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Mrs. Jones, a 59 year old female reports she is having difficulty because she has severe pain in her calf muscles after walking for more than a city block. The pain decreases if she rests for a few minutes, but returns with activity. Her feet are cool to the touch and pale, pedal and posterior tibial pulses are not palpable, and femoral pulses are difficult to palpate. Lately, she has been experiencing periods of light headedness. History – Diabetes, type 2 since 55 years old She lives in an apartment and uses public transportation to travel across town to visit her husband’s grave site. She drinks 2 glasses of wine/day, high stress job as a manager in a mortgage company, on hormone replacement therapy. VS – BP 146/88; P 110; R 22; T 37⁰C (98.6⁰F) Medications – doxazosin(Cardura) 5 mg. PO at night; nifedipine(Procardia XL) PO Daily, amount unknown by patient; HCTZ 25 mg. PO daily; Lisinopril(Zestril) 10 mg. PO daily; metformin (Glucophage) 500 mg po bid . Diagnostic weekly visit the grave of her husband. She has to walk several blocks from her ride. Upon admission for cardiovascular disease management, the history shows a 1 pack day, ceasing in 2002. Hgt. 5’7″, Wgt. 190 Lbs., savory diet with fried foods x4/week, 2 glasses studies – Hbg. 12.6; Hct. 43; cholesterol 296; HDL 40; LDL 120; Triglycerides 312. Ankle-Brachial Index (0.04); A1C 8; EKG: Tachycardia, decreased cardiac contractility.

Assignment – A. Complete the attached concept map 

Image transcription text

Anticipated Studies – To Be Done and What Else Should Be Done (Think
about why) This patient is most likely suffering from peripheral artery
disease and aside from blood tests and ankle brachial index, a… Show more

 

 

 

 

B. Then answer these questions separately:

please include al her diagnoses when answering question Pad , hypertension diabetics and high cholestrol 

1. Based on the clinical data, rank the most likely problems by urgency. 

2. What additional lab tests do you anticipate being ordered for Mrs. Jones? Why? 

3. What additional medication(s) do you anticipate being ordered for Mrs. Jones? Why? (Your rationale) 

4. Explain why you selected the nursing measures (actions) you identified on the concept map to help Mrs. Jones? 

5. Identify any questions you may have regarding Mrs. Jones’ medical management. 

6. What have you gained (personal, nursing) by completing this case study?

Image transcription text

Past/Current History Should Be Done (Think about why) Past Medical
History – Diabetes type 2 since 35 yrs. Old Smoking history of 1 pack per
day, ceasing in 2002 This patient is most likely suffering from p… Show more

 

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HEALTH SCIENCE
NURSING
NURSING 253