Personal Impact Paper

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Boone Thomas

Personal Impact Paper

Nurs/427 Health and Chronic Disease Management

01 October 2011
Personal Impact Paper

|Student: |Boone Thomas | |Date of Care: |28 September 2011 | | | | | |Patient | | | | | | |Gender: |Male |Age: |82 |Number of Days in Hospital: |3 | | | | | | | |The subject of this paper, who shall be known as Bill, is an 82-year old male with a long history of coronary artery disease, | |congestive heart failure and aortic valve replacement. His condition had been stable until about four days prior to admit to the | |ED. While visiting with his daughter he became increasingly short of breath and was subsequently transported to the emergency | |department by ambulance. This client has experienced an exacerbated state of CHF. On admission the patient was confused and | |exhibited extreme shortness of breath, fluid in the lungs and 3+ edema bilaterally in his lower extremeties. His admitting vital | |signs were: BP 130/70, HR 100, Resp 26, SpO2 70%. Untreated the condition could have led to myocardial infarction or acute | |respiratory failure, renal failure, and ultimately death. | |Background | |Bill moved from Washington state approximately 2 months ago. He is married and lives locally. He denies using tobacco or alcohol. | |He Has two children; neither lives locally, nor has limited contact with them due to vicinity. His wife is wheel chair bound and | |requires full assistance with transferring and ADL’s. Bill is a retired machinist and is currently collecting a union pension and | |social security benefits, and qualifies for medicare. His wife is eligible for and collects disability. | | | | | | | | | | | | |

Physical Assessment Findings:
My assessment of this patient was two days after admission. Most of the extreme symptoms he exhibited on admission had mostly been resolved. He did however still have moderate edema in his lower extremities. His lungs sounds were also drastically improved although they were slightly decreased with coarse crackles in the bases. He complained of shortness of breath. His oxygen saturation was 95% on 2 liters oxygen via nasal cannula. The patient complained of exertional fatigue and dizziness upon sitting up. He had full sensation in his upper extremities, but some numbness in his feet due to long standing...
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