Care of Patients with Cardiac Problems

Care of Patients with Cardiac Problems

Chapter 35: Care of Patients with Cardiac Problems

The Patient with Aortic Stenosis

A 49-year-old woman is admitted to the hospital for a report of syncope and dyspnea on exertion. The patient states that, after she ambulates 20 to 30 feet, she has difficulty breathing and stops to rest for 1 to 2 minutes. The patient reports experiencing marked fatigue with her daily routine in the past month.
Assessment reveals bilateral 2+ edema of the lower extremities. Radial pulses are 2+ bilaterally and pedal pulses are 1+ bilaterally. Capillary refill of the fingernail beds is less than 3 seconds. Auscultation of heart sounds reveals a systolic murmur. Her abdomen is soft and nontender with bowel sounds auscultated in all four abdominal quadrants. The skin is warm, dry, and intact. The patient is alert and oriented to person, place, and time.
Auscultation of the lungs is clear in the upper lobes anteriorly and posteriorly, with fine crackles in the anterior and the posterior bases. It is noted that the patient has a dry, nonproductive cough. The patient says that, at night, she sleeps in a recliner and has been doing this for several months. Professional Custom Writing Services from the Experts!
A history of the patient includes endocarditis 10 years ago that was treated with antibiotics. Vital signs are: temperature, 98.7° F (37.1° C); heart rate, 72 beats/min, in sinus rhythm with first-degree atrioventricular (AV) block; respirations, 22 breaths/min; pulse oximeter reading 92% on room air at rest.

The physician has confirmed the diagnosis of aortic stenosis from the following procedures:
Transesophageal echocardiography
Electrocardiogram (ECG)
Stress echocardiography

1. What is aortic stenosis?

2. Of the following below, what are the top three patient problems in this case study? AND why are they the three top (explain in detail)

-Inadequate oxygenation related to cardiac problem.
-Decreased Cardiac Output.
-Fatigue and weakness related to cardiac problem.
-Insufficient knowledge related to the new diagnosis.
-Possible risk of neurologic problems.

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