G. E., a 52-year-old Mexican migrant farm worker, has been discharged from the hospital for a deep vein thrombosis two days ago. You are the home health nurse assigned to visit G.E. When you arrive, you see that he is apprehensive, restless, diaphoretic, and extremely anxious. His SaO2 is 82% (previously had been 97% on room air), his heart rate is 116 beats per minute, and his blood pressure is 100/56 mm Hg. He is complaining of a sharp chest pain that gets worse when he breathes in, and he has shortness of breath. G. E. and his eight-months pregnant wife do not speak English well. Their 11-year-old son is interpreting and tells you his dad has a past medical history of congestive heart failure (CHF), hypertension, and diabetes. Interview reveals a change in his condition with the following symptoms: increase in number of pillows from two to four; decrease in activity tolerance; a dry, hacking cough; and a decrease in appetite.
Address all of the following: Develop a problems list from the objective and subjective data. From the readings, discuss the most probable causes of the symptoms. Articulate what cardiac changes can be attributed to the aging process and separately to culture and genetics.
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