FIGURE 1. PATHOPHYSIOLOGY DIAGRAM OF 49 YR.

OLD FEMALE CLIENT WITH CONGESTIVE HEART FAILURE FUNCTIONAL

CAPACITY II SECONDARY TO VALVULAR HEART DISEASE SECONDARY TO RHEUMATIC HEART DISEASE

RISK FACTORS: Infiltration of

· Lives in rural area Group A Beta- Tonsillitis
· Lack of access to Sore throat
Hemolytic (1980s)
medical services due
to low socioeconomic Streptococci
strata (unemployed)
· Poor nutrition
(inadequate food
intake)
· Environmental BLOOD CULTURE:
exposure to Activates antibodies that
No growth of MO
pathogens cause Acute Inflammation of
after 2 days of
the Heart X-RAY: Prominent incubation
prosthetic valves,
metal clicks on
RHEUMATIC HEART DISEASE auscultation
CEFTRIAXONE PARACETAMOL

Vegetative lesions occur in heart

valves
PROSTHETIC
RISK FOR
VALVE Fever
INFECTION
HOLO- REPLACEMENT
ABDOMEN
UTZ: Fatty Risk Factors:
Infiltration or · Rheumatic
Heart Disease VALVULAR HEART
streaks in DISEASE
pancreas · Family history of
VHD (mother)
RISK FOR
· Family history of
PULMONARY COUMADIN
Hypertension
EMBOLISM
(father)
· Female, 49 y/o
· High sodium 2D ECHO: Mild
and cholesterol Tricuspid
in diet Triscupid, Mitral
regurgitation,
and Aortic
good opening
Insufficiency
and closing of
valves

Increased afterload, preload and

increased pressure

2D ECHO:
Concentric Left
Left Ventricular hypertrophy
Ventricular
Hypertrophy

Myocardial Dysfunction

Myocardial Failure

Heart Pump failure

Continued on next page.

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FIGURE 1. PATHOPHYSIOLOGY DIAGRAM OF 49 YR. OLD FEMALE CLIENT WITH CONGESTIVE HEART FAILURE FUNCTIONAL CAPACITY II
SECONDARY TO VALVULAR HEART DISEASE SECONDARY TO RHEUMATIC HEART DISEASE (CONT.)

2D ECHO: Ejection Fraction 53%

Teicholtz’s, 47% Simpson’s
Systolic ECG: 45 beats per min HR
2D ECHO: Mildly depressed
Dysfunction,
overall systolic function
Failure

DECREASED Easy Fatigability,

Decreased end- ACTIVITY
CARDIAC Walks only 3
systolic volume INTOLERANCE
OUTPUT flights of stairs

Decreased
Increased Venous
Perfusion of Increased Sodium and Water Increased Plasma
Pressure to the Pulmonary Edema
Tissues in the Aldosterone Retention Volume
Lungs
Body
Pulmonary
Congestion
Increased
Increased Renin, Peripheral Risk factor: HOLO-ABD
Vasoconstriction vascular · Genetic UTZ:Bilateral
Angiotensin
Resistance predisposition Renal cysts 2-Pillow
Orthopnea

Increased Increased Capillary

Renal
Sympathetic Peripheral endothelial INEFFECTIVE
Vasoconstriction
Activity Vasoconstriction damage URINALYSIS: BREATHING
Hematuria (Taces PATTERN
of Blood in Urine)
Decreased Blood
METOPROLOL Pressure, Heart
Rate

Decreased
Oxygen Supply to
Tissues
BRAIN: GASTROINTESTINAL
MYOCARDIUM: LIVER: Liver
Decreased TRACT: Decreased
Increased Cardiac dysfunction
Oxygen Supply to Oxygen Supply to GI
Workload
Cerebral Tissues Tract

URINALYSIS: Minimal
Decreased Blood Albumin in Urine
ACTIVITY Dizziness
Flow to
INTOLERANCE
Myocardium Increased Acid
RISK FOR Production
INEFFECTIVE
CEREBRAL OMEPRAZOLE
Ischemia TISSUE
PERFUSION Superficial mucosal
lesions of stomach and
duodenum develop
Anaerobic
Metabolism

Increased Lactic Decreased Appetite,

Acid Production Weight loss

Chest pain
IMBALANCED NUTRITION: LESS
THAN BODY REQUIREMENTS

RISK FOR INEFFECTIVE

MYOCARDIAL TISSUE PERFUSION

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