M2 Assgn Alexandre H- nurs 6501- advanced pathophysiology 6501N

 

 

Case Study Analysis Assignment

Scenario: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 hours to go to the bathroom.”

She now has to sleep on two pillows in order to get enough air.

Cardiovascular and cardiopulmonary pathophysiologic processes resulting in these

symptoms

According to Parmley (2015), congestive heart failure is known for being a syndrome

resulting from a variety of abnormalities such as loss of muscle, volume overload, primary

muscle disease, excessive peripheral demands like high output failure. In the usual form of heart

failure, the heart muscle tends to lead to a reduction in contractility. Consequently, this process

ends up producing a reduction in cardiac output, which makes it challenging to meet the

peripheral demands of the body (Parmley, 2015). In fact, this determinant of left ventricular

performance known as preload or left atrial filling pressure is increased, resulting in pulmonary

congestion and dyspnea or shortness of breath, which is one the symptoms experienced by the

patient in the scenario (Parmley, 2015). As for the manifestations of peripheral edema and

abdominal swelling, these symptoms are mainly due to the heart inability to pump blood around

the body properly, so the blood gathers in front of the heart (NCBI, 2016). As a result, and due to

the increased blood pressure in the veins, fluid seeps out into the surrounding tissue. This may

cause swelling in the legs or a build-up of fluid in the abdomen(NCBI, 2016).With that said,

these cardiovascular and cardiopulmonary pathophysiologic processes basically explain the

reasons behind the manifestation of these particular symptoms.

Any racial/ethnic variables that may impact physiological functioning

According to Dunsterfeld et al.(2016), racial and ethnic disparities in cardiovascular

disease care and outcomes persist after controlling for socioeconomic status, comorbidity, and

disease severity. Disparities are common in heart failure, a condition that affects 6 million

Americans and remains a frequent cause of hospitalization and mortality. In fact ,differences in

access and quality of care may partially explain the discrepancy between hospitalization and

mortality rates in minority patients compared to white patients (Dunsterfield et al., 2016).

Unfortunately, Black and Hispanic patients tend to receive care at poorer-performing hospitals

and have worse access to outpatient care. Hospitals with higher proportions of Black or Hispanic

Medicare patients have higher risk-adjusted heart failure readmission rates and greater racial and

ethnic disparities than hospitals that primarily serve white patients (Dunsterfield et al., 2016).

How these processes interact to affect the patient