In: Nursing
1. Explain the association between the manifestations and the pathophysiology associated with congestive heart failure.
2. Describe the compensatory mechanisms associated with congestive heart failure.
3. Analyze the above blood gas results. Explain the pathophysiologic mechanisms associated with these abnormalities.
Vital signs were:
BP: 136/98
HR: 120 BPM
Resp. 28/min
Temp. 37 degrees C.
Her arterial blood gas levels are:
pH:
7.20
pCO2: 52 mm Hg
pO2:
45 mm Hg
HCO3: 21 mmol/L
Answer to1st question:
The manifestations associated with congestive heart failure:
Signs and symptoms are --Dyspnea means shortness of breath,
--feeling tiredness excessively,
--exercise tolerance decreased,
-- legs,ankles and feet shows swelling or Edema,
--Fatigue, irregular heartbeat,
--Fluid retention in body results in weight gain rapidly ,
--Chest pain due to heart attack.
pathophysiology associated with congestive heart failure:
--Due to the pressure and volume overload in ventricles in the heart results in muscle contractility is reduced.
--This leads to decreases in the cardiac output and heart becomes insufficient to reach the peripheral needs in the body.
--muscle contractility shows reduction because overloading of ventricle,
--Pressure increases while preload or left atrial filling causes pulmonary congestion and shortness of breath or Dyspnea,
--frequent reduction in the systemic blood pressure however the afterload or systemic vascular resistance increases leads to further decreases in cardiac output,
--increase in heart rate , also there is imbalance happens with Myocardial oxygen need and supply,
--The Size of heart increases which cause damage to heart with high wall tension because high myocardial oxygen consumption,
-- Reduced in stroke volume shows due to failure of functions in systole and diastole.
Answer to 2nd question:
Compensatory mechanisms helps the body in adjusting the effects caused by Congestive heart failure for shorter period . If it prolongs for loner period result in further damage cause to heart muscles,enhances the heart size, decreases the ability to pump blood .
The compensatory mechanisms are
--The hormones and Nervous system increases the blood presssure with the help of sodium and water present in the body result in increases heart rate,
--The Catecholamines level increases which helps in the increasing heart muscle contracility and increase in heart rate in order to keep Cardiac output,
--The peripheral atrial venous oxygen need increases which helps in the increasing oxygen demand leads to cardiac output to maintain.
Answer to 3rd question:
In this, the Arterial blood gas levels are:
pH = 7.20 which is below than normal level ( 7.35 - 7.45)
PCO2 =52 which is above than normal level ( 35- 45 mm Hg)
PO2 = 45 which is below than normal level ( 75 -100 mm Hg)
HCO3 = 21 which is below than normal level ( 22 - 28 m mol /l)
Based on this, if pH Decreases and PCO2 increases than normal level then it is Acidosis.
if pH Decreases and HCO3 decreases than normal level then it is Acidosis.
This condition known as Respiratory Acidosis.
Pathophysiology:
The level of pH Decreases makes effect on mechanical ventilation and it results in ventilation decreased in function which leads to increase in arterial PCO2 level and causes acid-base imbalance happens.
-The acidosis happens when the lungs cannot remove adequate amount of carbon dioxide co2 produced in the body. So presence of high co2 in the body leads to decreases in pH levels and HCO3 levels make it too acidic.