Room 815-2. P.R. is a 77 year old nursing home resident with congestive heart failure (CHF). He is a bedridden patient due to his activity intolerance. He has a total self-care deficit because even limited activity results in chest pain. At the nursing home, the nurses give him Nitroglycerin (1/150 gr) 1 tablet SL whenever he has chest pain. He has a history of three previously documented MI’s with limited left ventricular function. He has been admitted with recurrent CHF with a respiratory rate of 44, and an oxygen saturation of 88% at the nursing home. The night nurse reports hearing a S3 gallop. His morning labs are: BNP 1098, hemoglobin-7.9, hematocrit 38%, and potassium 3.0. He had an echocardiogram done last evening which showed an ejection fraction of 35%. Home medications include: captopril 25 mg BID, furosemide 60 mg daily, potassium 20 meq daily.
1. define all the medical diagnosis, and evaluate all data describing it as normal or abnormal and implications of that information.