LCD Guideline Heart Disease
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Comparative Date
Change in Activity - Patient was going to activity daily now stays in room. Was able to walk down the hall now unable to walk more than 5 feet.
Change in Breathing – Patient is now using purse lip breathing, labored breathing
Increase in SOB - Patient was able to walk down the hallway without oxygen. Patient is now using oxygen and is only able to ambulate15 feet without resting
Pain - Increase in pain medications, chest pain noted with activity
Anxiety - Patient gets very anxious when short of breath. Patient states “I get very nervous when I can’t breathe”
Edema - Previously no edema noted, now edema noted in feet and ankles
Change in weight - Patient has gained 5lbs in 5 days related to edema
Depression - Patient is withdrawn, does not engage in activity
Intake
- Patient complains of feeling full but is only eating 25% of meal. Patient was eating 100% of meal and now only eating 50%
Change in ADL’s - Patient was previously stand by assist with bathing; now is a one person assist
Medication changes - We have changed Lasix every week Comorbidities Kidney failure Pain SOB Syncopal Episodes Anorexia Ascites Edema Weight Gain COPD Pulmonary Fibrosis
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