Passage / Scenario

The following scenario applies to the next 1 items
The nurse is reviewing the medical record of a 55-year-old male client.
Item 1 of 1
History and Physical
0818: Client reports severe shortness of breath and swelling in his lower extremities. He reports a 3-day history of fatigue and decreased urine output. During the assessment, the client was alert and fully oriented. He has 2+ pitting pedal edema in the lower extremities. 2+ peripheral pulses in the upper extremities. Bibasilar crackles upon auscultation. Skin is warm, dry, and normal for ethnicity. Normoactive bowel sounds in all quadrants. Vital signs: T 98┬░ F (36.7┬░C), P 89, RR 18, BP 164/95, pulse oximetry reading 96% on room air.

Laboratory Results
ÔÇó Capillary blood glucose 121 mg/dL (6.72 mmol/L) [70-110 mg/dL (4-6 mmol/L)]
ÔÇó Serum creatinine 2.5 mg/dL (221 mmol/L) [0.6ÔÇô1.2 mg/dL (53ÔÇô106 mmol/L)]
ÔÇó Serum BUN 36 mg/dL (12.9 mmol/L) ([10ÔÇô20 mg/dL (3.6ÔÇô7.1 mmol/L)]
ÔÇó Serum potassium: 5.2 mEq/L [3.5ÔÇô5 mEq/L (3.5ÔÇô5 mmol/L)]
ÔÇó Urinalysis: Mild proteinuria, no hematuria

Intake and Output
24 hour fluid intake: 1560 mL
24 hour fluid output: 250 mL

Medical History
ÔÇó hypertension
ÔÇó hyperlipidemia
ÔÇó coronary artery disease
ÔÇó glaucoma
ÔÇó diabetes mellitus (type two)
Current Medications
ÔÇó carvedilol 6.25 mg p.o. daily
ÔÇó multivitamin 1 tablet p.o. daily
ÔÇó lisinopril 10 mg p.o. daily
ÔÇó simvastatin 10 mg p.o. daily
ÔÇó ergocalciferol 10000 units p.o. daily
ÔÇó ethyl eicosapentaenoic acid 2 grams p.o. daily