The History Of Coronary Heart Failure And Chronic...

Introduction T.S. is a 75-year-old male who has a history of coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, cerebrovascular accident, hypertension, myocardial infarction, renal failure, atrial fibrillation, dyslipidemia, and severe cervical spinal stenosis C4-5. He underwent many procedures in the past, including coronary artery bypass graft, implantation of IV dual chamber permanent pacemaker, exploratory laparotomy, and cardiac pacemaker in situ. TS came into the ER at MMMC with complaints of nausea and vomiting, on March 21, 2017. He has been feeling nauseated and not feeling well for 3 days. When TS arrived at the ER, his peripheral capillary oxygen saturation or SpO2 was 80%, so 3L of oxygen†¦show more content†¦TS has not been tolerating his hemodialysis, and has been hypotensive. During my shift, midodrine was given prior to going to his hemodialysis to increase his blood pressure. TS’s diabetes is not well controlled; he had capillary blood glucose of 178 on March 22. He is currently receiving a sliding scale injection of Humalog. TS is not able to ambulate, stating, â€Å"they use hoyer lift to transfer me.† During his swallowing evaluation, I noticed that he was not able to lift up his right hand, and both of his upper and lower extremities were swollen. I also noticed that he had healing ulcers to his left and right second toes, and on the plantar surface of his fourth toe. He also had abrasion on his right shoulder, and a blister on his right elbow, covered with a dressing. After his session with the occupational therapist, we helped him reposition to reduce excessive pressure on his bony prominences. When I peeked at TS’s room after we documented his swallowing evaluation, he was staring at the window. He has depression, and a history of suicidal attempt. It would have been helpful to have a therapeutic communication with him, to help him express his feelings about his situation. Reflection Unfortunately, I was only with TS during my PT and OT experience for his swallowing evaluation. I was able to assist the occupational therapist with TS’s evaluation. During my hospital experience, TS went to his dialysis. I was not able to do a lot of interventions for his multipleShow MoreRelatedDisease Condition : Heart Failure906 Words   |  4 Pages Heart Failure Marikate Williams Delaware County Community College Disease Condition Heart failure (HF) is a chronic, progressive condition defined as the hearts inability to efficiently pump an adequate amount of blood to meet the demands of the body (Naab, 2011). 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