Cardiovascular/Respiratory

Cardiovascular/Respiratory

Case Study for Week 5

Marjorie Taylor, age 62, comes to the emergency department with mild respiratory distress, increasing dyspnea, orthopnea, bilateral ankle edema, and sudden weight
gain. She states that she has had severe hypertension for many years, and that she has been unable to afford her antihypertensive medication for the past several
months.
Answer the questions in the activity below to explore the pathophysiology of Ms. Taylor’s condition.

1. What assessment questions should you ask Ms. Taylor about her hypertension?
I would start by asking Ms. Taylor what was the name of her blood pressure medications and exactly how long ago has it been since she took her last pill. I would also
like to know if she monitors her blood pressure. I would ask what made her deciced today to come to the ER. I would ask she was having a fever, chest pain,
diaphoretic, shortness or breath, or feeling fatigue, weakness, I would also ask if she was having headaches, blurred vision or any vision changes.
PMX: Does she have high cholesterol, diabetes, does she smoke, drink, any illegal drug use. lifestyle
would ask the patient what is their target blood pressure.I would ask the patient if they have a history of elevated blood cholesertol and other past healthy history
questions. Then I would ask the patient about her current lifestyle and pyschosocial status. I want to know how her nutrition, smoking and alcohol intake has been. I
also want to know if she is getting any exercise and i know she has not been taking her medication because she cannot afford them. I would also want to know her weight
and her food intake.
I also want to if she has had a fever, sudden weight gain, chest pain, diaphoreses, dyspnea and feeling faint. I would also want to know if she is experiencing
headaches, nausea, blurred vision any dizziness and constipation.
2. Why should you ask her if she has had any recent episodes of chest pain or any history of angina or heart attack? I would ask if she had any history of angina
or heart attacks because un treated hypertenion damages the heart. Over time, the strain on your heart caused by high blood pressure can cause your heart muscle to
weaken and work less efficiently. Eventually, your overwhelmed heart simply begins to wear out and fail. Damage from heart attacks adds to this problem.
3. Why is it important to determine if Ms. Taylor has fainted or if she has a diminished urine output? I would ask if she had any history of angina or heart
attacks because un treated hypertenion damages the heart. Over time, the strain on your heart caused by high blood pressure can cause your heart muscle to weaken and
work less efficiently. Eventually, your overwhelmed heart simply begins to wear out and fail. Damage from heart attacks adds to this problem.
4. Why should you listen to Ms. Taylor’s lungs? I would listen to the lungs for any signs of fluid build up

5. Echocardiography leads to a diagnosis of systolic CHF. What is systolic heart failure? Systolic Heart failure happens when the left ventricle looses its
ability to pump out blood blood to the body that it needs.
6. Given her diagnosis of systolic heart failure, would you expect her ejection fraction to be normal, decreased, or increased? Explain your answer I would think
Ms. Taylor has congestive heart failure because of her symptoms. I think that her heart doesn’t pump as well is it should and as a result the kidneys may be responding
by causing the body to retain fluid and say. if the fluid builds up in the arms, legs, ankles, feet ad lungs and other oragns it is usually CHF.

7. Does Ms. Taylor have left, right, or biventricular failure? Explain your answer. I would think Ms. Taylor has congestive heart failure because of her symptoms.
I think that her heart doesn’t pump as well is it should and as a result the kidneys may be responding by causing the body to retain fluid and say. if the fluid builds
up in the arms, legs, ankles, feet ad lungs and other oragns it is usually CHF.

8. Ms. Taylor wants to know why she is so short of breath. How should you respond? I would tell Ms. Taylor she is so short of breath because your body can’t pump
the blood to your body because the heart is damaged somehow. When the body can’t pump the blood to your body the fluid builds up in your lungs.
9. Ms. Taylor says, “They said that I have heart failure. Is that a heart attack?” How should you respond? I would tell Ms. Taylor that they are not the same, a
heart attack is when the blood supply goes wrong suddenly and usually a blood vessel is blocked and heart failure usually when i have seen it follows a heart attack
because the heart muscles dies.
10.

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