Homework 3

1. Which type of heart failure (left or right sided) is usually associated with dyspnea? Left sided
2. What other clinical findings are likely to be present with this type of heart failure? Orthopnea, cough, crackles in the lungs, fatigue, oliguria, increased HR, confusion and anxiety
What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? Increased Heart Rate and LV EDV
What is the most likely cause of A.O.’s pedal edema? Right Sided heart failure
What is the cause of A.O.’s exertional chest pain? Stable Angina

Case 2 Questions:
C.C. is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. He was tachycardic, hypotensive, unresponsive, and ventilating poorly when admitted. He was placed on a mechanical ventilator and given IV fluids for shock. C.C. responded well to fluids, with an increase in blood pressure and an improvement in urine output.

1. Based on his case history and responsiveness to fluid therapy, what type of shock was C.C. experiencing? Hypovolemic Shock

2. What other clinical findings would be helpful in confirming the type of shock?
Low blood pressure, weak pulse, cyanosis of the lips and fingertips, shallow breathing
3. Because of his many open wounds and invasive lines, C.C. is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed? Chills, light-headedness, little or no urine, palpitations, skin rash or discoloration.