Nursing Aortic Stenosis Post

Nursing Aortic Stenosis Post

Create a discussion of a minimum of 300 words with the following

Question: Does my patient have significant aortic stenosis?

A 72-year-old woman with a history of CHF presents with several weeks of gradually progressive dyspnea on exertion (DOE). At her baseline, she is able to walk several blocks but now feels winded. She denies chest pain, palpitations, syncope/near syncope, cough, orthopnea, or PND. She states she is compliant with her medications and diet. She has had a recent functional study that showed minimal ischemia.

Meds

aspirin
digoxin 0.125 qi
lisinopril 20 mg qi
furosemide 20 mg qi
Kc 10 me qi

PE

HR 90, regular
PB 134/70

Nursing Aortic Stenosis Post

Labs

chem 7:
Na 132
K 5
Cl 94
HCO3 30
BUN 18
Cr 1.3
CBC: notable for Hgb 14 g/dL (Hect 43%)

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CV

RRR, normal S1 and S2
No S3 but has S4
2/6 mid-peaking systolic murmur at the LUSB that radiates to the carotids.

PMI is mildly enlarged and sustained

Neck

Carotid pulse is brisk.
JVP flat
Positive abdominojugular reflux

CXR

Xray shows cardiomegaly and mild vascular redistribution

ECG

Unchanged with an incomplete LBBB pattern

Clinical Diagnosis

Worsening of her congestive heart failure (positive AJR, enlarged and sustained PMI, cardiomegaly, and vascular redistribution).

Clinical Questions

Is this patient’s worsening CHF due to significant aortic stenosis?

Please elaborate why you think it may be aortic stenosis according to the patient’s symptoms and how do you assess each symptom.

CXR

Xray shows cardiomegaly and mild vascular redistribution

Nursing Aortic Stenosis Post

ECG

Unchanged with an incomplete LBBB pattern

Clinical Diagnosis

Worsening of her congestive heart failure (positive AJR, enlarged and sustained PMI, cardiomegaly, and vascular redistribution).

Clinical Questions

Is this patient’s worsening CHF due to significant aortic stenosis?

Please elaborate why you think it may be aortic stenosis according to the patient’s symptoms and how do you assess each symptom.

Clinical Questions

Is this patient’s worsening CHF due to significant aortic stenosis?

Please elaborate why you think it may be aortic stenosis according to the patient’s symptoms and how do you assess each symptom.