NRS 410V Module 3 Mrs. J. is a 63 year old woman NRS 410V Module 3 Mrs. J. is a 63 year old woman

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A + Solution NRS-410V Module 3

Pathophysiology and Nursing Management of Clients Health – Alterations of Hematology and Cardiovascular Systems

Use the following Case Scenario , Subjective Data , and Objective Data to answer the Critical Thinking Questions .

Case Scenario

Mrs . J . is a 63-year-old woman who has a history of hypertension , chronic heart failure , and sleep apnea . She has been smoking two packs of cigarettes a day for 40 years and has refused to quit . Three days ago , she had an onset of flu with fever , pharyngitis , and malaise . She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days . Today , she has been admitted to the hospital ICU with acute decompensated heart failure .

Subjective Data 1 . Is very anxious and asks whether she is going to die . 2 . Denies pain but says she feels like she cannot get enough air . 3 . Says her heart feels like it is " running away ." 4 . Reports that she is so exhausted she cannot eat or drink by herself . Objective Data 1 . Height 175 cm ; Weight 95.5 kg 2 . Vital signs : T 37.6 C , HR 118 and irregular , RR 34 , BP 90 / 58

3 . Cardiovascular : Distant S1 , S2 , S3 , S4 present ; PMI at sixth ICS and faint ; all peripheral pulses are 1 +; bilateral jugular vein distention ; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation