Question

Patient Profile

Mrs. E., a 70-year-old Hispanic woman, was admitted to the medical unit with complaints of increasing dyspnea on exertion.

Subjective Data

·     Had a severe MI at 58 years of age

·     Has experienced increasing dyspnea on exertion during the last 2 years

·     Recently had a respiratory tract infection, frequent cough, and edema in legs 2 weeks ago

·     Cannot walk two blocks without getting short of breath

·     Has to sleep with head elevated on three pillows

·     Does not always remember to take medication

Objective Data

Physical Examination

·     In respiratory distress, use of accessory muscles, respiratory rate 36 breaths/min

·     Heart murmur

·     Moist crackles in both lungs

·     Cyanotic lips and extremities

·     Skin cool and diaphoretic

Diagnostic Studies

·     Chest x-ray results: cardiomegaly with right and left ventricular hypertrophy; fluid in lower lung fields

Collaborative Care

·     Digoxin 0.25 mg PO qd

·     Furosemide (Lasix) 40 mg IV bid

·     Potassium 40 mEq PO bid

·     Enalapril (Vasotec) 5 mg PO qd

·     2 g sodium diet

·     Oxygen 6 L/min

·     Daily weights

·     Daily 12-lead ECG, cardiac enzymes q8hr x 3

2.    What clinical manifestations of heart failure did Mrs. E. exhibit? Name seven

Answer 1

Mr. E was admitted with complaints of dyspnoe on exertion.

Q is SEVEN CLINICAL MANIFESTATION OF HEART FAILURE FOR Mr. E.

we will start from presentation to past history to physical signs to investigations.

1 - old age female presenting with dyspnoea on exertion

2 - with past history of MI at age of 58 years with history of dyspnoe increasing since last 2 years who even cannot walk for two block and gets distressed.

3 - heart murmur (we usually get S-3 gallop)

4 - Moist crackles in both lungs

5- Cyanotic lips and extremities

6 - Skin cool and diaphoretic

7 - xray findings of cardiomegaly and right and left ventricular hypertrophy and pulmonary edema (Lung folled with fluid)