NSG6440 week 4 discussion latest 2018 july

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Week 4
discussion
Discussion
This week’s content addressed common chronic diseases. Please review the case study below and answer
the following questions:
A sixty-year-old baker presents to your clinic, complaining
of increasing shortness of breath and nonproductive cough over the last month.
She feels like she can’t do as much activity as she used to do without becoming
tired. She even has to sleep upright in her recliner at night to be able to
breathe comfortably. She denies any chest pain, nausea, or sweating. Her past
medical history is significant for high blood pressure and coronary artery
disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is
married and is retiring from the local bakery soon. She denies any tobacco,
alcohol, or drug use. Her mother died of a stroke, and her father died from
prostate cancer. She denies any recent upper respiratory illness, and she has
had no other symptoms. On examination, she is in no acute distress. Her blood
pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory
rate is 16. With auscultation, she has distant air sounds and she has late
inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2
are distant and an S3 is heard over the apex.
What is the chief complaint?
Based on the subjective and objective information provided
what are your 3 top differential diagnosis listing the presumptive final
diagnosis first?
What treatment plan would you consider utilizing current
evidence based practice guidelines?

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