Nursing Case Study Assignment Paper
1 Nursing Case Study Student’s Name Institutional Affiliation Course Date 2 Nursing Case Study A 60yo male teacher from the local high school presents to you with complaints of swelling in the feet/ankles by the end of the day, frequent urination at night and increasing fatigue/shortness of breath upon light exercise like taking the steps to a different floor. He does not sleep well at night and feels that breathing while in bed seems to be a bit harder than when sitting or standing. Use of added pillows seems to help. He has a history of heart disease in the family and he has previously been diagnosed with mild atrial fibrillation, which is only being monitored. Nursing Case Study Assignment Paper
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Upon examination, you find BP 170/110, pulse rate 70-75, normal temperature and mild pitting edema at the ankles bilaterally. Chest exam reveals light crackles (rales) upon respiration and no abnormal heart sounds. There is no dullness upon listening to the heart. Rectal exam reveals normal sized prostate and no bleeding/blood in the stool. Abdominal exam reveals only mildly enlarged liver, normal spleen and no areas of tenderness. The jugular vein appears distended when in a reclined position to 30 degrees, but not when upright. Central venous pressure measured by JVD is 9cm H2O. 1) Considering the Starling forces (not cardiac Frank-Starling law) Nursing Case Study Assignment Paper