Reference no: EM133787080

Question

Mr Johnson is a 57 yo male that admitted to your unit from the emergency department last night c/o increasing SOB and inability to lie flat in bed and has been sleeping in a recliner. He states he has not been able to wear some of his shoes due to his feet swelling. He has a history of Hypertension, Diabetes type II, A fib, Hyperlipidemia. EF 45%. He lives with his wife of 35 years. You have completed receiving report and make rounds on your patient. The following are his vital signs the HSA has reported to you. BP 162/54, HR 120, T 98.6(oral), 02 sat 91% on 1L nasal cannula., Resp. rate 24/min. You go to his bedside and find him mildly diaphoretic, RR 28/min and using accessory muscles. His heart rate is 124/min and irregular. He is alert and oriented but states he feels a little anxious. He has voided a "small amount" per the CNA via urinal. His morning labs Troponin is 0.10 ng/ml, BNP 1725 pg/ml, (previous BNP 455 on admission), Na +138, K+3.2, BUN 45, Creat 1.9, CL 98, CO2 22, Gluc 127. Orders include: Titrate 02 to keep sat>92%, Lasix 40 mg IVP.