Purpose

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 minimum requirement.  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 Wednesday, 11:59 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:

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