PEPSI Heart Failure JoAnn Smith, 72 years old Primary Concept Perfusion Interrelated Concepts

JoAnn Smith, 72 years old Primary Concept Perfusion Interrelated Concepts (In order of emphasis) 1. Gas Exchange 2. Fluid and Electrolyte Balance 3. Clinical Judgment 4. Patient Education 5. Communication 6. Collaboration UNFOLDING Reasoning Case Study: STUDENT History of Present Problem: Heart FailureJoAnn Smith is a 72-year-old woman who has a history of myocardial infarction (MI) four years ago and systolic heart failure secondary to ischemic cardiomyopathy with a current ejection fraction (EF) of only 15%. She presents to the emergency department (ED) for shortness of breath (SOB) the past three days. Her shortness of breath has progressed from SOB with activity to becoming SOB at rest. The last two nights she had to sleep in her recliner chair to rest comfortably upright. She is able to speak only in partial sentences and then has to take a breath when talking to the nurse. She has noted increased swelling in her lower legs and has gained six pounds in the l