NURSING 101 CASE STUDY – HEART FAILURE Patient: Donald Bergman

CASE STUDY – HEART FAILURE Donald Bergman Patient Assignment D.B. is a 67-year-old male who was admitted to the telemetry unit 1 day ago for medical management with a diagnosis of chronic heart failure (HF). D.B. has a 20-year history of hypertension and had an MI 6 years ago. He began having fatigue, tachycardia, and dependent bilateral lower extremity edema about 18 months ago, and was diagnosed with right ventricular HF. He was already taking enalapril for hypertension and was prescribed furosemide, potassium, and digoxin after his HF diagnosis. D.B.’s symptoms have worsened over the last month. Upon admission 1 day ago at 0800 VS: T 36.4° C (97.5° F), BP 156/98, P 126 and regular, R 36 and labored. O2 saturation 88% on RA. He had 3+ pitting edema in his feet and ankles, dyspnea, tachycardia, JVD, and crackles bilaterally in his lungs. He stated that he has been unable to “get enough air,” has been sleeping in the recliner, and has gained 5.5 kg (12 lb) in the past month. Admission weight 100 kg (220 lb), height 177.8 cm (70 in). He is a full code.