NR507 Week 3 Discussion

The purpose of this discussion is to apply pathophysiological concepts to an individual presenting with cardiovascular dysfunction (heart failure). Related concepts will also be applied that includes potential alterations in fluid and electrolytes and acid/base balance. 

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to: 

  1. Explore age-specific and developmental alterations in the cardiovascular system. (CO 3, 1) 
  2. Relate pathophysiological alterations in cardiovascular processes to the development, diagnosis and treatment of heart failure. (CO 4, 2) 
  3. Examine current evidence to support the management of patients who present with alterations in the cardiovascular system. (CO 5, 3) 

 

Due Date

The student must provide an answer to the graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. 

 Students must post a minimum of two times (response to peers) in the graded discussion. The two posts in the discussion must be on separate days.  Posting twice on two different days meets the minimumrequirement.  For full credit, the student must post at least three substantive posts on three different days. In addition, students must respond to all faculty questions. 

 A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday11:59 p.m. MT regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT. 

 A 10% penalty will be imposed for not entering the minimum number/type of interactive dialogue posts OR not posting on the minimum required number of days. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). 

Total Points Possible:  100

Requirements:

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 failure. 
  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 symptoms. 
  4. Include two points of teaching for this patient 
  5. Support your response with at least one current evidence based resource. 
  6. Students must post a minimum of three times in each graded discussion (see participation guidelines below).

Solution:

Discuss the pathophysiological mechanisms that can lead to heart failure

 When heart failure occurs, it results from a reduction in the efficiency of the heart muscle. This can result from n array of factors with hypertension and myocardial infarction being the key factors. The pathophysiological mechanism that could have to lead the heart failure in the patient is the loss of myocardium function that could have resulted from the ischemic disease or infraction (Rosenthal & Burchum, 2018). Similarly, the patient had hypertension which could have resulted in excessive pressure overload. The dysfunction, therefore, leads to an increased amount in the ventricle hence an increase in both end-systolic and end-diastolic volumes (Rosenthal & Burchum, 2018). As a result, an increase in LV end-diastolic pressure is caused and atrial pressure increases the pressure in the lungs and forces the fluid…Please click the icon below to purchase full solution at $5