Monday, April 25, 2022

Why Did Mr Stone Develop Heart Failure

Don't Miss

Association Between Arterial Stiffness And Heart Failure With Preserved Ejection Fraction

Approach to Pediatric Heart Failure
  • Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

Cardiovascular diseases are the leading cause of mortality in the world. Heart failure with preserved ejection fraction accounts for about half of all heart failure. Unfortunately, the mechanisms of HFpEF are still unclear, leading to little progress of effective treatment of HFpEF. Arterial stiffness is the decrement of arterial compliance. The media of large arteries degenerate in both physiological and pathological conditions. Many studies have proven that arterial stiffness is an independent risk factor for cardiovascular disorders including diastolic dysfunction. In this perspective, we discussed if arterial stiffness is related to HFpEF, and how does arterial stiffness contribute to HFpEF. Finally, we briefly summarized current treatment strategies on arterial stiffness and HFpEF. Though some new drugs were developed, the safety and effectiveness were not adequately assessed. New pharmacologic treatment for arterial stiffness and HFpEF are urgently needed.

The Frequent Forgotten And Often Fatal Complication Of Diabetes

  • David S.H. Bell, MB, FACE
  • From the Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
  • Address correspondence and reprint requests to David S.H. Bell, MB, FACE, 1808 Seventh Ave. S., Rm. 813, Birmingham, AL 35294. E-mail: dbellendo.dom.uab.edu
  • Students Who Viewed This Also Studied

    video case study fluid volume.docx

    Lone Star College System

    case study heart failure .pdf

    University Of Connecticut

    Western Nebraska Community College NURS 2280

    Hinojosa_Unit2_MSII.docx

    Lone Star College System BIOL 2401

    video case study fluid volume.docx

    University Of Connecticut NURS 3120

    case study heart failure .pdf

      Recommended Reading: Does Acid Reflux Cause Heart Palpitations

      This Problem Has Been Solved

      Why did Mr. Stone develop heart failure?

      The patient is a 60-year-old male who has hypertension and heartfailure. He had Hydrochlorothiazide prescribed by MD for hishypertension a couple of years ago. However, the patient has nottaken the medications as directed. He complains that he isexperiencing increasing fatigue, shortness of breath, paroxysmalnocturnal dyspnea and weight gain. An ECG and a chest x-ray wereperformed and also had blood drawn. The patient is alert andoriented. His bp was 168/96 mmHg, the temperature was 98.4, pulse98/min and RR was 22/min. Oxygen saturation 90% on room air andincreased to 94% with oxygen at 2 liters/min, per nasal cannula.The nurse administered Enalapril 5 mg PO.

      This Homework Is Solved By This Writer

      How are kidney stones formed?  Timeslifestyle

      You can always ask and chat with this writer about your homework needs.

      Client’s rating on Homework:

      5.00

      Contact Online Assignment Help to complete a Homework like this.

      “You Will Get Top Grades in your Class”

      Singapore

      I Provide “Top Class Academic Writing Services” to my Clients

      Canada

      I will help you get A Grades in your Assignments

      United States of America

      Best Homework Helper & Writer on Tutorsonspot.com

      Pakistan

      I Promise you Top Results

      Kenya

      Highly Qualified and Experienced Academic Writer

      Pakistan

      “Top Assignment Solver on Tutorsonspot”

      Australia

      India

      Read Also: How Much Blood Does The Heart Pump

      What Other Information Should I Know

      Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly, and blood tests should be done occasionally.

      Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking hydrochlorothiazide.

      Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

      It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

      See The Difference Between Good Ideas And Bad Ones

      We bet the last thing you want to hear from your teacher after turning in your paper is, Thats an interesting idea. However, you were supposed to write about an absolutely different thing. With us, your paper will be exactly what your teacher expects to see.

      Served 13821 different students from America, Australia, Canada, United Kingdom, Saudia and UAE Universities. Chat free with our top online writers to get homework writing help.

      Read Also: Vitamin D3 And Heart Palpitations

      Why Did Mr Stone Develop Heart Failurethe Patient Is A 60

      Why did Mr. Stone develop heart failure?

