cardiac unit concept map(1).docx - 56 year old African...

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56 year old African American male with a history of Type II diabetes, hyperlipidemia, and hypertension presents to the emergency room with a one week history of progressive shortness of breath with exertion and PND. The client relates an episode of chest pain with some diaphoresis two hours ago that “went away when I went to sleep”. Assessment of the patient reveals bilateral crackles, cap refill of >4 seconds, mottling of hands and feet, pedal and posterior tibal pulses only obtainable by Doppler. The patient appears slightly confused to time and place. A foley was inserted and drained 120 cc of dark amber urine. The patient’s wife states the patient has felt so poorly that he hasn’t eaten or urinated all day. Vital signs: BP 102/40, HR 128, RR 32, Temp 37.2, O2 Saturation -94% on 2L of oxygen. EKG – Sinus tachycardia with frequent ventricular premature beats with ST elevation in V1-V5. Echocardiogram: Severe left ventricular dysfunction with an EF of 20%, left anterior wall shows global akinesis, impaired diastolic filling, thickened left ventricle, and normal valve function.
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  • Spring '18
  • patho

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