C.B. 70 years old female patient, retired history teacher presents today with gradual onset progressive dyspnea on exertion
C.B. 70 years old female patient, retired history teacher presents today with gradual onset progressive dyspnea on exertion
Reflection: Address the following questions:
- Which diagnostic tests did you select for this client? Using the estimated national average cost for each diagnostic test from a website such as MD saveLinks to an external site., https://www.mdsave.com/ calculate the total cost for diagnostic testing for this client if she was uninsured and did not meet age requirements for Medicare. How might this information change your decision to order diagnostic tests for the client? Would lack of insurance change your management plan? Why or why not?
- The client in this encounter would likely benefit from community and health care support services. Which services might you recommend? What is available in your community? What is the process of referral in your area?
Patients diagnosis: Aortic Valve Stenosis
Community: Miami Dade County in Florida
Diagnostic Tests Ordered:
– 12 lead electrocardiogram EKG
– BNP brain natriuretic peptide
– Chest Xray, PA and Lateral
– Complete blood count CBC
– Coronary angiogram (cataterization)
– Arterial Blood gas ABG’s
– Echocardiogram Transesophageal TEE
– Echocardiogram transthoracic TTE
– Holter cardiac monitor
– Peak expiratory flow PEF
– Pulmonary Function test PFT
– cardiac nuclear stress test Lexiscan
Scenario : C.B. 70 years old female patient, retired history teacher presents today with gradual onset progressive dyspnea on exertion for approximately over 2 years. Patient reports vasovagal episode x 2 months ago while running after grandson, fatigue and mild difficulty to perform IADLs and SOB with exertions going up stairs). Reports mild swelling to bil ankles by end of day. PMHx includes HTN, Osteoporosis. Former smoker + 26 pack year history. Denies wheezing, asthma, cough, TB hx, orthopnea, PND, hx of heart disease or DM. PE reveals systolic murmur, bil +1 peritibial edema, Carotids/abdominal and femoral auscultation inconclusive findings. Normal lung sounds, No crackles, BP elevated. Patient denies traveling, MMR disease Hx., hx of bleeding disorders. Denies alcohol intake. Currently on amlodipine and Alendronate.
Requirements: as long as needed to cover requirements
Masters Nursing
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