Description

Problem Statement

The patient is an 86-year-old female with a history of hypertension, coronary artery disease, and status post coronary artery bypass graft (CABG) 8 years ago, who was at baseline 6 months ago but now presents with an
acute episode of tachycardia and dyspnea that occurred during routine exertion. She reports a 2-month history of progressive fatigue, generalized weakness, and exertional shortness of breath without chest pain. She denies cough, orthopnea, paroxysmal nocturnal dyspnea, or edema. On examination, she is normotensive and
tachycardic (HR 120) with conjunctival pallor, pale palmar creases, and no evidence of fluid overload. The physical exam reveals a flow murmur and findings suggestive of anemia. Review of systems is otherwise unremarkable except for chronic constipation.

Reflection

• Diagnostic testing and treatments available for this client’s diagnosis can be very expensive. How would your treatment plan change if your client did not have insurance?
• What resources are available in your area to support a client with these diagnostic and treatment needs?