      The patient is a 60-year-old male who has hypertension and heartfailure. He had Hydrochlorothiazide prescribed by MD for hishypertension a couple of years ago. However, the patient has nottaken the medications as directed. He complains that he isexperiencing increasing fatigue, shortness of breath, paroxysmalnocturnal dyspnea and weight gain. An ECG and a chest x-ray wereperformed and also had blood drawn. The patient is alert andoriented. His bp was 168/96 mmHg, the temperature was 98.4, pulse98/min and RR was 22/min. Oxygen saturation 90% on room air andincreased to 94% with oxygen at 2 liters/min, per nasal cannula.The nurse administered Enalapril 5 mg PO.

      Long term hypertension can lead to heart failure:

      Mechanism behind it is, left ventricular hypertrophy.As due toincreasing blood pressure there occurs increasingly resistance toblood pumping by the left ventricle into the aorta.This increasedresistance leads to building of muscle fibers in the left ventriclewall leading to its hypertrophy

      This leads to narrowing of the left ventricle chamber.So theamount of blood present in the chamber decreases leading to reducedstroke volume which in turn leads to heart failure

      Add Answer to:

      Why did Mr. Stone develop heart failure?The patient is a 60-year-old male who has hypertension…

      Why Did Mr Stone Develop Heart Failure

      AFRAID of Full Body Routines! (3 Reasons Why You’ll HAVE to Change!)

      Why did Mr. Stone develop heart failure? The patient is a 60-year-old male who has hypertension…Why did Mr. Stone develop heart failure?

      The patient is a 60-year-old male who has hypertension and heart failure. He had Hydrochlorothiazide prescribed by MD for his hypertension a couple of years ago. However, the patient has not taken the medications as directed. He complains that he is experiencing increasing fatigue, shortness of breath, paroxysmal nocturnal dyspnea and weight gain. An ECG and a chest x-ray were performed and also had blood drawn. The patient is alert and oriented. His bp was 168/96 mmHg, the temperature was 98.4, pulse 98/min and RR was 22/min. Oxygen saturation 90% on room air and increased to 94% with oxygen at 2 liters/min, per nasal cannula. The nurse administered Enalapril 5 mg PO.

      Recommended Reading: Does Acid Reflux Cause Heart Palpitations

      How To Manage The Increasing Complexity Of Hf Management

      The 2017 HF ECDP was motivated by an increasingly complex HFrEF management environment and the need to assist clinicians in navigating it . In the 3 years since its publication, GDMT for HFrEF now has additional medications that improve patient outcomes, thus further increasing the complexity of achieving target GDMT in all patients with HFrEF. As detailed in , the modulation of 12 pathophysiological targets has now been shown to improve symptoms and/or outcomes for patients with HFrEF.

      Table 14 Important Pathophysiological Targets in Chronic, Hemodynamically Stable HFrEF and Treatments

      Target
      Surgical or percutaneous mitral valve repair
      Reduced aerobic capacityAerobic exercise training

      ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; ARNI = angiotensin receptor-neprilysin inhibitor; HFrEF = heart failure with reduced ejection fraction; HYD/ISDN = hydralazine/isosorbide dinitrate; SGLT2 = sodium-glucose cotransporter-2.

      Principle 1: GDMT is the foundation of HF care, and the GDMT with the highest expected benefit should be prioritized. Based on large randomized trials for HFrEF, ARNIs, evidence-based beta-blockers, aldosterone antagonists, and SGLT2 inhibitors are first-line medications for all populations. HYD/ISDN is also a first-line medication for self-identified African Americans. Ivabradine is a second-line medication for select populations.

      Scenario: Worsening renal function or hyperkalemia.

      Scenario: Symptomatic hypotension.

