Pathophysiology When Pulmonary Stenosis is present, resistant to blood flow cause right ventricular hypertrophy – right atrial pressure will increase – reopening of the foramen ovale, shunting of unoxygenated blood into the left atrium, systemic circulation. Clinical manifestation: Cyanosis, characteristic murmur , cardiomegaly . Treatment: Baloon angioplasty (neonate).
Annexe 1 : Heart murmur 1. An unusual sound coming from the heart that can be detected by a stethoscope. These noises are caused by an abnormal turbulence produced when blood flows across one of the heart (valves, cardiac chambers) and or vessels close to the heart Heart murmurs are classified by the intensity of the sound heard: Stage I (murmur is of low intensity and can hardly be heard) to Stage VI (murmur is extremely loud).
TAVI is an invasive procedure to aortic valve. In this invasive surgery a new valve that is a stainless steel tube with biological materials of cows, is inserted through a balloon catheter to the heart. This procedure can be done with local or general anaesthetic. This new valve insertion can be done with two common ways. Firstly is the transfemoral, which means through the femoral artery or second common way is the transapical way that is through a small cut to the left side to the chest.
The patient is a 63-year-old woman who presents for follow up after hospitalization at [Place], because of GI bleeding. The patient had presented here after years of living away, complaining of a history of progressive bloody diarrhea. Lab work was markably abnormal with significant anemia, with hypoalbuminemia, hypokalemia. The patient underwent a full evaluation, and was found to have colitis. She was treated with IV steroids, and has noted marked improvement in her condition.
There is also a necessity to avoid venous stasis in the legs that may cause a pulmonary embolus. Head drop is more prevalent during this final stage of the disease and the patient’s ability to breath is also compromised. Breathing complications may require the use of a suction machine to assist the patient. Physical therapy techniques should be used to assist cardiopulmonary distress. Techniques include repositioning the patient so the body is able to exchange oxygen and blood adequately.
Appendix NCLEX Questions The following two alternate format NCLEX questions were created related to the case study information and focus on the nursing responsibilities prior to blood administration and the signs/symptoms of acute hemolytic transfusion reactions. NCLEX Question #1 The RN on day shift is looking after Anita, a 93-year-old female patient in with an upper GI bleed. Anita’s latest lab results show an Hgb of 62
From January 2011 to July 2013, 112 pacemakers were implanted at the ICL, Hospital Queen Elizabeth II. The longer duration of the pacemaker implantation or the hardware change procedure took was associated with an increased risk of pacemaker infection. The choices of antibiotic before and after the procedure will also play role in protecting the patient from infection. In addition, we found that the use of cefazolin after implantation procedure may reduce the risk of getting infected compared to the other antibiotics. Contrarily, age, preoperative antibiotic choices and gender were not associated with a risk of pacemaker infection.
The laboratory evaluation for sepsis was reported later as negative. Subsequent abdominal ultrasonogram revealed a left sided hydronephrosis. Echocardiogram confirmed the presence of multiple small ventricular septal defects (VSD), patent ductus arteriosus (PDA) of moderate size and markers of pulmonary hypertension. After discussion with surgical services two management options were considered; the first was surgical intervention to facilitate patient care and possibly ameliorate the course of illness and the second was the expectant conservative management. As the long-term outcomes were dependant on the final diagnosis, parents and treating team opted for no surgical intervention at this stage.
1281). Damage to the pulmonary endothelium triggers the release of neutrophils in a great amount, and the neutrophils stimulate the release of other inflammatory mediators such as tumor necrosis factor, prostaglandin, leukotrienes, histamine and platelet-activating factor (McKane, 2010, 1281). Consequently, capillary membrane becomes more permeable which further allows more fluids, proteins and red blood cells casts to flow into alveoli (McKane, 2010, p.1281). It later causes the lungs to collapse resulting in atelectasis and reduce the lungs compliance (McKane, 2010, p.1281). In addition, pulmonary vasoconstriction can result from platelet aggregation, atelectasis and inactivated surfactant (McKane, 2010, p. 1281).
The existence of cardiomyopathy was first proposed by Rubler et al, In 1974 Framingham study showed that heart failure was more common in diabetes due to diabetes cardiomyopathy.58,59 The Framingham heart study reveals a marked in congestive heart failure, coronary artery disease and myocardial infarction in diabetes patients.60 Diastole is that phase of the of the cardiac cycle when the heart is not contracting to propel blood out (systole) to the body, brain and lungs but instead is relaxing and filling with incoming blood that is being return from body through inferior vena cava from lungs through the pulmonary veins and the through superior vena cava. Diastole begins with aortic valve closure and ends with mitral valve closure. Diastole
Laboratory finding were: Le 12,7x109/L, Neutophils 80% and C reactive protein was 123ng/l. The patient was feeling better. We have done echocardiography which showed enlargement in left heart chamber, systolic dysfunction, ejection fraction 25%, moderate mitral and aortic regurgitation, pulmonary artery pressure (42mmHg). The patient introduced intensive IV loop diuretic therapy. 48 hours later, a significant decrease in the pleurlaleffusion was observed [Figure
My patient is an 89 year old male; the patient will be referenced as WP. WP was admitted to Lutheran 3 East for a primary diagnosis of pneumonia. His health history consists of COPD, acute respiratory failure, chronic kidney disease, coronary artery disease, vascular dementia without behavioral disturbance, CAD, carotid artery disease, and hyperlipidemia. My client also has a permanent cardiac pacemaker and use hearing aids. He’s allergic to oxycodone and Vicodin.
Heartworm is a serious and potentially fatal disease that can be easily contracted by dogs if they’re not adequately protected. The veterinarians and professional staff at Cerbat Cliffs Animal Hospital wants to ensure that dog owners in Kingman, AZ and the surrounding areas are well aware of the risks posed by heartworm. That way, they can make preventative efforts to protect their dogs from contracting the disease in the first place. Before preventative heartworm medication can be administered, however, it’s important to first test for the disease. Dogs under seven months can be put on a heartworm preventative without having a test, but dogs over that age need to be tested prior to administering a preventative.
The patient was kept in the propped up position with the head end elevated to 450. 2. He was initially given 60% oxygen via a venturi mask 3. His vital parameters were monitored ECG, Heart rate ,SPO2, NIBP, Hourly urine output, temperature, GCS score 4. His initial arterial blood gas with 60% oxygen was pH-7.39 pO2-385 mm