The client’s creatinine and serum potassium were elevated, she was referred to a nephrologist for possible dialysis. Make pathophysiology on how kidney failure happens to a client with acute congestive heart failure. 2. Create CHART (C-hief complaint, H-istory, A-ssessment, R-x/treatment, T-ransport) documentation for the patient. (see 2nd photo for reference)
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QUESTIONS.
1. The client’s creatinine and serum potassium were elevated, she was referred to a nephrologist for possible dialysis. Make pathophysiology on how kidney failure happens to a client with acute congestive heart failure.
2. Create CHART (C-hief complaint, H-istory, A-ssessment, R-x/treatment, T-ransport) documentation for the patient. (see 2nd photo for reference)
Thank you!
Step by step
Solved in 3 steps
- This is a case of a 65 year old female with a 10 year history of hypertension and diabetes. She is taking Micardis 40 mg in the morning and Amlodipine 5 mg at night for hypertension. For diabetes she is being given Janumet 100mg/1g 2x a day and Gliclazide 60 mg OD before breakfast. The daughter reported poor compliance with medications. The patient was brought to the emergency room due to difficult of breathing. Condition started 2 days PTA when the patient had easy fatigability going to the comfort room. She started taking all her medications again but she did not seek consult. Symptom persisted until she would have difficulty of breathing when getting out of bed. In the emergency room BP 180/100 HR 110/min RR 35/min O2 sat 93%, Temp 36.8, patient is pale, diaphoretic and in severe respiratory distress. (+) edema up to the knees area, (+) crackles from lower to mid portion of the lungs. In the emergency room, the client was given O2 per canula at 4-5lpm. IVF was initiated. The doctor…This is a case of a 65 year old female with a 10 year history of hypertension and diabetes. She is taking Micardis 40 mg in the morning and Amlodipine 5 mg at night for hypertension. For diabetes she is being given Janumet 100 mg/1g 2x a day and Gliclazide 60 mg OD before breakfast. The daughter reported poor compliance with medications. The patient was brought to the emergency room due to difficulty breathing. Condition started 2 days PTA when the patient had easy fatigability going to the comfort room. She started taking all her medications again but she did not seek consultation. Symptoms persisted until she would have difficulty breathing when getting out of bed. In the emergency room BP 180/100 HR 110/min RR 35/min O2 sat 93%, Temp 36.8, patient is pale, diaphoretic and in severe respiratory distress. (+) edema up to the knees area, (+) crackles from lower to mid portion of the lungs. In the emergency room, the client was given O2 per cannula at 4-5lpm. IVF was initiated. The…Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. What concerns do you have with the propranolol?
- Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. What role does Lisinopril have in patients with DMPatient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTNList the long term complications of DMPatient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. Despite her medication regimen, her blood sugar has been very, very high and her physician decidedto start a long acting insulin. Which insulins are long acting?
- Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. What type of diabetes does she have?2. Describe the mechanism of action of metformin. In which patients is metformin contraindicated?3. List some non-pharmacologic measures that can lower her blood sugar?4. List the long term complications of DM5. What role does Lisinopril have in patients with DM?6. What concerns do you have with the propranolol?7. Despite her medication regimen, her blood sugar has been very, very high and her physician decidedto start a long acting insulin. Which insulins are long acting?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygiene