Activity 4: Chronic Heart Failure

Question Answered step-by-step Activity 4: Chronic Heart Failure Aim: to discuss the… Activity 4: Chronic Heart FailureAim: to discuss the pathophysiology and treatment of chronic heart failureCXA240 Pathophysiology for Health Care 1 Intensive 1: Alterations in Cardiovascular HealthOne year ago, Albin Larsson, 67 years old, had a large anterior wall MI and underwent subsequent coronary artery bypass surgery. On discharge, he was started on a regimen of enalapril, digoxin, frusemide, warfarin and a potassium chloride supplement. He is now in the cardiac unit complaining of severe shortness of breath, haemoptysis and poor appetite for 1 week. He is diagnosed with acute heart failure.Mr Larsson refuses to settle in bed, preferring to sit in the bedside recliner in high-Fowler’s position. He states, ‘Lately, this is the only way I can breathe.’ Mr Larsson states that he has not been able to work in his garden without getting short of breath. He complains of his shoes and belt being too tight.Mr Larsson insists that he takes his medications regularly. He states that he normally works in his garden for light exercise. In his diet history, Mr Larsson admits fondness for bacon and takeaway food and sheepishly admits to snacking between meals ‘even though I need to lose weight’.Mr Larsson’s vital signs are: BP 95/72 mmHg, HR 124 and irregular, R 28 and laboured, and T 36.5°C. The cardiac monitor shows atrial fibrillation. An S3 is noted on auscultation; the cardiac impulse is left of the midclavicular line. He has crackles and diminished breath sounds in the bases of both lungs. Significant jugular venous distension, 3+ pitting oedema of feet and ankles and abdominal distension are noted. Liver size is within normal limits by percussion. His skin is cool and he is diaphoretic. Chest x-ray shows cardiomegaly and pulmonary infiltrates.Mr Larsson is diagnosed with acute heart failure. With your own words, explain what acute heart failure is and how it is related to the MI that he suffered a year ago.Mr Larsson refuses to lay down flat because he feels that he cannot breathe. What is the reason for this? Explain the pathophysiological mechanism for this observation.Mr Larsson presents 3+ pitting oedema of feet and ancles. What other observations are related to this? What effect would this have on his blood pressure?  Health Science Science Nursing CXA 240 Share QuestionEmailCopy link Comments (0)

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