NR507 week 3 Discussion
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.
- Discuss the pathophysiological mechanisms that can lead to heart failure.
- Differentiate between systolic and diastolic heart dysfunction
- 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.
- Include two points of teaching for this patient
- Support your response with at least one current evidence based resource.
- Students must post a minimum of three times in each graded discussion (see participation guidelines below).
Solution:
Pathophysiology of Heart Failure
Heart failure is a condition in which the heart is unable to pump sufficient blood to meet the metabolic needs of the tissues. The key underlying cause of heart failure is chronic hypertension and myocardium infarction. Other causes include coronary artery disease, dysrhythmias as well as aging of the myocardium. In the initial phase of heart failure, the hear undergoes remodeling a process through which he ventricles dilate, hypertrophy, and become more spherical. The alteration increases the stress on the wall and reduced LV ejection fraction. Remodeling results from cardiac injury. As remodeling continues, cardiac performance declines. The body continues to undergo adaptive change as cardiac output continues to reduce….Click link below to purchase full tutorial at $5
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