Past medical history


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Atrial fibrillation happens when higher chambers of heart (Atrium) contract within an unsynchronised style, which means that they beat extremely rapidly and irregularly. The electrical impulses are not produced from SA node rather from everywhere over the atria on the rate of 300-600 is better than per minute. Because of excessive volume of signals getting through AV node, the ventricular rate might increase to 60-130 is better than per minute or more which result in inadequate emptying of ventricles. As a result, bloodstream is not pumped properly to other regions of the body system which leads to symptoms like palpitation, fatigue and a suffocating feeling. Audrey should be monitored to get signs and symptoms of AF and heart rhythm should be watched.


Hypertension is characterised with a systolic BP>140 millimeter of Hg and diastolic BP>90 mm of Hg. Someone with hypertonie may have got increased cardiac output, elevated systemic vascular resistance or perhaps both. BP should be watched before administering Coversyl. Individual should be alerted to watch intended for side effects just like headache, dried cough, fatigue and exhaustion. A sodium restricted diet should be prescribed for Audrey to control HTN.


Cerebrovascular accident (Stroke) is the sudden death of brain cells due to ischemia resulting from insufficient blood supply to brain. This could occur as a result of blockage or rupture associated with an artery supplying to brain. The symptoms include loss in balance or perhaps coordination, weak point, difficulty in going for walks, numbness or perhaps paralysis in face, lower-leg or arm. The person’s risk for fall season and GCS should be evaluated in every move and proper care should be delivered to avoid injuries due to declines.


Type 2 Diabetes Mellitus is a condition in which usually body become resistant to the standard effects of insulin and eventually results in inability of pancreas to create enough insulin. Both innate as well as exterior factors just like obesity, anxiety, food behaviors and aging contribute to this problem. Blood sugar of patient should be monitored ahead of administering mouth hypoglycaemic prescription drugs. She should also be knowledgeable and encouraged to take low carbohydrate, low-fat and large fibre food. She also need to be monitored for symptoms of hypoglycaemia. Close monitoring is needed to rule out long term problems like retinopathy, neuropathy, nephropathy and peripheral vascular disease.


GORD entails the swelling of reduced oesophagus as a result of reflux of gastric acid solution and meals. It happens due to deterioration of decrease oesophageal muscle and acidity leaks into oesophagus. The symptoms contain heartburn, regurgitation and trouble swallowing. Audrey should be discussed that foods like coffee, citrus fruit, high fat meals and delicious chocolate will exacerbate the condition. Ask the patient not to lie down soon after food and inquire her to sleep with brain elevated to stop regurgitation.


Brittle bones is decrease of bone thickness, making even more fragile and prone to fracture. It arises due to imbalance between cuboid resorption and bone creation. This condition might present without the symptoms till a bone fracture happens. Therefore , special attention should be given to avoid any fracture. Foods containing Florida and Vitamin D should urged.


An overall total hysterectomy can be surgical removal of uterus and cervix. This procedure is done to get conditions just like uterine fibroids, uterine prolapse, cancer of uterus or perhaps cervix, endometriosis and adenomyosis. Audrey needs to be monitored pertaining to long term difficulties of hysterectomy like pelvic urine prolapse, urinary incontinence, bowel dysfunction, llaga etc .


Mental health disorder is characterised by continuously depressed disposition or lack of interest in activities, that significantly affect activities. Causes of despression symptoms can include factors such as individuality, family history, drug and alcohol abuse and also life incidents or upsetting experiences. Audrey’s condition can be related to the demise of her husband. Support groups may be arranged for her. Compliance together with the drug regimen should be ensured for the sufferer.



Digoxin Heart failure, Control of ventricular charge in atrial flutter and fibrillation HR and BP should be monitored just before administration of drug. Really should not be administered in the event HR

Beneficial level of serum digoxin can be 0. 64-1. 2 nmol/L. Patient should be monitored pertaining to signs and symptoms of toxicity like nausea, nausea, diarrhoea, unusual pulse and confusion.

Use with caution in electronic imbalances. Hypokalaemia and hypomagnesemia trigger digoxin degree of toxicity.

Serum digoxin level should be monitored

Digoxin is given to Audrey to treat Atrial fibrillation. This increases vagal impulse and decrease heart rate.

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