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1. Each group will create a post in the appropriate section. Include all four components based on the scenario.

•Name: Mr. Omar Hassan

•Age: 76

•Gender: Male

•Ethnicity: Middle Eastern

•Medical History: Chronic heart failure (CHF) – NYHA Class IV, hypertension, type 2 diabetes, chronic kidney disease (stage III)

•Recent Hospitalization: Admitted due to worsening dyspnea, fatigue, and fluid overload despite optimal medical management

Background

•Medical History: Chronic heart failure (EF 18%), hypertension, type 2 diabetes, CKD stage III

•Recent Labs:

·BNP: 1850 pg/mL (elevated, worsening heart failure)

·Creatinine: 2.1 mg/dL (signs of renal decline)

·Hemoglobin: 9.3 g/dL (anemia, likely chronic disease-related)

•Recent Medications:

·IV Furosemide (adjusted due to renal impairment)

·Morphine PRN for dyspnea

·Oxygen 2L via nasal cannula for comfort

Assessment:

•Neurological: Alert, but fatigued; anxious about his condition.

•Cardiovascular: BP 88/55, HR 108 (sinus tachycardia), cool extremities, +3 pitting edema.

•Respiratory: Dyspneic at rest, crackles in bilateral lung bases, SpO2 87% on room air, improved to 92% with 2L O2.

•Gastrointestinal: Poor appetite, small meals tolerated.

•Renal: Urine output reduced, signs of worsening renal function.

•Psychosocial: Family involved in care decisions; they are struggling with the idea of palliative care. The patient follows Islamic beliefs and has expressed the desire for comfort and dignity in his final days.

Recommendations:

•Continue comfort care measures: Oxygen, low-dose opioids for dyspnea.

•Monitor for worsening respiratory distress or pain.

•Encourage small meals for energy and hydration.

•Provide emotional and spiritual support to the patient and family.

•Follow up with the palliative care team to finalize goals of care discussions.

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Mr. OH a 76 y/o male w/ a history of CHF, htn,t2d,and ckd, was admitted due to worsening dyspnea, fatigue and fluid overload despite optimal medical management

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This is Omar Hassan, a 76-year-old male. Came to the ED with worsening dyspnea, fatigue, and fluid overload despite optimal medical management.

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Worsening dyspnea, fatigue and the fluid overload despite.

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Worsening dyspnea, fatigue and the fluid overload despite.

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 The patient is Omar Hassan,76 yr old male admitted for Fatigue , fluid overload and worsening dyspnea.

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 The patient is Omar Hassan,76 yr old male admitted for Fatigue , fluid overload and worsening dyspnea.

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Mr. OH has a history of CHF, hypertension, type 2 DM, and stage 3 CKD.

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Mr. H 76 yo male hx of chf, htn, present for dyspnea, fatigue, fluid overload, currently receiving comfort care

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Mr. Omar Hassan, a 76-year-old male with end-stage heart failure (EF 18%), CKD stage III, and type 2 diabetes, was admitted for worsening dyspnea, fatigue, and fluid overload despite optimal medical management. He is now showing signs of clinical decline.

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Hypotensive

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Medical history: NYHA Class IV heart failure, hypertension, CKD stage III, anemia, and type 2 diabetes.

Recent hospitalization due to worsening symptoms despite IV diuretics.

Recent labs:

BNP: 1850 pg/mL (elevated)

Creatinine: 2.1 mg/dL (renal decline)

Hemoglobin: 9.3 g/dL (anemia)

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He was previously admitted for CHF exacerbation and an ejection fraction of 18%. Labs indicate worsening heart failure BNP (1850), renal decline (creatinine >1mg/dl), and anemia (hgb 9.3g/dl). Medications inclue IV furosemide (adjusted for renal impairment), morphine PRN for dyspnea, and oxygen 2L via nasal cannula.

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He is a middle Eastern male with history of Chronic heart failure, Hypertension ,Type II Diabetes and chronic kidney disease(stage III).

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He is a middle Eastern male with history of Chronic heart failure, Hypertension ,Type II Diabetes and chronic kidney disease(stage III).

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Mr. Omar Hassan, a 76-year-old male, was recently hospitalized for worsening shortness of breath, fatigue, and fluid retention despite receiving optimal medical treatment.

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BP 88/55, HR 108 (tachycardia), cool extremities, +3 pitting edema.

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BP 88/55, HR 108 (tachycardia), cool extremities, +3 pitting edema.

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Dyspnea at rest, crackles in lung bases, SpO2 87% on room air, improving to 92% on 2L O2.

Reduced urine output, poor appetite, fatigue, and increased anxiety.

Family struggling with palliative care decision-making, and the patient has expressed a desire for comfort and dignity in line with his Islamic beliefs.

