Client was admitted to the telemetry unit

Client was admitted to the telemetry unit after experiencing increasing shortness of breath and fatigue over the past 2 days. Client reports that shortness of breath occurs especially when trying to lie flat or with exertion. Client thought it was related to their pregnancy; client is at 28 weeks’ gestation with their first child. Today the client experienced palpitations, dizziness, and some chest discomfort. Then, they passed out for a few seconds. Their spouse drove them to the emergency department (ED). Client’s chest pain had subsided by the time they arrived at the ED. A 12-lead electrocardiogram (ECG) and cardiac enzymes were obtained and a myocardial infarction was ruled out but some abnormalities of the left ventricle were noted on the ECG. Client was admitted to the telemetry unit for further observation. A focused cardiac assessment revealed pulsus bisferiens, faint bibasilar crackles, harsh systolic murmur heard after S1 at the apex near the left sternal border, and a prominent “a” wave when the neck veins were evaluated. Pedal pulses are 2+ bilaterally, no edema is observed. Vital signs: temperature, 98.4°F (36.9°C); heart rate, 102 beats/min; respiratory rate, 18 breaths/min; blood pressure, 140/92 mm Hg. Oxygen saturation, 96% on room air. SCIENCE HEALTH SCIENCE NURSING

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