Case Study # 2A 50-year-old man has developed shortness of breath with exertion several weeks afterexperiencing a viral iliness. This is accompanied by swelling of the feet and ankles and some increasingfatigue. On physical examination he is found to be mildiy short of breath lying down, but feels better sittingupright. Pulse is 105 and regular, and blood pressure is 90/60 mm Hg. His lungs show crackles at bothbases, and his jugular venous pressure is elevated. A third heart sound is present but no mumurs areheard on auscultation of the heart. The liver is enlarged, and there is 3+ edema of the ankles and feet. Anechocardiogram shows a dilated, poorly contracting heart with a left ventricular ejection fraction of about20%. Because of an abnormal ECG, he undergoes a coronary angiogram, which shows normal coronaryarteries. The presumptive diagnosis is dilated cardiomyopathy secondary to a viral infection with stage Cheart failure. He is placed on a low-sodium diet and treated with a diuretic (furosemide 40 mg twice daily)and digoxin 0.25 mg daily. On this therapy, he is less short of breath on exertion and can aiso lie flatwithout dyspnea. An ACE inhibitor is added (enalapril 20 mg twice daily) and over the next few weeks hecontinues to feel better. Three months after the first visit, the man is asymptomatic at rest and with mildexercise. Heart rate is 80, and blood pressure is 110/70. A repeat ECG shows that his heart is smaller(though not back to nomal) and his left ventricular ejection fraction has improved to 40%.Questions:1.What disease condition of the heart does the above case shows?2. Give the normal ejection fraction of the left ventricle.3. What do you mean by dyspnea?4.What other pharmacologic options are available is this man's disease remains stable?5.What treatments are available if his heart failure suddenly becomes worse?Page 7

The swelling of the ankles and feet due to fluid retention is called edema. Difficulty in breathing…

Answered: Questions: 1. What disease condition of…

Surgical Tech For Surgical Tech Pos Care

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Case Study 3:An 18-year-old man with no significant past medical history presented to the emergencydepartment with a history of cough and shortness of breath with exertion, along withsubjective fevers, chills, and rigors. He was noted to be hypoxic (low oxygen saturation level)on examination. The chest X-ray showed bilateral infiltrates in a diffuse butterfly patterninvolving both central lung fields. The patient reported a history of IV drug use, with frequentsharing of needles.Diagnosis: PCP PneumoniaCase study presentation should include the following:1. Case2. Patient initials (Ex. 50-year-old man)3. History of the present illness (Symptoms and may include the physical exam of the patient)4. Chief Complaints (Ex. Morning stiffness in his joints for over a year)5. Diagnosis and Causative agent6. Pathophysiology7. Treatment and Management8. ReferencesPossible answer: Chief complaint: Cough and shortness of breath Diagnosis: PCP Pneumonia Causative Agent: Pneumocystis jirovecii…
What are 3 interventions with rationale for a patient with impaired gas exchange due to lung cancer.
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Case Study 3 – Congestive Heart Failure Dottie is a 78-year old CHF patient. She has been exercising with your facility for several years now. She had a CABGx3 in 2020. She came in today with a 5 lb. weight gain since yesterday when she weighed on her home scale this morning. Her meds include- Lipitor, Procardia, and Lasix. (Cholesterol, Calcium channel blocker Hypertension, and Diuretic, respectively) Her blood pressure is 132/88 and her HR = 102; Her weight is 196, up from 191 when last measured. She is a pleasant, overweight individual who enjoys walking on the treadmill and visiting with other members of your facility. 1. What are specific considerations for someone with CHF and exercise? How is the exercise prescription any different from the apparently healthy adult prescription? 2. What is your biggest concern with Dottie today and how would you handle this concern(s)?
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Case Study E.W., a 76-year-old white man, comes to the emergency department after a syncopal episode at a local restaurant. He is accompanied by two friends. Subjective Data Has been feeling weak for a few days Became dizzy and fainted while awaiting his dinner Takes one medication, a “water pill” for high blood pressure Objective Data Physical Examination Blood pressure 92/50, pulse 125 and irregular, respirations 24, temperature 97° F Alert and oriented Lung sounds clear in all fields Diagnostic Studies ECG monitor shows atrial fibrillation Questions What is atrial fibrillation? What additional history should you obtain from E.W.? Describe the risks associated with atrial fibrillation.
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Case Study: Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon’s postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function. The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the…
Case Study: Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C. The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon’s postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes a nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function. The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the ICU…
Case Study: Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon's postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function. The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the ICU…

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Questions: 1. What disease condition of the heart does the above case shows? 2. Give the normal ejection fraction of the left ventricle. What do you mean by dyspnea? 4. What other pharmacologic options are available is this man's disease remains stable?