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hx DM, chf class 4, stage 3 CKD, htn

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Neurological: Alert but fatigued; anxious about his condition.

Cardiovascular: BP 88/55, HR 108 (sinus tachycardia), cool extremities, +3 pitting edema.

Respiratory: Dyspneic at rest, crackles in bilateral lung bases, SpO2 87% on room air (improved to 92% with 2L O₂).

Gastrointestinal: Poor appetite, tolerating small meals.

Renal: Reduced urine output, worsening renal function.

Psychosocial: Family involved in care decisions, struggling with palliative care discussions; patient desires comfort and dignity in his final days.

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Continue comfort care measures (oxygen, low-dose opioids for dyspnea).

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Continue comfort care measures (oxygen, low-dose opioids for dyspnea).

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Monitor for worsening respiratory distress and pain.

Provide emotional and spiritual support.

Engage palliative care team to finalize goals of care and facilitate family discussions.

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This is Omar Hassan, a 76-year-old Middle Eastern male. Past medical history includes CHF, HTN, Type 2 DM, and CKD stage 3. Recent labs include a BNP of 1850, creatinine of 2.1, and hemoglobin of 9.3. His recent medications include IV furosemide which was adjusted due to his renal impairment. Morphine PRN for dyspnea. Current oxygen is at 2L.

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Continue comfort care: Oxygen, low-dose opioids for dyspnea.

Monitor for worsening respiratory distress or pain.

Encourage small meals for energy and hydration.

Provide emotional and spiritual support to the patient and family.

Follow up with the palliative care team to finalize goals of care.

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OH, 76 y/o M came into the ED due to worsening SOB, fatigue, and fluid overload despite optimal medical management.

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Medical History: Advanced heart failure (NYHA Class IV), hypertension, type 2 diabetes, and stage III chronic kidney disease.

• Recently admitted due to worsening symptoms, indicative of end-stage heart failure.

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Situation: Mr Omar Hassan, a 76 year old male with chronic heart failure, chronic kidney disease, and type 2 diabetes, was admitted due to worsening dyspnea, fatigue, and fluid overload

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Medical hx: CHF, HTN, type 2 diabetes, CKD stage III

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mr.o came in with his of HNT, chf, and ckd, he is admited because of worsefatigue,FOL,Fatigue 

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mr.o came in with his of HNT, chf, and ckd, he is admited because of worsefatigue,FOL,Fatigue 

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and worsening dyspnea

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alert and fatigue, a worsening condition overall, b/p88/55, anemia, +3 pitting edema, cool extremities, spo2 92% 2L o2, poor appetite, <renal function, < urine output, family involved, patient is a practicing Islam

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H, Hassan is a 76 year old male admitted for worsening dyspnea, fatigue, and fluid overload.

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Continue comfort care measures: Oxygen and low-dose opioids for dyspnea.

- Monitor for worsening respiratory distress or pain.

- Encourage small meals for energy and hydration.

- Provide emotional and spiritual support to Mr. Hassan and his family.

- Follow up with the palliative care team to finalize goals of care discussions, focusing on comfort and dignity in line with the patient’s wishes.

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Respiratory difficulty caused by CHF and fluid accumulation.

• Fatigue and weakness associated with disease progression.

• Nutritional challenges due to decreased appetite and possible fluid restrictions.

• Emotional and spiritual support needs due to the advanced nature of his illness.

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Hx of class IV CHF, HTN, type 2 diabetes, and stage III CKD.

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Group 2: Mr Hassan, age 76, Male, admitted due to worsening dyspnea, and fluid overload. Right now he is fatigue, edema, w crackles lungs, reduce UO. 

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Group 2: Mr Hassan, age 76, Male, admitted due to worsening dyspnea, and fluid overload. Right now he is fatigue, edema, w crackles lungs, reduce UO. 

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offer small meals, continue comfort care, offer family education on how to provide the best care for the patient upon d/c, palliative care consult, monitor breathing comfort level, emotional and spiritual support

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Alert ,anxious and fatigued. He has SOB at rest,crackles in lung bases bilaterally,+3 pitting edema , cool extremities,His appetite is poor , can only tolerate small meals.He follows Islamic beliefs. His urine output is reduced .

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Alert ,anxious and fatigued. He has SOB at rest,crackles in lung bases bilaterally,+3 pitting edema , cool extremities,His appetite is poor , can only tolerate small meals.He follows Islamic beliefs. His urine output is reduced .

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Vital Signs-BP 88/55, HR 108,SpO2 87%RA,and 92% on 2l O2,

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The patient is A&Ox4. Current vitals include BP 88/55, and HR 108.

Cardiovascular: cool extremities and +3 pitting edema. Sinus tach

Resp: Crackles in bilateral lung bases, 87% on RA, 92% with 2L on NC

GI: poor appetite

Renal: Reduction in urine output

Psychosocial: family involvement with the plan of care

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Continue comfort care with oxygen therapy and low-dose opioids for breathlessness.

