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Predisposing factors Age: 88 y.o. Hypertension DM 2 Precipitating factors Sedentary lifestyle Diet (high Na intake) Non-compliance to meds
Aspirin
Inc. Afterload
Decrease blood flow to kidneys BUN= 24 mg/dL Prompts kidneys to secrete renin Inc. CO
Ventricular dilation
Vasoconstriction
Angiotensin 2 Sympathetic activation Aldosterone release Inc. tubular Na reabsorption S3 gallop Tachyarrthymias Pale extremities 4 seconds capillary refill Trop T <0.1 ug/dL Low HCT & HGB
H2O conservation
Digoxin
Inc. amount of blood in L. ventricle Dec. capacity to receive blood from L. atrium Metoprolol&Ramipril, Dobutamine, Morphine, Isosorbidedinitrate
LEFT Manifestations SOB (3-pillow orthopnea) Use of accessory muscles when breathing RR-36cpm Productive cough Rales Pale extremities Loss of appetite due to SOB Activity intolerance/very fatigued Exhausted facie
Backward flow of blood from systemic circulation Arixtra Nexium Inability to receive full systemic blood
Systemic congestion
Inc. Preload
Spironolactone & Furosemide RIGHT Manifestations Bipedal edema Distended Jugular neck veins @ 45 degree position Anorexia Nausea Vomiting Headache Metoclopramide
Lactulose &Dolculax
KCL supplementations
Legend:
Phenomenon
Direction of Pathology
Manifestations
Treatment/Management
Please email me for any suggestions or highly constructive criticisms for my pathophysiology @ arthascourge@gmail.com!!! Any idea on the subject will matter & this is also for me to know other peoples perspectives on the tackled subject!!!
Thanks:P