Jonas has been experiencing problems pertaining to his heart, blood vessels, and respiratory system. He has had chronic hypertension for 7 years and his doctor prescribed medication for it, but Jonas has not been taking it frequently enough to actually bring his blood pressure down. He usually misses three pills a week, so of the estimated 2,500 hypertension medication doses that he was supposed to take, he has only taken around 1,450 doses. His breathing has suffered as he has shortness of breath, wheezing, and a constant bloody cough. In addition to the blood being apparent in his cough, his ankles, legs, abdomen, and neck vein are all swollen or distended.
In order to treat Jonas, we have to look at previous health history, genetic
…show more content…
The other type of classification is the American College of Cardiology/American Heart Association guidelines. This is a classification using letters A-D, where A is a patient without heart failure, B is a patient showing no signs or symptoms but does have heart failure, C is a patient that is experiencing some signs or symptoms, and D is a patient with advanced heart failure. Jonas would be class D in this classification (Hunt 2997-2998).
The first test that would help to see Jonas’s heart behavior better would be a physical. The doctor could see his swollen abdomen, legs, ankles, and neck vein. The doctor would use a stethoscope to heart any abnormalities in his chest. He would also be able to tell that Jonas had a chronic bloody cough based on questions that he could ask him. All of Jonas’s genetic and health history would be covered by the basic questions that doctors ask all their patients during a physical. Due to his chronic hypertension, the probability that he has CHF is increased, but does not necessarily mean that he definitely has CHF. At this point, the doctor may have a general idea that Jonas has CHF. However, more extensive tests must be used to correctly diagnose Jonas (Figueroa 406-407).
Several tests are used to look at how well the heart is functioning. A B-type Natriuretic Peptide (BNP) Blood Test would be given to test for heart failure. The blood is taken and put into
tells you that he began feeling changes in his heart rhythm about 10 days ago. He has hypertension
Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).
Jonathan is a 63-year-old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was from southern Ontario, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patient’s weight is 95 kilograms; he is 178 centimeters tall and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not exercise enough and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his myocardial infarction (MI) or heart attack. He was transferred from another hospital in the beginning of November and was waiting for more tests to be completed before he could be discharged. Jonathan has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.
Q3) – Why would Uncle Jed be started on a beta blocker (which slows the heart and lowers blood pressure)?
K.H. is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and stethoscope with her in the hope of learning to take her husband’s blood pressure at home.
Pulse rate is at 72. The blood pressure was 140 / 95,which is suggestive of high blood pressure and related to his medical history. No heart murmur was noted, and no other abnormalities were noted.
Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,
The heart, blood and blood vessels make up the basis of the cardiovascular system also known as the circulatory system. The average human body contains approximately 5 litres of blood which is carried around the body via a network of blood vessels split into three types; arteries, veins and capillaries. The arteries are the largest of the three vessels and carry blood away from the heart. Veins carry blood to the heart and are smaller than arteries, then finally the smallest vessels known as capillaries distribute the oxygen rich blood to organs whilst simultaneously picking up the waste carbon dioxide and water from the organs to transport back to the heart where it can be pumped into the lungs to be exhaled.
The diagnosis is made when an ejection fraction of less than 40% is found during an echocardiogram test. Patients with known systolic heart failure and current or prior symptoms are Stage C. Most common symptoms include, shortness of breath, fatigue and reduced ability to exercise. Stage D is patients with systolic heart failure and presence of advanced symptoms after receiving optimum medical care. Other risk factors for heart failure are some diabetes medications, sleep apnea, congenital heart defects, viruses, and irregular heartbeats. Heart Failure can be treated and managed but not cured. It is a chronic condition.
“Manual of Clinical Problems in Cardiology : With Annotated Key References” book is written by L. David Hillis in 1980. Hillis has MD degree obtained from Columbia University , New York,
* I: Monitor for symptoms of heart failure and decreased cardiac output. Listen to heart sounds, lung sounds and note flowing symptoms: dyspnea, orthopnea,
Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary
A person's symptoms can provide important clues to the presence of heart failure. (Cadwallader p. 1143). Some of these include: JVD, SOB, frequent coughing when lying down, edema, acites, fatigue, syncope, vertigo, and sudden death. (Cadwallader p. 1142).
has to work harder pumping blood to the rest of the body. Blood in our
Jonathan is a 63 year old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was not born here, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patients weight is 95 kilograms; he is 178 centimeters all and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not get a lot of exercise and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his MI. He was transferred from another hospital in the beginning of November and currently is waiting for more testing before he can be discharged from the hospital or moved to another facility. The patient has some known comorbidities that can exacerbate his CHF, this includes