Chapter 31, Problem 3CAQ

Summary Introduction

To determine:

During the assessment of the patient’s heart, what position should Mrs. M assume, and what might you expect as you locate the PMI.

Case summary:

The nurse receives morning report for Mrs. M, age 71, admitted to the hospital yesterday with fatigue, a cough, and dyspnea; she is diagnosed with chronic heart failure. She states that she had increasing difficulty with shortness of breath and swelling in her legs. Pedal pulses are +1 bilaterally. On auscultation the nurse hear bilateral crackers in the lung bases and an S₃ gallop when auscultating the heart. Respiratory rate is 18; heart rate is 84 and regular. The patient has an occasional non-productive cough. She is receiving 2L of oxygen by nasal cannula.