Problem
This is Robert. He is an 88-year- male patient. He came into the ER last night and was admitted to 3S cardiac telemetry floor that you work on. You are his nurse today. You go in to assess your patient today and you notice that he is SOB. He starts to cough and you notice the sputum is frothy that he coughed up. He tells you that he feels very tired, and this is not normal for him. Report from night shift nurse. Molly RN states that Robert arrived at 2300 last night from ER. She states that Robert seems confused at times, That when he lays down to go to sleep he becomes more short of breath. She states that she hears S3 heart sounds on auscultation. Lung sounds are bilateral crackles. Patients skin is warm and dry and intact. Your assessment- Bilateral crackles, dyspnea with and without activity. S3 heart sounds. Frothy sputum. Patient is alert to self and situation but not time. Vitals... B/P 88/58 HR 108, rep rate 30, Temp 97.6. Patients' history- HTN, CAD, Mitral valve regurgitation, High cholesterol, Chronic kidney disease stage 4. Labs- BNP - 2500 What do you think is going on with the patient? What is a BNP and what does Roberts level tell you about his disease process What are some medications you anticipate will be given. What are you patients risk factors? What kind of tests do you think the physician will order to diagnose your patient? What should you assess and monitor? What are your nursing interventions? What would you teach your patient about their new diagnosis?