Problem: Kyle, age 72 years, is a lifelong 2 ppd smoker, who doesn't go to the doctor routinely. He has recently suffered a heart attack, damaging his left ventricle. He appears to be suffering from left-side heart failure. Stroke volume, blood pressure, and cardiac output are all reduced. He is hypoxic and has audible wheezing. On assessment, he has clubbing of the fingers and a barrel-shaped chest. He is pursed-lip breathing, and is using accessory muscles to breath. He is having difficulty catching his breath while speaking. Inspection reveals peripheral edema. Vital signs include a heart rate of 82 beats per minute and respiratory rate of 12 breaths per minute. Oxygen saturation is 82%. Spirometry results show reduced vital lung capacity and reduced forced vital capacity. Kyle's renal function is also impaired. Serum BUN and Cr levels are increasing and GFR is significantly reduced. Oliguria is present, as are edema of the face and extremities. Kyle seems to be becoming more and more confused and disoriented. Further blood laboratory values reveal hypocalcemia, hyperkalemia, and anemia. Need Assignment Help?