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Case Study: A 66-year-old female presents to the FNP for a new patient visit. On arrival, she is noted to have a blood pressure of 160/90 mm Hg, which is verified after she has sat for 20 minutes in the exam room. She reports that she is no longer able to go for her daily walks around her neighborhood due to shortness of breath and intermittent substernal chest pressure which are relieved with rest. She uses 3 pillows in bed to prop herself up and is unable to lie flat. On physical exam, she has the following clinical findings: heart rate 75 beats/min, BP 160/90; bibasilar crackles, jugular venous pulsations are elevated, and bilateral lower extremity pitting edema.
Dx Congestive Heart Failure (CHF) (I50.9)
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