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Care Map 10/27 - Coggle Diagram

- - - - Objective: Patient's BP elevated while resting
      - Subjective: "I feel a little bit dizzy and short of breath when I move too fast or try to sit up at the edge of the bed"
    - - Modifiable:
      - Non Modifiable:
    - - Pharm: diltiazem, furosemide
      - Non Pharm: exercise, diet, water intake
    - - BP 146/85 MAP 106
    - - Reduced excretion of sodium increases plasma volume which increases stroke volume
- - - - Subjective: "Does my blood pressure seem high to you?"
      - Objective: Patient's BP elevated while resting
    - - Modifiable: diet, exercise, smoking
      - Non Modifiable: age, ethnicity, family history, genetics
    - - Pharm: N/A
      - Non Pharm: diet, exercise, losing weight, not smoking
    - - BP 146/85 HR 108
    - - Cholesterol builds up and forms plaque deposits on arterial walls
- - - - Subjective: "I feel a little sleep"
      - Objective: Patient appeared tired but not unconcious
    - - Modifiable: obesity, hypertension, poor diet, lack of exercise
      - Non Modifiable: age, genetics, ethnicity
    - - Pharm: blood sugar fingerstick checks, insulin lispro
      - Non Pharm: low fat, low carb diet, exercise, less sugar
    - - Blood sugar 156
    - - Insulin resistance and impaired regulation of hepatic glucose production
- - - - Subjective: "My heart feels like it's beating really fast - is my heart rate high?"
      - Objective: Patient's resting heart rate in the 100s
    - - Modifiable: diet, exercise
      - Non Modifiable: diabetes, obesity, high blood pressure
    - - Non Pharm:
      - Pharm: buspirone, furosemide,
    - - History of afib, acute respiratory failure, obstructive sleep apnea, stroke
    - - Changes in heart muscle resulting in poor blood flow to the body
- - - - Subjective: "I feel short of breath and need more oxygen"
      - Objective: Patient's O2 sats in the 80s, respirations were 22
    - - Modifiable: smoking, diet, exercise
      - Non Modifiable: age, genetics, history of asthma
    - - Pharm: budesonide, busprione, guafenesin, motelukast
      - Non Pharm: elevate head of bed, incentive spirometer
    - - CO2 elevated - 37
    - - Poorly reversible airflow obstruction and abnormal inflammatory response in lungs
- - - - Subjective: "I feel a little dizzy"
      - Objective: Patient's color in face and lips looks slightly pale; no blood in stool today
    - - Modifiable: diet
      - Non Modifiable: age, family history, menopause
    - - Pharm: ferrous sulfate
      - Non Pharm: intake of fruits, vegetables, teas
    - - Hemoglobin down 9.7, hematocrit down 29.4
    - - Decrease number of red blood cells transporting oxygen and carbon dioxide which impairs gas exchange to tissues
- - - - Subjective: "I feel like I have a fever, and I am short of breath"
      - Objective: Patient's respirations 22
    - - Modifiable: diet, weight, oral hygiene
      - Non Modifiable: asthma, COPD, diabetes, CHF
    - - Non Pharm: humidifier, warm bath, warm drinks
      - Pharm: antibiotics
    - - CO2 elevated - 37
    - - Infection causing inflammation in the alveoli restriction gas exchange