Questions for Patient
During the interview process, the physician should ask the client questions regarding his general health, including; swelling around the neck, ankles, extremities, sudden changes in vision such as blurred vision, frequency of urine output, and lightheadedness, fatigue, numbness, and exercise tolerance. The doctor also inquires about increased thirst and palpitations, sensations that the heart is pounding or racing.
Types of Diagnosis
The top three preferential diagnoses include; congestive heart failure, pulmonary hypertension, and renal failure. The patient blood pressure is above the standard 140/90, thus showing signs of hypertension. Hypertension occurs when blood pressure against the artery walls is too high, leading to heart diseases such as congestive heart failure and pulmonary hypertension. Congestive heart failure symptoms include; shortness of breath, frequent urination at night, swollen extremities, weight gain, palpitations, dizziness, and inability to exercise (Lewis, Bucher, Heitkemper, Harding, Kwong, and Roberts, 2016). Pulmonary hypertension symptoms include; shortness of breath, fast heart rate, fatigue, lightheadedness, and inability to exercise. Diabetes is the most common cause of kidney failure as it affects the kidney’s ability to remove waste and extra fluids from the body. The early renal failure symptoms include; reduced urine output, swollen extremities due to kidney failure to eliminate water waste, and shortness of breath. Hypertension leads to loss of blood to the kidney leading to renal failure.
Plan of Care
The physician should initiate tests for each of the three diagnoses. Congestive heart failure tests include; electrocardiogram (ECG), blood tests, and magnetic resonance imaging (MRI). Chest X-ray, ECG, and echo diagram tests are used for pulmonary hypertension diagnosis. Renal failure diagnosis tests blood samples for urea electrolytes and creatinine, indicators of failing kidney (Hinkle and Cheever, 2018). The physician should provide antihypertension drugs to control blood pressure and manage diabetes, depending on the finding. The patient requires education on drug adherence and compliance.
Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing. Wolters kluwer India Pvt Ltd.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2016). Medical-Surgical Nursing-E-Book: Assessment and Management of Clinical Problems, Single Volume. Elsevier Health Sciences.