Module 2 Assignment: Case Study Analysis

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact. Module 2 Assignment: Case Study Analysis

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

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To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario (will paste below) for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting. Module 2 Assignment: Case Study Analysis

SCENARIO:

Week 3: Concepts of Cardiovascular and Respiratory Disorders

The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.

Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.

This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

Analyze concepts and principles of pathophysiology across the lifespan
Assignments Due:

Knowledge Check (KC) due by day 7 of week 3
Module 2 Case Study Analysis- You are encouraged to work on your Module 2 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 4.
Scenario: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF) Module 2 Assignment: Case Study Analysis

In your Case Study Analysis related to the scenario provided, explain the following
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.—

Excellent 28 (28%) – 30 (30%)

Good 25 (25%) – 27 (27%)

Fair 23 (23%) – 24 (24%)

Poor 0 (0%) – 22 (22%)

Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.—

Excellent 28 (28%) – 30 (30%)

Good 25 (25%) – 27 (27%)

Fair 23 (23%) – 24 (24%)

Poor 0 (0%) – 22 (22%)

Explain any racial/ethnic variables that may impact physiological functioning.—

Excellent 23 (23%) – 25 (25%)

Good 20 (20%) – 22 (22%)

Fair 18 (18%) – 19 (19%)

Poor 0 (0%) – 17 (17%)

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.—

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation—

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.—

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Total Points: 100

 

Solution

 

Concepts of Cardiovascular and Respiratory Disorders

The cardiovascular and cardiopulmonary pathophysiologic processes

Knee arthroplasty or total knee replacement surgery is a noncardiac procedure that may lead to cardiovascular and cardiopulmonary complications. Mortality and morbidity due to cardiovascular and cardiopulmonary complications are costly and common for patients after undergoing a noncardiac surgical procedure (Basilico et al., 2008).

Atrial fibrillation is a common cardiovascular complication that is reported after noncardiac surgery. Subsequently, thromboembolic stroke is a debilitating complication resulting from atrial fibrillation (AlTurki et al., 2020). The cardiovascular complication showcased by the 65-year-old patient in this case study after the surgery can be attributed to postoperative electrolyte shifts, advanced age, among other factors.

The patient is presenting with shortness of breath, palpitations, and pleuritic chest pains. These symptoms may be primarily due to pulmonary complications. According to Reamy et al. (2017), pulmonary embolism is a major culprit in the development of pleuritic chest pains.

Pulmonary embolism is a cardiopulmonary complication that is caused by blood clots in the lungs that have traveled from other parts of the body, such as the legs. The formation of emboli is mainly due to inactivity as blood thickens and clots in deep veins within the leg. Symptomatic pulmonary embolism is prevalent in patients who have undergone total knee replacement surgery, with incidences in certain studies being about 3.5% (Cafri et al., 2017).

Pulmonary embolism causes pressure to increase in the right side of the heart resulting in palpitations. Shortness of breath may arise because the supply of oxygen from the lungs is hampered by the clots resulting from pulmonary embolism. In this case, therefore, the patient may have developed a pulmonary embolism after the surgery, which might have impacted the outcome.

Racial/Ethnic Variables that May Impact Physiological Functioning

Physiologic functioning varies significantly between racial or ethnic groups. An individual’s susceptibility to certain infections may be influenced by their genetic makeup. Bulatao and Anderson (2004), imply that ethnic and racial health differences in early life could be important for late-life health differences among individuals. Genetic makeup or life events in a person’s life may impair or enhance their physiological functioning.

An article by Harvard Health Publishing (2017), suggests that ethnic and racial differences may contribute to differential susceptibility to cardiovascular complications. Regardless of ethnic or racial implications, factors such as age or gender; intertwined with socio-economic characteristics may also impact the physiologic functioning of an individual. Module 2 Assignment: Case Study Analysis

Interaction of Processes

Differences in postoperative complications may arise from a complex interplay between environment, hospital-level, and patient factors. Interaction of these factors may influence the susceptibility of the patient to cardiovascular and cardiopulmonary complications. Changes in a patient’s respiratory system take place immediately after the induction of general anesthesia due to a reduction in lung volume, and alteration of muscle function and respiratory drive, and atelectasis which occurs in more than 75% of patients (Miskovic & Lamb, 2017).

The respiratory system usually takes about 6 weeks to return to its optimal capacity as during preoperative procedures (Miskovic & Lamb, 2017). Environmental and patient factors, as well as care received, may determine how fast the patient comes around from the effect of anesthesia. Inefficient respiration after surgery compounded with prolonged bed rest may contribute to the development of cardiopulmonary complications due to pulmonary embolism.

Blood flow is usually hampered with inactivity, which might result in clots within the circulation system as blood thickens, resulting in cardiovascular complications. The patient, in this case, had a knee surgery which could impact how he exercises his leg resulting in the formation of embolism in the leg. Clinicians should therefore be aware of the risk factors that may trigger cardiopulmonary and cardiovascular complications in postoperative patients in order to optimize their care.

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References

Basilico, F. C., Sweeney, G., Losina, E., Gaydos, J., Skoniecki, D., Wright, E. A., & Katz, J. N. (2008). Risk factors for cardiovascular complications following total joint replacement surgery. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 58(7), 1915-1920. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256246/

Bulatao, R. A., & Anderson, N. B. (2004). Understanding racial and ethnic differences in health in late life: A research agenda. National Academic Press. https://www.ncbi.nlm.nih.gov/books/NBK24681/ Module 2 Assignment: Case Study Analysis

Cafri, G., Paxton, E. W., Chen, Y., Cheetham, C. T., Gould, M. K., Sluggett, J., … & Khatod, M. (2017). Comparative effectiveness and safety of drug prophylaxis for prevention of venous thromboembolism after total knee arthroplasty. The Journal of arthroplasty, 32(11), 3524-3528. https://www.sciencedirect.com/science/article/abs/pii/S0883540317304813

Harvard Health Publishing. (2017). Race and ethnicity: Clues to your heart disease risk? Harvard Medical School. https://www.health.harvard.edu/heart-health/race-and-ethnicity-clues-to-your-heart-disease-risk

Miskovic, A., & Lumb, A. B. (2017). Postoperative pulmonary complications. BJA: British Journal of Anaesthesia, 118(3), 317-334. https://academic.oup.com/bja/article/118/3/317/2982040

Reamy, B. V., Williams, P. M., & Odom, M. R. (2017). Pleuritic chest pain: sorting through the differential diagnosis. American family physician, 96(5), 306-312. https://www.aafp.org/afp/2017/0901/p306.html