 1/6 blowing holosystolic murmur heard best at the apex that radiates to the axilla. Point of maximal impulse is displaced to the left. There are scattered rales and wheezes on lung exam. There is 9cm of JVD. The liver edge is tender and 4cm below the costal margin. He has marked peripheral edema.1- What is the relevant objective and subjective assessment data from the case study?2- What does this data indicate? What conclusions can you make? What is your preliminary diagnosis(es)?3- What is the underlying pathophysiology that produce the clinical manifestations in this case study? You can use text, flowchart or outline to provide a detailed discussion.4- Based on the pathophysiology, what clinical course and complications could you anticipate5- What patient education and follow up is required for the case study patient? Health Science Science Nursing NUR 3460 Share QuestionEmailCopy link Comments (0)
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