What subjective information should the nurse obtain?
When assessing a patient, nurses collect a wide range of data to determine their feelings and perceptions before making decisions regarding medication and diagnosis. While subjective data is obtained by interviewing the patient, objective data can be measured through physical examination or through making observations. In the case study, the nurse will collect information about how long the patient has had breath shortness symptoms, swelling of legs, and productive cough. Collecting this information will enable the nurse to determine how long the patient has been sick before visiting the healthcare facility (Crowley et al., 2017) . The nurse could discover whether the patient has sort medication for the reported symptoms by collecting such data and information. The nurse should ask the patient how long her blood pressure has been high. The nurse will discover whether the patient has a previous case of high blood pressure of the health condition is prolonged. The nurse will collect information about the patient’s duration of productive cough. The nurse should also collect information about the duration of time the patient has reported swelling in her legs. It is essential that the nurse enquires if the patient’s family has any history of family conflicts and other influence of culture which could trigger congestive heart complications and the stated symptoms.
The nurse is assessing the patient’s pulses. Which locations should the nurse check?
The nurse should check the pulse rate of a patient while making a physical examination of a patient. By assessing the pulse rate, the nurse discovers any abnormality in the heart rhythm. The nurse collects the data by taking data on the rate of heartbeat counts. The counts indicate the strengths of the heart's contraction. There are several locations where a nurse can collect information on a patient's pulse rate. The locations are the pedal pulse, the brachial pulse, and the popliteal pulse. The pedal pulse is measured from the wrists or the pedis on top of the foot. The nurse can sense any disruptions in the flow of blood through the various patients' arteries. An average pulse rate assumes a range of 60 to 80 counts per minute (Isler et al., 2019) . The rate tends to be higher in children. By taking the pedal pulse rate, the nurse can discover any heart challenges. The brachial pulse rate is measured from the anterior elbow aspect. The nurse's equipment is a stethoscope; however, a blood pressure cuff or the sphygmomanometer is also used to measure the patient's blood pressure. Examining the popliteal pulse is critical for a patient in the case study, reporting swollen legs. The popliteal pulse is located behind the knee, where blood flows to the popliteal artery, which facilitates the flow of blood to the lower part of the leg. Several health disorders disrupt the flow of blood from the popliteal pulse and the artery. The nurse in the case study needs to determine whether the patient's illness has affected the popliteal pulse rate.
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The nurse needs to evaluate the adequacy of the collateral circulation before obtaining an arterial blood gas sample. How should the nurse proceed?
In evaluating collateral circulation's adequacy, the nurse needs to check the patient’s nail beds and hands for the capillary review. The nurse can also check the brachial pulse, the radial pulse, or the pedal pulse. The nurse should ensure the patient is informed about the medical procedures that she is set to undergo. The patient’s family should be allowed to be part of the medication decision making. A deficiency of enough circulation in the pedal pulses could imply that there would be limited or no pulse in the peripherals. Before obtaining the arterial blood gas, the nurse should ensure that the above is accomplished.
What is the most likely cause of this patient’s shortness of breath, productive cough, and swelling in both legs?
The most likely cause of the patient’s symptoms is congestive heart failure. The symptoms mentioned by the woman are similar to the symptoms reported by patients with congestive heart failure. The significant heart failure symptoms include difficulties in breathing, swellings in the patient's feet and legs, and productive coughing.
Reference
Crowley, M. J., Diamantidis, C. J., McDuffie, J. R., Cameron, C. B., Stanifer, J. W., Mock, C. K., ... & Williams Jr, J. W. (2017). Clinical outcomes of metformin use in populations with chronic kidney disease, congestive heart failure, or chronic liver disease: a systematic review. Annals of internal medicine , 166 (3), 191-200.
Isler, Y., Narin, A., Ozer, M., & Perc, M. (2019). Multi-stage classification of congestive heart failure based on short-term heart rate variability. Chaos, Solitons & Fractals , 118 , 145-151.
