Congestive heart failure (CHF,) and Emphysema

You are assigned to take care of Mrs. Jones, a 62-year-old patient with peripheral vascular disease (PVD), congestive heart failure (CHF,) and Emphysema. She has severe dyspnea, is emaciated due to her lack of appetite, is dehydrated, and is easily fatigued. She requires frequent small snacks because she does not have the energy to eat large meals. She also requires supplemental oxygen continuously to keep her oxygen saturation above 93%.  

She needs many breaks during her ADL’s to conserve energy.  Her feet and ankles are usually swollen and she does not like to wear shoes.

She is on a fluid restriction, ‘no added salt’ diet, and must be weighed daily. She smokes 3-4 cigarettes a day, outside in the resident smoking area. 


  1. What is ‘Dyspnea,’ and what position is most comfortable for patients with COPD who suffer from dyspnea?
  2. What are at least 3 risk factors for pressure ulcer development in Mrs. Jones’s case (Think about her diagnosis of Emphysema and the signs and symptoms that go along with it, as well as the position she will be spending most of her time.)
  3. What are the most likely body sites for pressure ulcer development on Mrs. Jones? (Think back to the position you answered in question 1. What are her pressure points most likely going to be? These are the body sites.)
  4. Lists many precautions that the nursing assistant must take because of Mrs. Jones’s Peripheral Vascular Disease diagnosis. (ways to protect her from injury due to her diagnosis)
  5. Mrs. Jones’ grandson arrives to visit and brings Mrs. Jones a Raising Cane’s combo which includes chicken fingers, fries, coleslaw, Texas toast and a 32 oz lemonade. He wheels her outside into the courtyard to eat the meal and then have a cigarette. What is the correct action of the nursing assistant? And why.

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