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.

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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.

Will the prescribed home medications be therapeutic for H.J’s presenting problem? Explain

How do the medication actions relate to the medical history?

Physical Assessment

Vital Signs

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

  • 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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