CABALLERO, CLAIRYSSA MYN D.

NOVEMBER 10, 2022

BSN 1 – PENDER ANATOMY AND PHYSIOLOGY LECTURE

INSTRUCTIONS: Based on this case study and other information in this chapter, answer the following questions.

1. Does Kyle’s CBC reveal any abnormalities in the number, shape, or size of blood cells?
- Kyle’s hematocrit level 50% which results to high hematocrit level count. The normal range for 2-6 years old is 44%. In Kyle’s
case his hematocrit level is high due to a congenital heart disease. Failure of the right side of the heart, too little water in the
body, low levels of oxygen in the blood.
- Kyle’s hemoglobin level is 14 g/dl which also results to high hemoglobin count. The normal range for 2-6 years old is 11.0/dl. In
Kyle’s case his hemoglobin level which is caused by a low oxygen level in the blood (hypoxia), present over a long period of
time common reason is (polycythemia) congenital heart disease.
- Kyle’s platelets count, WBC count, RBC count are all in normal range count.

2. Why is a heart murmur heard in both systole and diastole in Kyle’s condition?
- A heart murmur was heard in both systole and diastole in Kyle’s condition because there is a constant shunt (a passage by which
blood moves from one area to another in a pattern that isn’t normal) between the high- and low-pressure blood vessel.

3. Why does PDA reduce a child’s growth rate? Why does it increase the incidence of respiratory infections?
- The PDA reduce a child’s growth rate because it doesn’t supply enough oxygenated blood to the other parts of the body. It
increases the incidence of respiratory infections by supplying more oxygenated blood through the lungs.

4. Why does the left ventricle sometimes undergo hypertrophy in patients with PDA?
- The left ventricle sometimes undergo hypertrophy in patients with PDA due to an increased flow returning to the left heart results
in increased left atrial and left ventricular end-diastolic pressures. The left ventricle compensates by increasing stroke volume and
eventually may hypertrophy to normalize wall stress.

5. If edema were to occur in a PDA patient, would it most likely be localized to the systemic or the pulmonary circulation?
- It will be localized to the pulmonary circulation, due to too much blood goes to the lungs that can cause fluid build-up in the lungs
called pulmonary edema.

6. Although all aneurysms are serious health concerns, why are dissecting aortic aneurysms more serious than small aortic
aneurysms?
- A dissecting aneurysm is a serious condition in which a tear occurs in the inner layer of the body’s main artery which is the aorta.

7. Nancy has been working on a term paper for the past 3 hours. Upon hearing the doorbell ring, she gets up quickly and faints.
Her roommate, Angie, hears Nancy fall and comes running. Assuming that Angie understands the causes of syncope, what
could she do to help Nancy?
- Angie can help Nancy by laying her down comfortably first then passively raising or propping up Nancy’s legs in the air. To
restore blood flow to the brain, and help Nancy to regain consciousness.

8. Medical support hose is often used to treat both orthostatic hypotension and varicose veins. How could support hose alleviate
the signs and symptoms of either disorder?
- – The support hose alleviates the signs by exerting pressure against the legs, compression stockings reduce diameter of the veins
and increase blood flow in the legs.

9. A patient suffering a hemorrhagic stroke is mistakenly given coumarin. Discuss why you would expect this patient’s condition
to worsen rather than improve.
- Coumarin is a drug that has the main function to prolong clotting time (anticoagulant). By giving this to a hemorrhagic stroke
patient instead of instant coagulation it will prolong that can cause death

10. Do you think orthostatic hypotension could be more successfully treated with a diuretic or an antidiuretic drug? Explain your
reasoning.
- The Anti-diuretic drugs are more successful to help control blood pressure by acting on the kidneys and the blood vessels. Higher
concentrations of anti-diuretic hormone cause blood vessels to constrict (become narrower) and this increases blood pressure.
While the diuretics lower blood pressure by lowering the intravascular volume and sodium content. Lower sodium content may
also reduce the vascular tone. Diuretics lower intravascular volume and vascular tone.
Activity
Refresh your physiologic knowledge on all the factors involved in blood pressure; use the mean arterial pressure formula. Research
normal ranges for heart rate, end-diastolic volume, end-systolic volume, and stroke volume. Research the actions of these generic
blood pressure medications: diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and
Vasodilators. Assume an individual has primary hypertension, thus no identifiable cause was found. However, palliative treatment
must be initiated. Based on the laboratory values given in the following clinical scenarios, postulate an initial generic medication to
use.

