NR 507 Week 1 Case Study: A 35-year-old woman presents to the primary 100% correct
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Course
NR 507 Advanced Pathophysiology (NR507)
Institution
Chamberlain College Of Nursing
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Utilizing the Week 1 Case Study Template (Links to an external site.), provide your responses to the case study questions listed
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of ...
nr 507 week 1 case study a 35 year old woman presents to the primary
read the case study listed refer to the rubric for grading utilizing the week 1 case study template links to an external site
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Chamberlain College Of Nursing
NR 507 Advanced Pathophysiology (NR507)
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A 72-year-old male presents to the primary care office with shortness of breath, leg
swelling, and fatigue. He reports that he stopped engaging in his daily walk with friends
three weeks ago because of shortness of breath that became worse with activity. He
decided to come to the office today because he is now propping up on at least 3 pillows
at night to sleep. He tells the NP that he sometimes sleeps better in his recliner chair.
PMH includes hypertension, hyperlipidemia and Type 2 diabetes.
Physical Exam:
BP 106/74 mmHg, Heart rate 110 beats per minute (bpm)
HEENT: Unremarkable
Lungs: Fine inspiratory crackles bilateral bases
Cardiac: S1 and S2 regular, rate and rhythm; presence of 3rd heart sound; jugular
venous distention. Bilateral pretibial and ankle 2+pitting edema noted
ECG: Sinus rhythm at 110 bpm
Echocardiogram: decreased wall motion of the anterior wall of the heart and an ejection
fraction of 25%
Diagnosis: Heart failure, secondary to silent MI
Discussion Questions:
Differentiate between systolic and diastolic heart failure.
Heart failure is the hearts inability to effectively pump enough blood to meet the body’s
need sometimes leading to decreased cardiac output. Systolic heart failure is when the
left ventricle does not have a strong enough contraction. Signs and symptoms of
systolic heart failure are shortness of breath, fatigue, swelling in legs, ankles and feet,
confusion, dizziness, nocturia.
Diastolic heart failure is when the left ventricle cannot relax between heartbeats this is
caused due to the heart tissues becoming too stiff. Cardiac output is compromised by
poor ventricular compliance. Ejection fraction is normal in diastolic heart failure. Just like
systolic heart failure shortness of breath, edema, unexplained fatigue, bulging jugular
vein.
State whether the patient is in systolic or diastolic heart failure.
With the patient having history of hypertension, decreased ejection fraction of 25%, the
patient has systolic heart failure. When ejection fraction is less than 40%, systolic heart
failure is likely, diastolic failure ejection fraction is normal (Ponikowski et. al., 2016).
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