Question

CHAPTER 19 CLASS EXERCISE IN-CLASS CASE STUDY S.P. is a 75-year-old female who presents to the provider's office with fatigue. Subjective Data PMH: HTN, hyperlipidemia, MI 3 years ago Fatigue started about a month ago, getting worse Relieved with rest, exacerbated with activity Denies chest pain Ankles swollen Objective Data Vital signs: T 37 P 112 R 18 BP 110/54 Lungs: bilateral lower lobe cfackles О, Sat-94% Skin cool to touch Cy heart rate regular, positive peripheral pulses, ECG no changes +2 edema bilateral ankles Medications: Metoprolol 20 mg per day, 325 mg of aspirin per day Questions 1. What other questions should the nurse ask about the fatigue? 2. What other assessments are necessary for this patient? 3. What are some causes of fatigue? 4. Develop a p list from the objective and subjective data. 5. What should be included in the plan of care? 6. Based on the readings, what is the most likely cause of fatigue for this patient?

Answer 1

Solution:-

1. WHAT OTHER QUESTIONS SHOULD THE NURSE ASK ABOUT THE FATIGUE? The medical attendant can get some information about 1. what time do you rest in the night? ( in light of the fact that adjustments in sleep times can cause exhaustion) 2. Do you have torment around evening time? ( on the grounds that patient have the indication of chest torment and to know how frequently) 3. What drugs do you take around evening time?

2.OTHER ASSESSMENTS:a) Routine research facility test ( Hemoglobin, serum creatinine and lipid profile) b) Chest x-beam ( to discover lung blockage) c) Electrocardiogram ( to discover the beat and heart changes) and d) Echocardiogram ( to discover the cardiovascular capacities).

3. A few CAUSES OF FATIGUE: Fatigue implies feeling of outrageous tiredness. The reasons for weakness incorporates an) endocrine/metabolic scatters, for example, iron deficiency, hypothyroidism, kidney and liver ailments, diabetes and electrolyte irregularity. b) Infections causing, for example, hepatitis, flu, intestinal sickness, tuberculosis and HIV diseases. c) cardiovascular and aspiratory ailments( congestive heart disappointment, coronary supply route illness, valvular coronary illness, asthma, constant obstuctive aspiratory ailment and pneumonia. d) meds, for example, antidepressants, narcotic, and hypertension drugs causes exhaustion. e) rest issues and f) nutrient insufficiencies, for example, nutrient B12 lack, nutrient D inadequacy, press lack causes weariness.

4. Rundown OF DISEASES: From the rundown of signs and manifestations from goal and emotional information, the patient may have issues like cardiovascular, pneumonic and kidney disappointments.

5. PLAN OF CARE: a) ceaseless observing of fundamental signs (temperature, circulatory strain , pulse and breath) b) confine the liquid admission to 1liter/day c) screen the admission and yield graph. d) weight day by day to screen the liquid status in the body e) assess every day the level of size of edema and ascultate lung and heart sounds. f) help the patient to keep up a place of solace to decrease weariness and to lessen the pain. g) turn the patients position as often as possible to keep from bedsore as a result of liquid over-burden. h) chest physiotherapy to decrease the lung discharges and to keep from some other complexities and I) oxygen treatment. 6. These side effects that patient experience is a direct result of low heart yield.