Course  

NR 507 Advanced Pathophysiology

Instructions

A 64-year-old woman presents to the primary care office with shortness of breath, leg swelling, and fatigue. She has a history of type 2 diabetes and hypertension. She reports that recently she had been able to go for daily walks with her friends, but in the past month, the walks have become more difficult due to shortness of breath and fatigue. She also sometimes awakens in the middle of the night due to shortness of breath and has to prop herself up on three pillows. On physical examination, she is tachycardic (110 beats per minute) and has a blood pressure of 106/74 mm Hg. Fine crackles are noted on inspiration in bilateral bases. The cardiac exam reveals the presence of a third and fourth heart sound and jugular venous distension. 2+ pitting edema is noted in the knees bilaterally. An ECG shows sinus rhythm at 110 bpm with Q waves in the anterior leads. An echocardiogram shows decreased wall motion of the anterior wall of the heart and an estimated ejection fraction of 25%. She is diagnosed with systolic heart failure, secondary to a silent MI.

1. Discuss the pathophysiological mechanisms that can lead to heart
2. Differentiate between systolic and diastolic heart dysfunction
3. Discuss the causes of the patient’s shortness of breath, awakening in the middle of the night and the need to prop herself up on three pillows. Include pathophysiological mechanisms that causes each of these signs and
4. Include two points of teaching for this patient
5. Support your response with at least one current evidence based
6. Students must post a minimum of three times in each graded discussion………

SOLUTION  

Heart failure (HF) is a pathophysiologic condition in which the heart is unable to produce adequate cardiac output, leading to inadequate perfusion or increased diastolic filling pressure of the left ventricle, or both (Mccance, Huether, Brashers, & Rote, 2019). Some of the most common risk factors for developing HF includes hypertension, age, smoking, obesity, diabetes, renal failure, valvular heart disease, cardiomyopathies, myocarditis, congenital heart disease, and abusive use of alcohol (Mccance et al., 2019). Most causes of HF result of dysfunction of the left ventricle (systolic and diastolic heart failure). Left heart failure or congestive heart failure is associated with either a reduced ejection fraction which is the systolic heart failure or a preserved ejection fraction which is the diastolic heart failure….please click the purchase button below to access the entire solution at $7