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Case Study Essay

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Case Study #5 Heart & Neck Vessels, Lungs & Thorax Mrs. Lee, 80 year old Asian American female Admitted to the medical-surgical unit with a chief complaint of “breathing problems”. She speaks broken English & requests that her daughter be allowed to stay with her. She is on nasal cannula oxygen & sitting up in bed. At this time, she seems slightly short of breath, but is not in acute distress. You note that she is pale & has a petite frame. Her ankles are swollen. Her daughter tells you that she has been complaining of feeling more tired in the evenings & “unable to catch her breath”. While at home, she has been sitting up either in an easy chair or in bed with three pillows. Her daughter states that Mrs. Lee has not had to …show more content…

2. What additional questions should you ask regarding this patient’s chief reason for seeking care? Chest pain, dyspnea (especially on exertion), orthopnea, cough, fatigue, cyanosis or pallor, edema, nocturia, history of cardiac problems, family history of cardiac problems, cardiac risk factors, & current medications. 3. After completing the health history, you prepare for the physical examination. What steps should you include in your assessment? Inspection, palpation, percussion, & auscultation of lung sounds, heart sounds, & adventitious sounds. 4. What should you keep in mind, regarding this patient’s age, when assessing her neck veins? View the right internal jugular vein when measuring jugular venous pressure. With aging, the aorta stiffens, dilates, & elongates, resulting in decreased pulsations on the left side. In addition, use caution when palpating & auscultating the carotid artery. Pressure in the carotid sinus may cause a reflex slowing of the heart rate. 5. Describe how you would assess her heart sounds. Explain to her (through her daughter as necessary) what you will be doing. You might want to explain that t takes extra time to listen to her heart & that just because you listen for a long time does not indicate there is a problem. Move your stethoscope in inch-long increments, in a Z pattern across the chest, from the base of the heart, across & down, then over to the apex. Although heart sounds are generally lower in pitch,

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