NURS 312 – Pathophysiology Mystery Case Study

You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning.

Case Study-76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hour to go to the bathroom.” She now has to sleep on two pillows in order to get enough air.NURS 312 – Pathophysiology Mystery Case Study

References

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier. Chapters 32, 33, 35, 36.

Heart Failure: Diagnosis, Management and Utilization

Arati A. Inamdar1,2,* and Ajinkya C. Inamdar2 https://www-ncbi-nlm-nih-gov.

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Pathophysiology Case Study: A 76-Year-Old Female with a History of Congestive Heart Failure

The 76-year-old female patient has a significant history of congestive heart failure (CHF). She now presents with a chief complaint of weight gain, peripheral edema, dyspnea, and abdominal swelling. Management with diuretics (especially loop diuretics such as torsemide or furosemide) is one of the hallmarks of congestive heart failure treatment. This elderly patient has admitted to not taking her diuretic medication as prescribed. It is therefore plausible that the accumulation of fluid in her body is what is responsible for her symptoms. When the heart fails, it cannot effectively pump blood to the rest of the body. This causes a backflow of oxygenated blood in reverse direction from the left ventricle to the left atrium to the pulmonary vein and finally back to the lungs. The fluid then seeps into the lung interstices causing pulmonary edema and dyspnea. This pressure is transferred back to the pulmonary artery, right ventricle, right atrium, the vena cavae, and finally backwards into the venous system. The result is an extravasation of intravascular fluid into the peripheral interstices causing peripheral edema. The same fluid seeping from the venous system due to the HF pressure collects in the abdomen as ascites causing the abdominal swelling. Lastly, the collective accumulation of fluid due to the CHF and lack of effective diuresis (lack of adherence to treatment) causes the increase in weight or weight gain experienced by the patient (McCance & Huether, 2019; Hammer & McPhee, 2018; Inamdar & Inamdar, 2016).NURS 312 – Pathophysiology Mystery Case Study

For African Americans (AA), the risk of even more severe symptoms is even higher due to genetic predisposition to more serious heart disease. AA are more likely to have hypertension and to die from all-cause mortality related to heart disease (Hammer & McPhee, 2018). Lastly, the fact that this patient is elderly and experiencing normal physiological deterioration in function associated with ageing makes the symptoms more pronounced. This is because the normal physiological compensatory mechanisms are no longer as efficient as before.

References

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Inamdar, A.A., & Inamdar, A.C. (2016). Heart failure: Diagnosis, management, and utilization. Journal of Clinical Medicine, 5(7). https://doi.org/10.3390/jcm5070062

McCance, K.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children, 8th ed. Mosby/Elsevier

NURS 312 – Pathophysiology Mystery Case Study