History of congestive heart failure

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62 year old female with history of congestive heart failure (CHF) was admitted from the Emergency Department with Left Lower Lobe Pneumonia. She has been living independently at home with no assistance needed with cares. She was complaining of pain with inspiration, vital signs were normal, oxygen saturation was 90% on room air. On hospital day 2, she was found on the floor at 2345 in severe pain. X-rays revealed a hip fracture. The next day she was taken to surgery for repair. During surgery she had an acute myocardial infarction (AMI) and expired while on the table. Further analysis of the timeline leading up to 2345 discovered that the nurse came on at 2300 that evening and got report which indicated the patient was pleasant and cooperative, asking for help as needed, didn't attempt to get up on her own, used the call light. Looking at the medical record found the patient had been given a sleeping pill and pain medication at 2200, the same as the previous night. The patient doesn't regularly take either a pain or sleeping pill at home. At 2330, the nurse checked the patient to do vital signs, found her dozing but easily arousable.

Reference no: EM133604797

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