Heart Cardiac Cardiovascular Pulmonary Involvement Case study for Mr Wright Essay Assignment Paper

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Heart Cardiac Cardiovascular Pulmonary Involvement Case study for Mr Wright Essay Assignment Paper

Heart Cardiovascular Involvement Case Study

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Question Description

BIOL 204 Case Study Assignment

Part I – Emergency

Mrs. Wright came in through the front door of her house with an armful of groceries. She put the bag down on the kitchen counter and called to her husband. “Sean, I’m home! Are you ready for lunch?” She didn’t get an answer, so she walked to the living room and found Mr. Wright lying on the floor. “Sean! Are you okay?” she asked as she grabbed his shoulder. Mr. Wright responded weakly while clutching his chest. Mrs. Wright frantically called 911. It only took EMS a few minutes to arrive and the paramedics transported Mr. Wright to the hospital. Upon admission to the hospital, Mr. Wright vital signs were recorded as follows:

Vital sign
Mr. Wright
Normal
Systolic blood pressure (mm Hg)
90
90 – 120
Diastolic blood pressure (mm Hg
52
60 – 80
Oral temperature (°F)
98.9
97.8 – 99.1
Heart rate (beats per minute)
120, irregular
60 – 80
Respiratory rate (breaths per minute)
33, labored
12 – 20
Oxygen saturation
89%
95 – 100%
Questions

Which of Mr. Wright’s vital signs and lab values were abnormal? (1 p)
What additional medical tests would you order for Mr. Wright? In other words, what other information would be useful? (2 pts)
What component of blood is responsible for transporting oxygen throughout the body? (1 pt)

Part II – Cardiac Involvement

Mr. Wright was admitted to the hospital with chest pains and shortness of breath. His wife was panicked since her 72 year-old husband had a history of heart disease. After examination and further testing, Dr. Buda spoke with Mrs. Wright. “I’m very sorry, but your husband has had another heart attack resulting in valve failure. A papillary muscle that controls a valve in his heart has been severely damaged and is no longer working.”

Questions

Describe blood flow through the heart starting with blood entering the right side of the heart and including all chambers and valves. (4 pts)
What is the function of heart valves? (2 pts)
What is the function of papillary muscles? (2 pts)

Part III – Cardiovascular Involvement

Dr. Buda called Nurse Amaya from the patient’s room and confided, “Mr. Wright is in bad shape. His left posteromedial papillary muscle was damaged from his heart attack. The papillary muscle is no longer able to maintain closure of the valve, and this has resulted in mitral valve prolapse. With decreasing cardiac output, this patient is in for a fight for his life.” Nurse Amaya knew that maintaining cardiac output was necessary for adequate blood flow through the body. As Dr. Buda walked away, Nurse Amaya composed herself to tell Mrs. Wright the bad news and returned to the patient’s room. Nurse Amaya explained to Mrs. Wright that her husband had left-sided heart failure and that his blood pressure was slowly and steadily decreasing.

Questions

Define mitral valve prolapse. (1 pt)
Define ejection fraction. (1 pts)
Explain how mitral valve prolapse causes a decrease in cardiac output. (3 pts)
What effect might a prolapsed mitral valve have on Mr. Wright’s ejection fraction? Briefly explain. (3 pt)
Explain how cardiac output determines blood pressure. (3 pts)

Part IV – Pulmonary Involvement

Mrs. Wright was very upset with the news of her husband’s condition. As the day progressed, she noticed that Mr. Wright’s breathing was increasingly difficult. He could barely speak without losing his breath. Mrs. Wright called the nurse to her husband’s room. “My husband can’t breathe! What is wrong? I thought he had a heart attack not a respiratory condition!” Nurse Amaya auscultated the patient’s chest listening to Mr. Wright’s respirations, which were rapid and wet, producing rales or crackling sounds. Nurse Amaya calmly informed Mrs. Wright, “I’m sorry. Your husband’s condition is worsening. The damage to his heart is causing his respiratory problems.”

Questions

Does pulmonary blood pressure increase or decrease with left-sided heart failure? (1 pt)
Consider the factors that determine net filtration pressure in capillaries. Does this change in pulmonary blood pressure (from #12) cause an increase or decrease in capillary filtration in the lungs? Briefly explain. (3 pts)
How is left-sided heart failure causing Mr. Wrights breathing to become rapid and wet? (3 pts)

Part V – Resolution

Dr. Buda rushed Mr. Wright into surgery for valve replacement. Mrs. Wright waited anxiously in the waiting area for family for hours until she saw Nurse Amaya coming toward her with a big smile. “Your husband is in the recovery room. He’s going to be just fine.” Mrs. Wright sighed with relief and gave Nurse Amaya a big hug.

 

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