Case Study of the Week: About half of individuals diagnosed with heart failure die within 5 years of diagnosis.
Distributive[ edit ] Distributive shock is due to impaired utilization of oxygen and thus production of energy by the cell. Septic shock is the most common cause of distributive shock.
Terminology. Heart failure is a pathophysiological state in which cardiac output is insufficient to meet the needs of the body and lungs. The term "congestive heart failure" is often used, as one of the common symptoms is congestion, or build-up of fluid in a person's tissues and veins in the lungs or other parts of the body. Specifically, congestion takes the form of water retention and. Congestive Heart Failure CHF occurs when the left ventricle cannot pump out the amount of blood entering the ventricle, or when the ventricle is damaged and cannot effectively pump enough blood to meet the body’s requirements. Med-Surg Success in the Palm of Your Hand Master the art of critical thinking and clinical reasoning with this book designed to help you develop and utilize the nursing process and prioritization in real to life case studies surrounding the most commonly seen and tested patient diagnosis.
Septic shock can be caused by Gram negative bacteria such as among others Escherichia coliProteus species, Klebsiella pneumoniae which have an endotoxin on their surface which produces adverse biochemical, immunological and occasionally neurological effects which are harmful to the body, and other Gram-positive cocci, such as pneumococci and streptococciand certain fungi as well as Gram-positive bacterial toxins.
Septic shock also includes some elements of cardiogenic shock. Patients who are receiving inotropic or vasopressor agents may have a normalized blood pressure at the time that perfusion abnormalities are Congestive heart failure case study nursing.
High spinal injuries may cause neurogenic shock. Endocrine[ edit ] Based on endocrine disturbances such as: Hypothyroidism can be considered a form of cardiogenic shock in people who are critically ill patients, reduces cardiac output and can lead to hypotension and respiratory insufficiency.
Thyrotoxicosis cardiogenic shock may induce a reversible cardiomyopathy. Acute adrenal insufficiency distributive shock is frequently the result of discontinuing corticosteroid treatment without tapering the dosage. However, surgery and intercurrent disease in patients on corticosteroid therapy without adjusting the dosage to accommodate for increased requirements may also result in this condition.
Relative adrenal insufficiency distributive shock in critically ill patients where present hormone levels are insufficient to meet the higher demands Pathophysiology[ edit ] Effects of inadequate perfusion on cell function.
There are four stages of shock. As it is a complex and continuous condition there is no sudden transition from one stage to the next. Poor blood supply leads to cellular damage, which results in an inflammatory response to increase blood flow to the affected area. This is normally very useful to match up blood supply level with tissue demand for nutrients.
However, if enough tissue causes this, it will deprive vital nutrients from other parts of the body. Additionally, the ability of the circulatory system to meet this increase in demand causes saturation, and this is a major result, of which other parts of the body begin to respond in a similar way; thus, exacerbating the problem.
Due to this chain of events, immediate treatment of shock is critical for survival. Due to the lack of oxygen, the cells perform lactic acid fermentation.
Since oxygen, the terminal electron acceptor in the electron transport chain, is not abundant, this slows down entry of pyruvate into the Krebs cycleresulting in its accumulation. Accumulating pyruvate is converted to lactate by lactate dehydrogenase and hence lactate accumulates causing lactic acidosis.
Compensatory[ edit ] This stage is characterised by the body employing physiological mechanisms, including neural, hormonal and bio-chemical mechanisms in an attempt to reverse the condition.
As a result of the acidosisthe person will begin to hyperventilate in order to rid the body of carbon dioxide CO2. CO2 indirectly acts to acidify the blood and by removing it the body is attempting to raise the pH of the blood.
The baroreceptors in the arteries detect the resulting hypotensionand cause the release of epinephrine and norepinephrine.
Norepinephrine causes predominately vasoconstriction with a mild increase in heart ratewhereas epinephrine predominately causes an increase in heart rate with a small effect on the vascular tone; the combined effect results in an increase in blood pressure.
The renin—angiotensin axis is activated, and arginine vasopressin Anti-diuretic hormone ; ADH is released to conserve fluid via the kidneys. These hormones cause the vasoconstriction of the kidneysgastrointestinal tractand other organs to divert blood to the heart, lungs and brain.
The lack of blood to the renal system causes the characteristic low urine production. However the effects of the renin—angiotensin axis take time and are of little importance to the immediate homeostatic mediation of shock.
Due to the decreased perfusion of the cells, sodium ions build up within while potassium ions leak out. As anaerobic metabolism continues, increasing the body's metabolic acidosis, the arteriolar smooth muscle and precapillary sphincters relax such that blood remains in the capillaries.
As this fluid is lost, the blood concentration and viscosity increase, causing sludging of the micro-circulation. The prolonged vasoconstriction will also cause the vital organs to be compromised due to reduced perfusion.
Brain damage and cell death are occurring, and death will occur imminently.INTRODUCTION — Optimizing drug therapy is an essential part of caring for an older person. The process of prescribing a medication is complex and includes: deciding that a drug is indicated, choosing the best drug, determining a dose and schedule appropriate for the patient's physiologic status.
Congestive heart failure (CHF), otherwise known simply as heart failure (HF) is the medical term that describes the heart’s inability to pump sufficiently to maintain blood flow and meet the body’s metabolic torosgazete.com ineffective pumping leads to congestion of the venous circuit on both the pulmonary and systemic sides, leading to poor tissue perfusion and fluid overload.
Pathophysiology of Congestive Heart Failure Case Study: Congestive Heart Failure DIAGNOSTIC TESTING CXR 12 Lead/Telemetry Echocardiography BNP CBC & Lytes ABG BUN/Cr D. L. (). Congestive heart failure. Nursing, 13(9), Risk Factors Coronary Artery Disease Diabetes Smoking Valvular Heart Disease Hypertension Obesity/Overweight Male.
Case Study: A Post-Prosthetic Valve Replacement Patient with Congestive Heart Failure. Congestive heart failure is defined as “the state in which the heart is unable to pump blood at a rate adequate for satisfying the requirements of the tissues with function parameters remaining within normal limits usually accompanied by effort intolerance, fluid retention, and reduced longevity 5/5(18).
Congestive Heart Failure 2 Congestive Heart Failure: A Comprehensive Case Study The patient is a year-old African-American male with a history of coronary artery disease, essential hypertension, tobacco-use, abdominal, aortic, and renal artery aneurysms, and Hepatitis C.
Published: Mon, 5 Dec Mr. SB, year-old male is a retiree and was admitted to the hospital accompanied by his daughter. He is kg at a height of cm so his calculated body mass index (BMI) was indicating that he was overweight.