NR 507 Week 3 Discussion Question: Congestive Heart
Failure
Rita Lewis
Week 3 Discussion
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
Category | Exam (elaborations) |
Release date | 2021-10-08 |
Pages | 5 |
Language | English |
Comments | 0 |
Sales | 0 |
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