Question

An EMT respond to a call for a 75 y/o ♂ ℅ SOB and CP. Pt’s PMH includes: HTN, COPD, and CHF. Patient has had an AMI in 2013 and was also Dx. with LVH.V/S: P 96, R 24, BP 150/92, SpO2 90%. Patient is AOx4, with Pupils PERRLA at 3mm. JVD and pedal edema noted. Pt. on home O2 at 2L/min via NC.

Answer 1

A 75-year-old male with a history of cardiovascular and respiratory diseases is exhibiting signs of distress, including shortness of breath, chest pain, jugular venous distention, and pedal edema, and requires prompt medical assessment and management.

Step-by-step explanation:

An emergency medical technician (EMT) responds to a call for a 75-year-old male complaining of shortness of breath (SOB) and chest pain (CP). The patient has a past medical history (PMH) of hypertension (HTN), chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), a previous acute myocardial infarction (AMI) in 2013, and was diagnosed with left ventricular hypertrophy (LVH). Upon examination, the EMT noted the following vital signs (V/S): a pulse (P) of 96 beats per minute, a respiratory rate (R) of 24 breaths per minute, blood pressure (BP) at 150/92 mmHg, and an oxygen saturation (SpO2) of 90%. The patient is alert and oriented times four (AOx4), with pupils that are equal, round, reactive to light and accommodation (PERRLA) at 3mm. Additionally, jugular venous distention (JVD) and pedal edema were observed. The patient is currently on home oxygen therapy at 2 liters per minute via nasal cannula (NC).

The presence of JVD and pedal edema are indicative of potential exacerbation of CHF, and the suboptimal SpO2 level suggests the need for increased oxygen delivery or further medical intervention. These observations, in conjunction with the patient's medical history and current complaints, require a careful assessment and prompt management to stabilize the patient and address the underlying causes of his distress.