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Caase Study

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Submitted By angelam
Words 299
Pages 2
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Congestive Heart Failure

Primary causes: Age

Precipitating Factors:

Diastolic Failure

Systolic Failure

Inability of the heart to pump blood

Inability of the ventricles to relax and fill

Decreased cardiac output

Main compensatory mechanisms

Sympathetic nervous system activation

Increase release of catecholamines

Increase myocardial contractility and peripheral vasoconstriction

s/sx: increased BP

Neurohormonal response

Decrease CO will be sensed by the kidneys

Decrease CO will be sensed by posterior pituitary gland

RAAS will be activated

Increase release of ADH

Increase aldosterone level

Peripheral vacoconstriction

Na and water retention

s/sx: increased BP

Nephrotoxicity /Nephropathy

Increase water reabsorption by renal tubule

Dilation and enlargement of heart chambers

Stretching of muscle fibers of the heart

Increase contraction (Frank-starling law)

Increase O2 requirement to perform work

Presence in the skin/skin changes

Tissue Hypoperfusion

s/sx: Weakness, fatigue, pallor. Pale nail beds and lips

Increase cardiac workload, leading to overworked heart

Heart failure

Increased Fluid backup into the lungs

Increased Pulmonary Pressure

Impaired Gas exchange

s/sx; dry Cough, Fatigue, Orthopnea, Irritability, Crackles

Legend: pathophysiology signs/symptoms lab result diagnosis

Kidney hypoperfusion

Decrease glomerular filtration rate

Decrease nephron function

Heart failure

Renal Failure (impaired renal excretory ability)

Increase amount of unconjugated bilirubin

Labs: increased BUN, serum Creatinine, Uric Acid

Diagnostic tests: ECG

s/sx: pulmonary hypertension

Renal Complications

Pulmonary complications

Increase Uric Acid leads to Gouty Arthritis

Diagnostic Test: x-ray Pulmonary congestion

s/sx: painful swelling on the left foot

Decreased erythropoietin production

Decrease production of blood cells by the bone marrow

Anemia

Increase Liver’s detoxification process

Increase RBC hemolysis/ Decrease RBC lifespan

Labs: Decrease Hgb

s/sx: Pallor, easy fatigability, pale nail beds and lips, pale conjunctiva

s/sx: Pruritus, jaundice

s/sx: Jugular neck vein distention, unidentical apical and radial pulse, weak peripheral pulse

s/sx: abdominal ascites

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