Question

A complex, multi-system disease process is defined as a condition or disorder that either affects the whole body or involves multiple organs. Your textbook uses diabetes as an example of a complex, multi-system disease process; while fundamentally a disease of dysfunctional glucose regulation, it affects nearly every system in the body and leads to altered elimination, altered perfusion, and so on.

You may select any complex, multi-system disease process that interests you except diabetes--the text has covered this disease in great detail. Some examples of disease process which may be explored include chronic kidney disease, systemic lupus erythematosus, Sjögren's syndrome, or vasculitis. There are, of course, many other diseases which would be appropriate to explore as nearly every disease process in the human body affects more than one physiologic system. If you have concerns about the appropriateness of your selected disease process, please contact the instructor early in the process of your project to review. The essay should include four major sections.

1. First, you should describe the altered physiology that leads to the disease state you have chosen. This may include more than one specific alteration.

2. Second, you should describe the clinical manifestations present in the disease, and explain why these manifestations present using pathophysiologic concepts to form your explanation.

3. Third, you should explain how the physiologic alteration causes multi-system alterations in function.

4. Finally, you should describe the treatment modalities used to restore normal function and give a simple explanation as to how the normal function is restored. Your must follow APA format with appropriate citations.

Answer 1

HYPERTENSION

Hypertension is defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation & Treatment of High Blood Pressure (JNC 7) as a systolic blood pressure greater than 140mmHg & a diastolic pressure greater than 90mmHg based on the average of two or more accurate blood pressure measurements taken during two or more contacts with a health care provider.(Chobanian, Bakris, Black, et al.,2003)

Hypertension is sometimes called the "SILENT KILLER" because people who have it are often symptom free.

Hypertension often accompanies other risk factors for artherosceloritic heart disease, such as dyslipidemis, obesity, diabetes mellitus, metabolic syndrome & a sedentary lifestyle. The prevalence is also higher in persons who have other cardiovascular conditions including heart failure, coronary artery disease & a history of stroke (Omg, et al., 2007).

The usual consequences of prolonged, uncontrolled hypertension are MYOCARDIAL INFARCTION, HEART FAILURE, RENAL FAILURE, STROKE & IMPAIRED VISION. As a disease, hypertension is a major contributor to death from cardiac, cerebrovascular, renal & peripheral vascular disease.

HENCE WE CAN SAY HYPERTENSION IS A COMPLEX, MULTISYSTEM DISEASE.

PHYSIOLOGY - PATHOPHYSIOLOGY OF HYPERTENSION

(Adapted from Kalpan, N. M., Lieberman, E. & Neal, W. (2006). Kalpan's clinical hypertension (9th ed.).

CLINICAL MANIFESTATIONS

• Elevated blood pressure
• Retinal changes such as hemorrhages, exudates, arteriolar narrowing & cotton wool spots
• In severe hypertension, papilledema may seen
• Coronary artery disease with angina & MI are common consequences of HTN
• Left ventricular hypertrophy
• Pathological changes in kidneys (such as elevated blood urea nitrogen, serum creatinine levels) manifests as nocturia
• Cerebro vascular involement may leads to stroke or TRANSIENT ISCHEMIC ATTACK

TREATMENT MODALITIES

1. PHARMACOLOGIC THERAPY

The medications used for treating hyprrtehyper decrease PERIPHERAL RESISTANCE, BLOOD VOLUME, OR THE STRENGTH & RATE OF MYOCARDIAL CONTRACTION. for patients with uncomplicated hypertension, recommended initial medications are DIURETICS, BETA BLOCKERS OR BOTH.

Treatment begins with lufestyli modifications and continues with various medication regimens. ACE-1, ANGIOTENSIN CONVERTING ENZYME INHIBITORS, ALDO ANT, ALDOSTERONE ANTAGONIST, ARB, ANGIOTENSIN RECEPTOR BLOCKER, CALCIUM CHANNEL BLOCKER, THIAZIDE DIURETIC (from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, & Treatment of High Blood Pressure. Reference card available from the National, Heart, Lung & Blood Institute, available at www.nhlbi.nih.gov/guide)

2. Lifestyle modifications include:

• Weight reduction
• Adopt DASH diet( dietary approaches to stop hypertension)
• Dietary sodium reduction
• Physical activity
• Moderation of alcohol consumption