This is a case of a 65 year old female with a 10 year history of hypertension and diabetes. She is taking Micardis 40 mg in the morning and Amlodipine 5 mg at night for hypertension. For diabetes she is being given Janumet 100 mg/1g 2x a day and Gliclazide 60 mg OD before breakfast. The daughter reported poor compliance with medications. The patient was brought to the emergency room due to difficulty breathing. Condition started 2 days PTA when the patient had easy fatigability going to the comfort room. She started taking all her medications again but she did not seek consultation. Symptoms persisted until she would have difficulty breathing when getting out of bed. In the emergency room BP 180/100 HR 110/min RR 35/min O2 sat 93%, Temp 36.8, patient is pale, diaphoretic and in severe respiratory distress. (+) edema up to the knees area, (+) crackles from lower to mid portion of the lungs. In the emergency room, the client was given O2 per cannula at 4-5lpm. IVF was initiated. The doctor ordered for Furosemide 40 mg IV stat. CXR was done in the emergency room showing pulmonary edema and heart enlargement The client’s creatinine and serum potassium were elevated, she was referred to a nephrologist for possible dialysis. Make a pathophysiology on how kidney failure happens to a client with acute congestive heart failure. TASKS: 1. Create all the nursing care plan needed for the above case scenario. (Use the format below)
This is a case of a 65 year old female with a 10 year history of hypertension and diabetes. She is taking Micardis 40 mg in the morning and Amlodipine 5 mg at night for hypertension. For diabetes she is being given Janumet 100 mg/1g 2x a day and Gliclazide 60 mg OD before breakfast. The daughter reported poor compliance with medications.
The patient was brought to the emergency room due to difficulty breathing. Condition started 2 days PTA when the patient had easy fatigability going to the comfort room. She started taking all her medications again but she did not seek consultation. Symptoms persisted until she would have difficulty breathing when getting out of bed.
In the emergency room BP 180/100 HR 110/min RR 35/min O2 sat 93%, Temp 36.8, patient is pale, diaphoretic and in severe respiratory distress. (+) edema up to the knees area, (+) crackles from lower to mid portion of the lungs.
In the emergency room, the client was given O2 per cannula at 4-5lpm. IVF was initiated. The doctor ordered for Furosemide 40 mg IV stat. CXR was done in the emergency room showing pulmonary edema and heart enlargement
The client’s creatinine and serum potassium were elevated, she was referred to a nephrologist for possible dialysis.
Make a pathophysiology on how kidney failure happens to a client with acute congestive heart failure.
TASKS:
1. Create all the nursing care plan needed for the above case scenario. (Use the format below)
2. What other significant data that you need to be gathered in this client?
3. What do you think are the other diagnostic tests that will be ordered for this client and their possible findings?
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