      How To Initiate Add Or Switch To New Evidence

      Established therapies for chronic HFrEF include ARNIs, angiotensin-converting enzyme inhibitors , angiotensin receptor blockers , beta-blockers, loop diuretics, aldosterone antagonists, hydralazine/isosorbide dinitrate , and ivabradine, an If channel blocker highly selective for the sinoatrial node pacemaker current. With the exception of loop diuretics, all of these therapies have been shown in randomized controlled trials to improve symptoms, reduce hospitalizations, and/or prolong survival . Use of digoxin as a treatment for HFrEF lacks new data; most of its use in modern HFrEF management focuses on its role as a rate control agent for atrial fibrillation in those with low blood pressure.

      Following the publication of the 2017 ECDP focused on optimizing therapy for HFrEF, more data have emerged to support an expanded role for ARNIs in patients with HFrEF. These data include their use as a de novo therapy in some patients naive to ACEIs or ARB therapies , evidence for rapid improvement in patient-reported outcome measures , and the demonstration of a reverse-remodeling effect of ARNIs in chronic HFrEF, independent of background therapy with ACEIs/ARBs . It is not yet clear that de novo initiation is best for all patients with HFrEF , and we do recognize access challenges for some patients with regards to payer coverage and associated costs of ARNIs.

      Table 1 Starting and Target Doses of Select GDMT and Novel Therapies for HF

      5.1.1 Initiating GDMT

      Don’t Miss: Acid Reflux Cause Palpitations

      Case Study On A Patient With Heart Failure

      Info: 4157 words Nursing Essay 13th Feb 2020

      Mr. SB, 60-year-old male is a retiree and was admitted to the hospital accompanied by his daughter. He is 100kg at a height of 180cm so his calculated body mass index was 30.9 indicating that he was overweight. When admitted, patient was complained of shortness of breath for 2 weeks and was worsening on the day of admission. Besides, he also experienced orthopnea, fatigue, paroxysmal nocturnal dyspnea and leg swelling up to his thigh. Mr. SB was admitted to the hospital for to the same problem last year.

      If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help!

      Mr. SB had known case of heart failure since 3 years ago and he had also diagnosed with hypertension for 5 years. Before admitted to the hospital, patient was taking frusemide 40mg, aspirin 150mg, metoprolol 50mg, amlodipine 10mg, and simvastatin 40mg for his hypertension and heart failure. Patient does not allergic to any medication and he does not take any traditional medicines at home. His family history revealed that his father had died of ischemic heart disease 4 years ago while his brother has hypertension. As for his social history, he smokes 2-3 cigarettes a day for 35 years and the calculated smoking pack years was 5 pack years. Besides, Mr. SB also drinks occasionally.

      Does Arterial Stiffness Relate To Hfpef

      Gallstones: Causes and Risk Factors

      Although many studies reported the associations among arterial stiffness, diastolic dysfunction, and HFpEF, till now there is very few evidence to prove that arterial stiffness is a key factor which drives the development of HFpEF. A study conducted by Wan et al. showed that, in 488 hypertensive patients with HFpEF, two arterial stiffness parameters, arterial pressure volume index and arterial velocity pulse index , were both significantly associated with the onset of HFpEF. Another case control study which included 77 matched pairs demonstrated that, participants with decreased aortic distensibility were more easily to develop HFpEF with asymptomatic diastolic dysfunction . However, negative association between arterial stiffness and HFpEF was also reported. In the Health ABC study, the authors divided 2,290 elderly participants into three groups based on the tertiles of PWV measured at baseline. This study demonstrated that, after adjustment for conventional cardiovascular risk factors, compared to participants with low PWV , participants with high PWV were not significantly associated the high risk of HFpEF with the mean follow-up time of 11.2 years . More large prospective studies are warranted to further investigate the relationship between arterial stiffness and HFpEF.

      Don’t Miss: List The Steps Of How To Calculate Your Target Heart Rate Zone

      Liver Size And Hepatojugular Reflux

      The key component of the abdominal examination is the evaluation of liver size. Hepatomegaly may occur because of right-sided heart failure and venous congestion.

