H.J. arrives to ED with c/o “racing heart”. 79 year old female experiencing sob during past 2-months and swelling in the ankles.

H.J. arrives to ED with c/o “racing heart”. 79 year old female experiencing sob during past 2-months and swelling in the ankles. She sleeps with several pillows to keep herself in a sitting up position. 5-years ago she had an anterior wall myocardial infarction and had two-vessel coronary artery bypass surgery. Family history for atherosclerosis, father died MI and mother a stroke. She smoked for 30-years but quit after having the CABG 4 1/2 years ago. She uses alcohol socially. She’s allergic to nuts, shellfish, strawberries and hydralazine. Her medical history includes osteoarthritis, hypercholesterolemia, and gout.

Current medications are; celecoxib, allopurinol, atorvastatin, daily aspirin and clopidogrel. She is admitted to cardiac observation unit in the hospital.

B/P 135/80 (left arm sitting); AP 125 and irregular; peripheral pulses +1, RR 28, SaO2 91%, nonproductive cough, T 97.5F oral; reported weight 215lb, admission weight 102.7 Kilos; Height 5’8”; appropriately anxious

  • Will the prescribed home medications be therapeutic for H.J’s presenting problem? Explain
  • How do the medication actions relate to the medical history?
  • What do you conclude about the patient’s blood pressure?                           
  • Why is the patient tachycardic? Why is the patient tachypneic?
  • Using the reported height and weight what is her BMI?
  • Discuss your conclusions about patient’s admission weight, do you have concerns, why?
 
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