Pathophysiology Top Priority Diagnosis Based On A Patient Complains and History

older adult: cad, htn, hld mr. sullivan, a 79 y/o current 1 pk/day smoker for over 50 yrs, has the diagnoses of hypertension (htn), hyperlipidemia (hld) & a relative new diagnosis of coronary artery disease (cad) having had a non st elevation myocardial infarction (nstemi) 4 weeks ago. he presents to the health clinic today for a routine follow-up following his mi. he tells the health care provider that he is short of breath (sob) lately, has been sleeping in the recliner for the past week as he would wake up when sleeping in his bed, with air hunger. he tells you that he now gets sob walking up the driveway after retrieving his newspaper in the morning. he also tells you that his socks are quite tight around his ankles & his shoes seem too small. he has no medication or food allergies. home medications include: ec asa 81 mg daily, clopidogrel 75 mg daily, metoprolol tartrate 50 mg q 12 hr, lisinopril 5 mg daily, atorvastatin 40 mg hs, and ntg sl prn chest pain. vital signs: bp 156/88, hr 110, rr 26, pox 90% ra, temp 97.8. weight 89 kg today; on hospital discharge weight documented at 81 kg. physical assessment: neuro a & o x3; neck +jvd to the ear lobe; lungs crackles throughout; heart sounds regular, tachycardic, s3, s1,s2, no murmurs appreciated; abd soft, nontender, nondistented, bowel sounds +; extremities pp+, 3+ pitting pedal edema. in your review of this case, for your initial posting address the following questions, including 1 references. please post the question before your response. 1. what do you consider the top priority diagnoses based on your understanding of this case? support your decision for your diagnoses & their priority. 2. briefly explain the pathophysiology r/t to the priority diagnoses. what client history & assessment data help support your priority diagnoses? 3. how do his medical diagnoses link together?
Based on the complaints presented by this patient, the first priority diagnosis is Pulmonary hypertension (PH).Pulmonary hypertension occurs when blood pressure within the lungs becomes abnormally elevated. It can be caused by a thickening of the pulmonary artery walls, heart failure and lung disease. It is common for ILD patients to also develop pulmonary hypertension and therefore causing Heart failure (Guazzi, 2014). Symptoms generally only occur once the disease starts to progress. Symptoms include shortness of breath, dizziness, and fainting, irregular heartbeat, racing pulse, shortness of breath during climbing of stairs or heights, difficulty breathing while lying flat, and swelling of the ankles.
As pulmonary pressures rise and right heart failure ensues, the physical findings of PH become less subtle. Examination of the jugular pulsations can reveal elevated neck veins and prominent v-waves. In the setting of more profound RV dysfunction, ….Please click the Paypal icon below to purchase full solution for only $10