Last Updated on March 5, 2024 by Admin
45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers
An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.
Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.
An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Scenario: 45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.
In your Case Study Analysis related to the scenario provided, explain the following
- The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
- Any racial/ethnic variables that may impact physiological functioning.
- How these processes interact to affect the patient.
Rubric
| Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:
Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms. |
28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation. |
25 (25%) – 27 (27%)
The response describes the patient symptoms. The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation. |
23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate. The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research. |
0 (0%) – 22 (22%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include reasons for either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research. |
||
| Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient. | 28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient. |
25 (25%) – 27 (27%)
The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient. |
23 (23%) – 24 (24%)
The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient. |
0 (0%) – 22 (22%)
The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient. |
||
| Explain any racial/ethnic variables that may impact physiological functioning. | 23 (23%) – 25 (25%)
The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation. |
20 (20%) – 22 (22%)
The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation. |
18 (18%) – 19 (19%)
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations based on inappropriate evidence/research. |
0 (0%) – 17 (17%)
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research. |
||
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. |
3 (3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. |
0 (0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
||
| Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. |
4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors. |
3 (3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. |
0 (0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
||
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. | 5 (5%) – 5 (5%)
Uses correct APA format with no errors. |
4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors. |
3 (3%) – 3 (3%)
Contains several (3 or 4) APA format errors. |
0 (0%) – 2 (2%)
Contains many (≥ 5) APA format errors. |
||
| Total Points: 100 | ||||||
Expert Answer and Explanation
Cardiovascular and Cardiopulmonary Pathophysiologic Processes that result in the Symptoms
The 45 y.o. woman who presents to the facility with shortness of breath, fevers, and thick green sputum is likely to face several cardiovascular and cardiopulmonary processes that influence the presence of these symptoms. One of these possible pathophysiologic processes that could result in the condition is the formation of blood clots in the capillaries of the lungs where gaseous exchange takes place.
Given the fact that the patient has a history of COPD and also has a flattened diaphragm, it is possible that the problems leading to the symptoms occurred when the endothelium wall of the smooth tissues of the lungs failed to make intelligent decisions regarding whether or not they should initiate the clotting process (André et al., 2019; Siddiqi & Ruberg, 2018). These conditions make it hard for the lung to function normally, with shortness of breath being one of the major presentations.
Racial and Ethnic Variables that may affect Physiological Functioning
Among the racial and ethnic variables that could influence physiological functioning include the fact that some groups have lower response to the attack of such conditions. When compared to whites, African Americans have lower lung functions, and hence are more susceptible to the diseases of the lungs. This variance is because of the absence of sufficient levels of alpha-carotene, and antioxidants vitamins C and A (Di Lullo et al., 2016).
People of color have smaller capacity of their lungs compared to whites, hence showing the presence of inferior physical organisms (Shaefi et al., 2018). This smaller lung capacity can specifically limit the ability of individuals to survive under strained conditions, such as areas of high altitude or places where the oxygen concentrations is extremely low (Flores, Loomba, & Bronicki, 2020). The fact that some ethnic communities involve themselves more with dangerous smoking habits also reduces the ability of their lungs to fight such conditions.
Interaction of these Processes to affect the Patient
Faulty cardiovascular and cardiopulmonary systems and processes lead to strain of the patient in accessing other elements that boost their health. Specifically, when patients have lower capacity to access oxygen in their lungs, it becomes hard for them to function well in other organs. The first organ affected is the heart, where an insufficient buildup of oxygen in the lungs leads to deficiency of oxygen in the coronary vessels, which slows down the rate of the heart and could even result in things such as heart failure.
Where there is failure of enough oxygen access to the brain, more dangerous conditions such as stroke can envelop in the patient. Kidney function, which aides in the efficient removal of waste products from the body, can also be affected by failed cardiopulmonary procedures (Gabriel-Costa, 2018). The glomerular flow of blood is determined by the pressure of the blood from the heart, and if it is not enough, there may be incorrect infiltration of substances in the kidneys (Hillegass, Lowers, & Barker, 2016).
Regular buildup of waste products in the body could lead to imbalance in the sugar levels which could also lead to even worse conditions such as ED for males and other reproductive problems among females (Sehgal et al., 2016). The bottom-line is that the failure to correct the failed cardiopulmonary processes can lead to a series of problems that could completely incapacitate the patient.
References
André, S., Conde, B., Fragoso, E., Boléo-Tomé, J. P., Areias, V., & Cardoso, J. (2019). COPD and cardiovascular disease. Pulmonology, 25(3), 168-176.
Di Lullo, L., Bellasi, A., Barbera, V., Russo, D., Russo, L., Di Iorio, B., & Ronco, C. (2017). Pathophysiology of the cardio-renal syndromes types 1–5: An up-to-date. Indian heart journal, 69(2), 255-265.
Flores, S., Loomba, R. S., & Bronicki, R. A. (2020). Heart–Lung Interactions and Cardiovascular Support in Pediatric Acute Respiratory Distress Syndrome. In Pediatric Acute Respiratory Distress Syndrome (pp. 159-172). Springer, Cham.
Gabriel-Costa, D. (2018). The pathophysiology of myocardial infarction-induced heart failure. Pathophysiology, 25(4), 277-284.
Hillegass, E., Lowers, S. T., & Barker, E. (2016). Cardiac muscle dysfunction and failure. Essentials of Cardiopulmonary Physical Therapy-E-Book, 78.
Sehgal, A., Malikiwi, A., Paul, E., Tan, K., & Menahem, S. (2016). A new look at bronchopulmonary dysplasia: postcapillary pathophysiology and cardiac dysfunction. Pulmonary circulation, 6(4), 508-515.
Shaefi, S., Mittel, A., Klick, J., Evans, A., Ivascu, N. S., Gutsche, J., & Augoustides, J. G. (2018). Vasoplegia after cardiovascular procedures—pathophysiology and targeted therapy. Journal of cardiothoracic and vascular anesthesia, 32(2), 1013-1022.
Siddiqi, O. K., & Ruberg, F. L. (2018). Cardiac amyloidosis: an update on pathophysiology, diagnosis, and treatment. Trends in cardiovascular medicine, 28(1), 10-21.
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