What factors in her past medical history

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Mrs. A, 78 years old, reports to her health care provider (HCP) that she has been waking up in the middle of the night feeling like she was going to suffocate. She has also noticed that her legs are tight, and it takes every bit of energy she has to walk to the mailbox.

1. What additional information would be helpful for the healthcare team to know?

Her past medical history includes the following:

Myocardial infarction 10 years ago

Hypertension for 30 years

Diabetes type 2 for 20 years

Hysterectomy secondary to ovarian cancer 10 years ago

The HCP makes a tentative diagnosis of heart failure.

2. What factors in her past medical history could have contributed to the development of heart failure?

3. What are some typical manifestations associated with heart failure? Be sure to distinguish between left sided and right sided heart failure.

4. Mrs. A is sent home with the instructions listed below. What is the rationale for each?

Digoxin 0.125 mg every day.

Check heart rate before taking Digoxin: If heart rate is less than 60 beats per minute, do not take the digoxin and call the HCP.

Daily weights-call HCP is there is a 5-pound weight gain over 2 days.

Lisinopril 5 mg every day.

Check blood pressure every morning and call HCP if systolic greater than 140 or diastolic greater than 90.

Reference no: EM132469821

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