Peripheral vascular 3 peripheral edema extending to

PERIPHERAL VASCULAR: 3+ peripheral edema extending to knees bilaterally; 2+ dorsalis
pedal pulses bilaterally
NEUROLOGIC: Awake, alert, and oriented to person, place, and time
Diagnostic results : Blood Work was drawn and the results are unknown at this time. The chest
x-ray was ordered, and showed cardiomegaly, edema, and some haziness around the margins.
The EKG results proved the patient was having cardiac events and not in NSR.
Various assumptions are relied upon during the diagnoses. Inamdar & Inamdar (2016), postulate
that B type natriuretic peptide has clinical significance both as a diagnostic and a prognostic
marker of heart failure. Patients with a higher than 200pg/ ml of BNP have a 9% mortality rate
while those with less than 200pg/ml have a mortality rate of 2%. Chest X-rays are used to
evaluate the size of the heart and to find out if there is any alternative cardiopulmonary disease
that could be causing the symptoms in the patient. An echocardiogram will assess the size, wall
motion and thickness, and valve function. It also shows the ejection fraction of the heart, which
is useful in therapy selection. Cardiac MRI (Magnetic Resonance Imaging) and CT are important
diagnostic tests. An MRI will give high anatomical resolution to all aspects of the heart and the
structures surrounding it.
A .

Differential Diagnoses
Primary Diagnosis/Presumptive Diagnosis: Congestive Heart Failure
Congestive Heart Failure
Congestive Heart Failure presents with symptoms including shortness of breath, persistent
coughing, edema, fatigue, nausea, or high heart rate (AHA, 2017). The patient present with all of
these excluding the nausea. The x-ray and EKG were both indicative of CHF as well. The sudden
weight gain with edema and ascites throw red flags, as well.
Pulmonary Emboli
Shortness of breath is one of the most common symptoms of pulmonary embolism (Duru et al.,
2014). Although the patient does not have hypotension and hypoxemia, it is important to query
pulmonary embolism especially in a patient who has risk factors predisposing him to the
condition.
Kidney Failure
Chronic kidney disease is accompanied by high blood pressure and edema (Razmaria, 2016).