Ms. Gloria Briggs continued – see below her subjective and o…
Ms. Gloria Briggs continued – see below her subjective and objective data points. Gloria is now taking a B-blocker in addition to her other medications. What other steps might be used to treat her stage C/class II HF? Ms. Gloria Briggs works as a librarian and presents with a 6-week history of fatigue and increasing shortness of breath. She believes that these symptoms are related to recent renovations at the library, which have reactivated her asthma; however, her nebulizer and inhaler have not relieved her symptoms. Gloria reports that her dyspnea is worse with ordinary activity and lying flat, but she is comfortable sitting. She has not experienced chest pain. She complains of her legs swelling and shoes “pinching.” She can no longer take her brisk lunchtime walk and has gained weight. Her history includes hypertension, type 2 diabetes (T2DM), and dyslipidemia; she is a nondrinker and quit smoking 7 years ago. Physical examination: o Height: 5 ft 6 in; weight: 165 lb (body mass index : 26.6 kg/m2) o Blood pressure (treated): 140/92 mm Hg o Heart rate: 116 bpm; respiratory rate: 22; temperature: 98.4°F o 1+ pitting edema ankles; S3 heart sound; bilateral rales at lung bases o Mild cardiomegaly