- Case 4 A 55 Year Old African American Male Complains Of Weakness And Exertional Shortness Of Breath He Denies Any Ches 1 (99.57 KiB) Viewed 38 times
Case #4 A 55-year-old African American male complains of weakness and exertional shortness of breath. He denies any chest pain. He is healthy with no previous hospitalizations or major illnesses. He golfs twice a week and runs 2 miles every other day, but the runs have been cut short secondary to his presenting symptoms. Vital signs: BP = 130/70 mmHg, heart rate (HR) = 100 beats/min, respiratory rate (RR) = 20 breaths/min, Physical exam is significant for pallor and a soft systolic murmur. Chest is clear to auscultation and there is no evidence of lower extremities edema. (Hint: shortness of breath in the absence of heart and lung pathologies—think hematology.) • What are some risk factors for, or potential causes of, shortness of breath? • As a nurse, what are you considering to be the differential diagnoses? • What questions might you ask your client? (i.e., health history questions) • The client returns 4 weeks later. Laboratory values are significant for a hemoglobin and hematocrit (H&H) of 10/32, reticular index of 2, low iron, and high total iron binding capacity (TIBC). What is the most appropriate next step in management? • What is the most likely cause for this client's anemia?