Assignment task:
70 y/o BM admitted for AMI yesterday and underwent Immediate PCI. Initial CE neg.with elevated Troponin noted in subsequent sets.PMH: left ventricularsystolic heartfailure, CAD, HTN, diabetes mellitus, chronic kidney disease, Mitral regurgitation.Social history: Married, 2 children, x-smoker (quit 10 years ago), occasionally drinks 2-4 beers on the weekendsHome Meds List:Lanoxin 0.25 mg Po dailyCarvedilol 6.25 mg Po BIDFurosemide 40 mg Po BIDK-Dur 20mEq Po BIDQuinapril 20 mg PO dailyAspirin 81 mg PO dailyAtorvastatin 40mg Po QPmHumulin N 20 units am/ 10 units pmEchocardiogram yesterday evening:Cardiac silhouette enlarged. LV hypertrophy noted.Severe mitral regurgitation. Mild Pulmonary HTN, Ejection Fraction 35%Current Physical Assessment: Lying in bed, HOB 25 degrees, Confused, anxious, laboredbreathing appears short of breath in bed, O2 NC 2L sat 86%, RR 34, BP 70/42, HR 120,skin grey, cool with truncal mottling, pale extremities and clammy, pupils equal anddilated 6mm reactive, crackles noted, new onset cough with pink frothy sputum, pedalpulses faint, radial pulses 1, edema 3 to BLE. What changes in the current assessment indicate the patient is worsening and progressed to ADHF with pulmonary edema? Explain their significance. Need Assignment Help?