Mr. C, a 70 year old presented to the FR with complaints of a gradual increase i
ID: 212755 • Letter: M
Question
Mr. C, a 70 year old presented to the FR with complaints of a gradual increase in shortness ot breath over the past couple of months. On assessment, the NP noticed that Mr. C. has 2+ pitting edema in his ankles. Vital signs are HR-| 06, RR-28, 52/96.. He has a productive cough, difficulty sleeping for the past 2 months and usually wakes up around 2 am; sleeps best in recliner while watching TV. le stated that he has chest tightness at times Ms. K, age 52 presented to the hospital with complaints of back and jaw pain. She also complained of severe stomach pains, nausea and vomiting. On assessment, she looked very palc, skin was cool and clammy. Vital signs are 70/50, HR 110, RR 36. Ms K. appeared confused at imes. Her family stated she started complaining of jaw and neck pain about 20 minutes earlier. Blood work was completed on both patlents. The lab provided the following results: A. Tropanin T .5 ng/ml CK-MB/CK isoenzyme 1% of total CK Creatine phosphokinase (CK) 148 units L Myoglobin 80mcg/l B. Troponin T 5.5ng/ml CK-MB/CK isoenzyme 5%oftotal CK Creatine phospbukinase (CK) 10 unilsL Myoglobin 140 mcg/L. 1. What is the most likely diagnosis for Mr. C? 2. What is the most likely diagnosis for Ms. K? . Which of the above cardiac markers would you expect to represent Mr. C's diagnosis? State e your rationale. Which of the ahove cardiac markers would you expect to represent Ms. K's diagnosis? State your Additional assessment included a low grade fever of 99.8 and lab results of potassium 6.2, glucose 160 and WBC 11,000. This information would most likely reflect Mr. C's on 4. rationale S. Ms K's diagnosis? State the rational for your answer and identify the reason for cach abnormal value Additional assessment included a BNP of 1000 pg/mL and an ejection fraction (EF) of 20%, which one of the patienis would mosl likely have these results? Identify lhe reason for the values Which patient would most likely have a history of mitral valve prolapsed? Which paticnt would most likely have a history of hypertension? Describe the heart sound you would expect to bear when you auscultate over the heart for Mr. C and for Ms, K? 6. 7. 8. 9. 10. Identily all the symptoms you would expect to assess for Mr. C. and Ms. K 11. Which one of the following Chest x-rays would most likely support Ms. K's diagnosis? State the rational for your answer.Explanation / Answer
Answer 1) MR. C is diagnosed with cor pulmonale.
Answer 3) hgh heart rate, high blood pressure, pitting edema in anklets, pulmonary hypertension.
Answer 5) the assessment gives the information of MR. C diagnosis disease because swelling an ion inatkes are related to salt inkake. low quantity of intake decreases heart rate and blood pressue while high intake involves increase heart rate and bloop pressure.
Answer 2) MR. K is diagnosed with meningitis.
Answer 4) cardiac marker invoves breathing fast, stiff neck, pale skin, muscle pain, severe headache, fever.
Answer 7) MR. C, because he suffers from a cardiac disease.
Answer 8) MR. C
ANSWER 9) high breathing rate,, heavy sound can be heard from stetoscope for both MR. C and MR. K.
Answer 10) symptoms for diagnosis of MR. C=
-high blood pressure, pulmonary disease, chronic blood clots, hypertension, swelling, headache, early heart attack.
symptoms of meningitis=
-fever, vomiting, headache,muscle pain, pale skin, fast brathing, rashes,stiff neck, sleepy.
Answer 11) MR. C heart rate can be diagnosed by figure (b) X-Ray reports. since he is breathing fast due to disease.
Answer 12) Normal heart X-ray.
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