72-year-old male admitted to Oakland after a 5-day hospitalization at St. Joseph’s University Medical Center, Paterson with Diagnosis of Acute on Chronic Systolic and Diastolic heart failure & Acute Renal Failure. He had a Cardioversion with this hospitalization. Patient has a BiV AICD placed last year. Patient is admitted to Oakland on IV Dobutamine Drip at 3.8ml/hr.

Nursing Interventions
Monitor Fluid Balance- Fluid Restriction, weights monitored daily and stable.
Medication Management- Torsemide 20 mg daily, Lasix 20 mg M W F, Amiodarone 200mg daily, Midodrine 10mg TID and Digoxin and Coreg.
Monitor Labs and Vitals- Patient on Xalerto for DVT prophylaxis
Maintain Adequate Oxygenation- Patient on 2 lpm via nasal cannula
Wound Healing- Right Dorsal foot wound
Weekly Cardiac Rounds lead by our onsite Cardiologist Dr. Navin Budhwani
Followed by our onsite Pulmonologist, Dr. Sharma as well as our on-site Respiratory Therapist. Patient Qualified for Home Oxygen therapy upon discharge from STR and Portable Oxygen Concentrator obtained for ease of mobility and increased quality of life.

Therapy
Upon admission, Patient required maximum assistance with all self-care tasks and was unable to ambulate. He was receiving occupational and physical therapy for 5 times a week throughout his stay. Upon discharge, he was independent with all self-care tasks, able to ambulate 40 feet with a rolling walker and ascend/descend two steps independently.
Patient returned to his apartment with his wife. His PCP in the Community is Dr. Lashin. He has VNA and Home Health Services in place with Patient Care and returned home on IV Dobutamine Infusion. His Oxygen therapy was arranged through Lincare and His Cardiologist is Dr. Naser Mohammad in the community.