Monitor for worsening respiratory distress or pain, adjusting medications as needed.

Encourage small, frequent meals to maintain energy and hydration.

Provide emotional and spiritual support for both the patient and family.

Collaborate with the palliative care team to discuss care goals and planning.

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• He remains dyspneic despite oxygen therapy and low-dose opioids.

• He is down with low BP, tachycardia, and signs of poor perfusion.

• He is fatigued and anxious about his condition.

• Nutritional intake is limited due to poor appetite.

• He has reduced urine output and increased creatinine.

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Background: His ejection fraction is 18%,  BNP (1850 pg/mL), increased creatinine (2.1 mg/dL), and low hemoglobin (9.3 g/dL), suggesting worsening heart failure, renal decline, and anemia. Current treatments include oxygen at 2L via nasal cannula for hypoxemia,  morphine PRN for dyspnea, and IV furosemide.

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The patient is showing signs of end-stage HF with worsening renal function and fluid overload. O.H. quality of life is declining. There is a need for discussion regarding care plan, symptom management, and transitioning to palliative care. Family and patient need education regarding condition and treatment plan.

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Hx: Chronic HF, HTN, DM2, CKD Stage III. Labs BPN and creatinine elevated, Hemoglobin low due to chronic condition. He has been on Furosemide, and Morphine PRN. O2 2L CN

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Hx: Chronic HF, HTN, DM2, CKD Stage III. Labs BPN and creatinine elevated, Hemoglobin low due to chronic condition. He has been on Furosemide, and Morphine PRN. O2 2L CN

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Assessment: He is hypotensive (BP 88/55 mmHg), tachycardic (HR 108 bpm), and has +3 pitting edema in the lower extremities. Respiratory assessment shows dyspnea at rest, bilateral crackles at the lung bases, and SpO₂ of 87% on room air, improving to 92% with oxygen. Urine output is reduced, indicating worsening renal function.

The family is involved in care decisions and is considering palliative care, respecting the patient’s cultural beliefs and preference for comfort and di

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The patient has a PMH of CHF, HTN, DM2, and CKD stage 3.

The lab for the patient indicated worsening HF and renal decline. The labs also showed signs of anemia that are most likely due to the patient's history of CKD. The patient is currently on IV furosemide, and it has been adjusted due to the patient's renal impairment. The HCP ordered morphine PRN for dyspnea and also has an order for O2 2L via nasal cannula

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The patient is alert, but very fatigued, has sinus tachycardia, cool extremities as well as +3 pitting edema.

Resp: bilateral crackles in base of lungs, 92% SPO2 with 2L of O2

GI: poor appetite

Renal: reduced amount of urine ouput

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The patient has verbalized to be on Pallative care , will continue with comfort care ,monitor for worsening respiratory distress and pain manage ment,fluid overload , encourage small meals . manage anxiety , and continue on supplementary oxygen supply. follow up with Pallative care team to finalize goals of care.

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The patient has verbalized to be on Pallative care , will continue with comfort care ,monitor for worsening respiratory distress and pain manage ment,fluid overload , encourage small meals . manage anxiety , and continue on supplementary oxygen supply. follow up with Pallative care team to finalize goals of care.

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Alert, fatigued and anxious. Hypotension and sinus tachycardia, cool extremities, and +3 pitting edema. Dyspneic at rest, crackles in the bilateral bases upon auscultation, low O2, 87% on room air, provided 2L of O2. Nutritional needs not met. Dysuria, possible worsening renal function. Familial support, struggling to cope with palliative care. Islamic beliefs, desired comfort and dignity in his final days.

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Recommendations: Continue oxygen therapy to maintain SpO₂ above 92%. Monitor fluid status, daily weights, and electrolyte levels. Adjust furosemide as needed to reduce fluid overload while preserving renal function. Administer morphine PRN to manage pain. Keep the family informed and involved in decision making, respecting their culture and religious values.

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We recommended small meals, along with continuing comfort care, which includes pain medication, Zofran, and oxygen. Monitor vital signs and I&O's. The social worker is involved with a plan for palliative care. Will provide emotional support for the patient and the family. Recommend family speak with the hospital spiritual advisor for support.

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-He is fatigue and anxious. BP is low at 88/55, tachy, +3 edema. crackles at lung base, O2 92% w 2L, poor appetite, reduced urine output. Family and pt struggle w coping. They follow Islamic beliefs

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-He is fatigue and anxious. BP is low at 88/55, tachy, +3 edema. crackles at lung base, O2 92% w 2L, poor appetite, reduced urine output. Family and pt struggle w coping. They follow Islamic beliefs

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is a 76 yr.old male who w/a history of HNT, chf, and ckd, he was admitted