Scenario 1—The individual has a heart rate of 99 beats per minute, left ventricular end-diastolic volume of 130 ml, and left
ventricular end-systolic volume of 60 ml. Blood volume has been found to be 5 liters. Calculate stroke volume from these values.
Based on these findings, what would be an ideal generic type medication to help treat the individual? Hint: look at what values are
slightly elevated, but not necessarily out of normal range.

Given:
End-Diastolic Volume of 130 ml
End-Systolic Volume of 60 ml
5 Liters of Blood Volume

Formula: MAP= [(2) (DP)+SP]/3

Solution:
MAP= [(2) (130) +60]/3

MAP= [(2) (130) +60]/3

MAP= [(260) +60]/3

MAP= [320]/3

MAP= 106.67 mmHg

Generic type of medication = Diuretic

Scenario 2—The individual has a heart rate of 65 beats per minute, left ventricular end-diastolic volume of 130 ml, and left
ventricular end-systolic volume of 20 ml. Blood volume has been found to be 5 liters. Calculate stroke volume from these values.
Based on these findings, what would be an ideal generic type medication to help treat the individual? Hint: look at what values are
slightly elevated, but not necessarily out of normal range.

Given:
Left Ventricular End-Diastolic Volume of 130 ml
Left Ventricular End-Systolic Volume of 20 ml
5 Liters of Blood Volume

Formula: MAP= [(2) (DP)+SP]/3

Solution:
MAP= [(2) (130) +20]/3

MAP= [(2) (130) +20]/3

MAP= [(260) +20]/3

MAP= [280]/3

MAP= 93.33mmHg
Generic type of medication = Calcium channel blocker
Scenario 3—The individual has a heart rate of 65 beats per minute, left ventricular end-diastolic volume of 150 ml, and left
ventricular end-systolic volume of 70 ml. Blood volume has been found to be 7 liters. Calculate stroke volume from these values.
Based on these findings, what would be an ideal generic type medication to help treat the individual? Hint: look at what values are
slightly elevated, but not necessarily out of normal range.

Given:
Left Ventricular End-Diastolic Volume of 150 ml
Left Ventricular End-Systolic Volume of 70 ml
5 Liters of Blood Volume

Formula: MAP= [(2) (DP)+SP]/3

Solution:
MAP= [(2) (150) +70]/3

MAP= [(2) (150) +70]/3

MAP= [(300) +70]/3

MAP= [370]/3

MAP= 123.33mmHg
Generic type of medication = Beta blockers, diuretics, or calcium channel blockers

Scenario 4—The individual has a heart rate of 65 beats per minute, left ventricular end-diastolic volume of 130 ml, and left
ventricular end-systolic volume of 60 ml. Blood volume has been found to be 5 liters. Calculate stroke volume from these values.
Based on these findings, what would be an ideal generic type medication to help treat the individual? Hint: Using the MAP formula
and examining the values given, what could be the problem? It is a value (factor) that cannot be adequately measured.

Given:
Left Ventricular End-Diastolic Volume of 130 ml
Left Ventricular End-Systolic Volume of 60 ml
5 Liters of Blood Volume

Formula: MAP= [(2) (DP)+SP]/3

Solution:
MAP= [(2) (130) +60]/3

MAP= [(2) (130) +60]/3

MAP= [(260) +60]/3

MAP= [320]/3

MAP= 106.67mmHg
Generic type of medication = Diuretics
Investigate atrial septal defect as it relates to the foramen ovale. Both are cardiac shunt conditions.
- An atrial septal defect and a patent foramen ovale are 2 types of holes in the wall (septum) that separates the 2 upper chambers
(parts) of the heart. An atrial septal defect happens when the septum wall doesn’t grow completely before a baby is born. The
larger the hole, the more likely it is to become a problem.

Compare and contrast the symptoms of a PDA and patent foramen ovale.

PDA - Low weight and Cardiomegaly (enlarged heart)

- Heart murmur
- Rapid heartbeat
- Breathlessness PFO
- Fast breathing - In the majority of cases, PFO causes no symptoms.
- Poor feeding - An infant with PFO could have a blue tint to their skin
- Slow growth when crying or passing stool called cyanosis.

What is the mechanism of action of coumarin? Which clotting study test does in prolong?
- Coumarin anticoagulants inhibit the release of plasma clotting factor VII by vitamin K in liver slices from vitamin K-deficient
animals without inhibition of protein synthesis