Mrs. Elizabeth (Libby) Gardner is a 63-year-old African-American woman who is arriving at the outpatient heart clinic for her first visit. She is married, has two adult children, and four grandchildren. Libby and her husband  Joe, live in a middle-class suburb, and her children live locally. Until this hospitalization, she worked as an administrative assistant for a law office. Her husband has recently retired and stays busy with community activities.

She was discharged from the hospital one week ago after experiencing a large anterior wall myocardial infarction (MI) which resulted in left-sided heart failure. The discharge summary from the hospital includes the following data: 

Blood      Pressure 136/88

Pulse 96      and regular

Respirations      20 and clear

• Temperature      37.1 C temporal

Weight of      156 pounds

• S3 heart      sound audible in early diastole 

Bilateral      non-pitting edema present in feet and ankles

• Libby states a past medical history of hypertension, elevated cholesterol, and type 2 diabetes mellitus; she states that all of these conditions µn in [her] family Her reported medication history includes an ACE inhibitor, Beta Blocker, diuretic, statin, and oral hypoglycemic agent. The patient states she is 2etty good!bout taking her medications and following dietary recommendations. 

Intake assessment data at the heart clinic includes: 

• Blood      Pressure 162/96

Pulse 92      and regular

• Respirations      32 with crackles in the bases, bilaterally

Temperature      37.1 C temporal

• The      patient denies pain

She is      mildly anxious and complains of shortness of breath at night and with mild      activity 

• Bilateral      2+ pitting edema is present in ankles and feet

Directions

Answer each question below using an outline format:

From the      case study choose ONE aspect of patient education that you will provide      for Mrs. Gardner.

For       example, you may want to discuss patient education related to:

Dietary        management

• Medication        management

Shortness        of breath with activity and at night

• Or,        another area you feel that is important

Discuss      briefly the Pathophysiology of congestive heart failure

• Include      one reputable resource that you can direct her or her family for further      support, maintenance, and/or reinforcement of the education you provided.      Be creative, you may want to use a community resource, electronic      resource, support group, technological tool, assistive device, etc.