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[ANSWERED] 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

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.

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.

To prepare:

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

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

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

Expert Answer and Explanation

Alterations in the Cardiovascular and Respiratory Systems

Medical professionals should have a better understanding of respiratory and cardiovascular processes to provide proper care to patients with cardiorespiratory conditions.

The Cardiovascular and Cardiopulmonary Pathophysiologic Processes

The symptoms present in the patient were caused by many cardiopulmonary and cardiovascular processes. The connection between the respiratory system, neural responses, oxygen carriers, and cardiovascular system caused the shortness of breath (Inamdar & Inamdar, 2016). The symptom occurred when the patient wanted more air, but the pulmonary ventilation did not match the demand. The pathophysiologic process that caused pleuritic chest pain the swollen pleural membrane layers separating the two lungs. The pain occurred when the inflamed tissues rubbed against the lungs when the patient inhaled or exhaled air (McCance & Huether, 2019). Palpitation occurred when the movement of the hart was affected, resulting in an abnormal cardiac rate.

Racial/Ethnic Variables that may Impact Physiological Functioning

One of the ethical variables that may impact physiological functioning is a gene known as peroxisome proliferator activated‐receptor γ (PPARγ). According to Cai et al. (2018), this gene is more active white ethnic group compared to the African American group. Regulating fat cells is one of the roles of this gene. Also, together with thiazolidinediones, the gene is responsible for reducing blood pressure. The Renin-angiotensin-aldosterone system (RAAS) is another racial

variable that will impact physiological functioning. The role of RAAS is to determine whether an individual will develop obesity, vascular condition, and vascular dysfunction. African American people have a condition where RAAS stays active even after BP has been restored.

How the Processes Interact to Affect the Patient

RAAS can reduce the functions of cardiovascular functions if it does not be deactivated. Mascolo et al. (2017) not that if RAAS stays active even after BP is restored, the gene can facilitate inflammation of the pleural membrane, and thus lead to chest pain. Also, inactive PPARγ can cause shortness of breath by increasing pressure on the cardiovascular system.

References

Cai, W., Yang, T., Liu, H., Han, L., Zhang, K., Hu, X., … & Leak, R. K. (2018). Peroxisome proliferator-activated receptor γ (PPARγ): A master gatekeeper in CNS injury and repair. Progress in neurobiology, 163, 27-58. https://doi.org/10.1016/j.pneurobio.2017.10.002

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Mascolo, A., Sessa, M., Scavone, C., De Angelis, A., Vitale, C., Berrino, L., … & Capuano, A. (2017). New and old roles of the peripheral and brain renin–angiotensin–aldosterone system (RAAS): Focus on cardiovascular and neurological diseases. International Journal of Cardiology, 227, 734-742. https://doi.org/10.1016/j.ijcard.2016.10.069

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

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