Cardiac Case Study

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Meet the Client: Bert Graham Sixty-three-year-old Bert Graham visits the health care clinic complaining of increasing fatigue and difficulty breathing. Physical assessment findings include a rapid, irregular heart rate of 138 beats per minute, BP of 140/86, and a respiratory rate of 28. His breath sounds are clear with fine crackles in the bases bilaterally. He has positive jugular vein distention (JDV) bilaterally and 1+ pitting edema of his ankles bilaterally. His initial medical diagnosis is heart failure (HF). Bert is immediately admitted to the acute care facility for further evaluation and treatment. Heart failure is called cardiac failure, pump failure, or congestive heart failure (CHF). It is defined as the inability of the heart to pump enough blood to meet the tissue's oxygen demands. Risk Factors Heart failure occurs most commonly in clients over the age of 60, and occurs more commonly in males than females. 1. In addition to these two risk factors, which question will provide the nurse the best data about any additional risk factors for heart failure? [pic]"Do you have any chronic lung disorders?" Lung disorders, such as asthma and chronic bronchitis, are not commonly associated with an increased risk for heart failure. However, they can precipitate heart failure. [pic]"Have you ever had a heart attack?" Correct Myocardial infarction, coronary artery disease, and ischemic heart disease are among the most common underlying causes of heart failure. In fact, the most common cause of heart failure is myocardial infarction. The nurse should also ask Bert if he has hypertension, another primary underlying condition causing heart failure. [pic][pic] [pic]"Do you have varicose veins?" Varicose veins are not associated with an increased risk for heart failure.

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