Case Study for Discussion

John is a 56 year-old male who was initially diagnosed 6 months ago with heart failure.

He was treated via a 3-day stay in the hospital and sent home with a drug regime and since then has been seen in the ER two times and is now hospitalized again with shortness of breath, pedal edema, and weight gain. He does not understand why the medications are not working. He cannot miss any more days at work or he will lose his job and medical insurance for him and his family. His wife is a stay-at-home mom for their three boys.

John is a construction worker and does take his medications as directed but continues to eat what he wants. He states he cannot exercise because he works 6 days a week and is just too tired when he gets home. He is always tired, is up all night going to the bathroom, and is extremely worried about his health issues and the future. His wife, Kathy, is also very worried, because she is a stay-at-home mom and has not worked since the birth of their first child, who is 16 years old.

During this hospital stay, another cardiac catheterization reveals that the ejection fraction of his heart is only 40. The doctor has told him he needs to change his lifestyle, continue with his meds, and monitor his vital signs at home.

Kathy is 40 years old and finds herself overwhelmed with the diagnosis and is worried that she may have to go back to work if John is not able to continue working. She wants to know what she can do to help John. She will do anything but is not sure what will help John. The nurse came in and handed her a bunch of papers about diet and exercise and said a home health nurse would set him up for home monitoring.

Formulate searchable, clinical questions in the PICO(T) format using the material in this case study.

There are several potential questions that could be asked, but you only need to identify two. Determine if the focus of each question is assessment, etiology, treatment, or prognosis.