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**Please make sure to number answers to match the corresponding question number.
**If the answer has multiple parts, please bullet the answers with the question number and a, b, c etc. For example 1a.
Image result for cartoon image of a student writing an assignment Case Analysis 2
A 78-year-old man is admitted to the hospital with the chief complaint of shortness of breath. He states the shortness of breath has been increasing over the past 2 months and is aggravated by exertion. He has found that he often awakens at night with a sensation of smothering that is partially relieved when he gets up and opens the window. He has had no ankle swelling or edema noted in the peripheral areas.
Past medical history is only positive for myocardial infarction 8 years ago. He currently does not have complaints of chest pain or pressure.
BP is 140/98. When the nurse listens to his heart, she hears a normal S1 and S2 with a rate of 88. When listening to the lungs, the nurse notes bi-basilar crackles on inspiration. The patient complains of an occasional dry irritating cough.
1. What would the nurse suspect that the diagnosis might be given the patient’s symptoms?
Describe the pathophysiology of left-sided heart failure.
In contrast, describe the pathophysiology of right sided heart failure from a cardiac and non-cardiac perspective. Describe why the patient may have the following classification of drugs administered by the nurse?
Diuretics ACE inhibitors. If held, what might be your next “go to” class of meds?
β-blockers
Cardiac Glycosides (digoxin) Normal value? Symptoms of toxicity? What would be your nursing concerns if on admission to the hospital, you note that the MD has ordered a calcium channel blocker? What lab test might be ordered that would help in diagnosing Heart Failure? What value is considered diagnostic? What is the normal value? Where is this substance made in the body? What is its function?
What supplement would you want to see ordered for the patient if he was on a diuretic such as lasix? In what range would you want to keep the lab value for this supplement?

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