ADULT GERONTOLOGY ACUTE CARE STUDY QNS & ANS 4VERSIONS 2026/2027(45 pages)

1. A 48-year-old female wt 70 kg, is in the ICU with acute pancreatitis. Her vital signs are as follows: BP 92/60 mm Hg; heart rate 116 bpm; She is intubated with current ventilator settings of VT 700 mL, assist control (AC) rate 12 bpm, FiO2 0.85, and positive end expiratory pressure (PEEP) 5.0 cm H2O. Her ABG reveals a pH of 7.31, PaCO2 of 53 mm Hg, and a PaO2 of 62 mm Hg. Her chest radiograph shows diffuse, fluffy infiltrates. Based upon this assessment the ACNP change to SIMV 2. . A 50-year-old woman presents to your office complaining of lower extremity edema that stated several weeks ago, and slowly progressed thereafter. Her past medical history is significant for hypertension, treated with metoprolol for 2 years. Amlodipine was added recently because of inadequate control of BP with metoprolol alone. She does not smoke or consume alcohol. She has no known drug allergies. Her blood pressure is 130/80mm Hg and her heart rate is 64/min. The physical examination reveals bilateral symmetric 3+ pitting edema of both lower extremities, without any skin changes or varicosities Her neck vein pulsation is normal. Other physical findings are within normal limits. Her laboratory studies reveal the following Serum albumin 4.5 g/dL Total serum bilirubin 0.8 mg/dL Serum sodium 140 mEq/L Serum potassium 4.0 mEq/L Serum creatinine 0.8 mg/dL Urinalysis is within normal limite. What is the most likely cause of the edema in this patient? Heart failure