A 55 year old Caucasian male with a diagnosis of congestive heart…

Question Answered step-by-step A 55 year old Caucasian male with a diagnosis of congestive heart… A 55 year old Caucasian male with a diagnosis of congestive heart failure (CHF) secondary to cardiomyopathy. Eight months ago, he developed a moderately severe upper respiratory infection infection (URI), which progressed into an acute febrile illness with hepatic, renal, and cardiac symptoms. At the time, he was diagnosed with viral myocarditis, for which he was treated with azathioprine and prednisone. Since that time, he has experienced progressive dyspnea with four hospitalizations for treatment of CHF, and remains in the hospital at this time. After a thorough diagnostic work-up that included an endomyocardial biopsy, he as diagnosed with dilated cardiomyopathy secondary to the previous bout of viral myocarditis. His ejection fraction has progressively fallen during the past during the past 4 months and is now 21%. This patient is unable to perform even the most basic activities of daily living. Due top his rapidly deteriorating condition, he remains in the medical ICU awaiting a donor heart for transplantation. A pulmonary artery catheter (PAC) has been placed to monitor hemodynamic changes and to guide therapy. The patient also has an arterial line placed in the left radial artery. Vital signs: HR 132/min, RR 28/min, BP 110/60, SpO2% N/A, Temperature 36.8 degrees. Appearance: Cachectic, height 6ft.1in, Weight 135 lbs, in moderate respiratory distress, conscious, alert and oriented X3, very anxious. HEENT: Normal in appearance, PERRLA, cranial nerves intact. Neck: Trachea in the midline with noticeable JVD, bilateral carotid pulse with no bruits. Chest: Inspection is normal thoracic configuration, palpitation – Pulsus alternans is noted. The PMI is displaced laterally. Auscultation: Bibasilar crackled heard on inspiration and exhalation. CV: S1 and S2 heart sounds are heard diffusely along with S3 and and S4 gallop. Abdomen: slightly distended with evidence of hepatomegaly and positive hepatojugular reflex. Extremities: Cool and clammy with some nailbed cyanosis and capillary refill time of 10 seconds. a. What inference can you make about the potential for this patient to develop both pulmonary and dependent edema and why? What additional data would you obtain for your assessment of this patient in the ICU?b. What specific findings do you anticipate and how would they guide you in the management of this patient? Health Science Science Nursing RESPIRATOR MISC Share QuestionEmailCopy link Comments (0)