      The hepatojugular reflux can be a useful test in patients with right-sided heart failure. This test should be performed while the patient is lying down with the upper body at a 45-degree angle from the horizontal plane. The patient keeps the mouth open and breathes normally to prevent Valsalva’s maneuver, which can give a false-positive test. Moderate pressure is then applied over the middle of the abdomen for 30 to 60 seconds. Hepatojugular reflux occurs if the height of the neck veins increases by at least 3 cm and the increase is maintained throughout the compression period.18

      Understand The Causes And Conditions Leading To Hf

      Most people who develop heart failure have another heart condition first. The most common conditions that can lead to heart failure are coronary artery disease, high blood pressure and previous heart attack. If youve been diagnosed with one of these conditions, its critical that you manage it carefully to help prevent the onset of heart failure.

      The American Heart Association is here to help. The best thing you can do for yourself is to follow all of your healthcare providers instructions and make any needed changes in diet, physical activity and lifestyle. This will help give you the highest possible quality of life.

      Read Also: Does Acid Reflux Cause Heart Palpitations

      What Should I Know About Storage And Disposal Of This Medication

      Keep this medicine in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture . Do not allow the liquid or capsules to freeze.

      It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

      Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

      What Members Of The Interprofessional Health Care Team Provide Palliative/hospice Care And What Roles Do They Play

      What are kidney stones, what causes them, and how do I prevent them?

      What members of the interprofessional health care team provide palliative/hospice care, and what roles do they play?

      2. From the report, what clinical manifestations did the nurse obtain that indicate diabetes mellitus type 1? What additional report information would the nurse need before beginning care for Billy?

      3. You have a patient with a suspected skin infection on his leg. What standard and isolation precautions do you need to follow? Why?

      4. What are the types and classifications of antibiotics, and their actions? What type of antibiotic should the nurse administer for this client and why?

      5.mr stone is hypertension and did not take his medication as directed, he recently notice a weight gain.He came to the hospital because he develop a heart failure, ;Why did Mr. Stone develop heart failure?

      You May Like: Does Acid Reflux Cause Heart Palpitations

      Blood Pressure And Heart Rate

      The patient’s blood pressure and heart rate should be recorded. High, normal or low blood pressure may be present. The prognosis is worse for patients who present with a systolic blood pressure of less than 90 to 100 mm Hg when not receiving medication .16 Tachycardia may be a sign of heart failure, especially in the decompensated state. The heart rate increases as one of the compensatory ways of maintaining adequate cardiac output. A decrease in the resting heart rate with medical therapy can be used as a surrogate marker for treatment efficacy. A weak, thready pulse and pulsus alternans are associated with decreased left ventricular function. The patient should also be monitored for evidence of periodic breathing .

      Informed Refusal Of Treatment

      Usually, left ventricular assist devices are employed as a bridge to heart transplant . It follows that they should be discontinued once one is no longer a candidate for transplant. Unfortunately the decision is not that easy; recent research suggests that a significant number of patients with advanced cardiomyopathy show a reduction in heart size and improvement in left ventricular function after receiving these devices . This recent data must be shared with the patient and a recommendation made about whether to keep the device for a certain period of time before discontinuation. Of course the ultimate decision will depend upon the nature of the original consent and upon a sincere discussion with the patient about the recent clinical findings. It must be emphasized that the decision either to persist with a treatment or discontinue it and bear the consequences rests with the patient; this is the doctrine of informed refusal of treatment. It is particularly applicable if the initial consent was for transient use of the device .

      You May Like: What Branch Of Medicine Deals With Heart Disease

      Is There A Link Between Hbp And Heart Failure

      Heart failure, a condition where your heart is unable to provide enough blood to the body, can take years to develop inside your body. The narrowing and blocking of blood vessels caused by high blood pressure; increases your risk of developing heart failure.

      • High blood pressure adds to your hearts workload: Narrowed arteries that are less elastic make it more difficult for the blood to travel smoothly and easily throughout your body causing your heart to work harder.;
      • Over time, a higher workload leads to an enlarged heart: In order to cope with increased demands, the heart thickens and becomes larger. While it is still able to pump blood, it becomes less efficient. The larger the heart becomes, the harder it works to meet your body’s demands for oxygen and nutrients.

      More articles

      Popular Articles