C155_Pathopharm.docx - Running head FOUNDATION Foundation for Advanced Nursing Practice C 155 Western Governors University April 2018 1 Foundation 2

C155_Pathopharm.docx - Running head FOUNDATION Foundation...

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Running head: PATHOPHARMOCOLOGICAL FOUNDATION 1 Pathopharmacological Foundation for Advanced Nursing Practice C 155 Western Governors University April, 2018
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Pathopharmacological Foundation 2 Pathopharmacological Foundation for Advanced Nursing Practice Investigation of Disease Process Congestive heart failure is a condition where the heart is unable to effectively pump to provide sufficient blood flow throughout the circulatory system. There are multiple causes and risk factors associated with the development of heart failure. More than 5 million Americans are living with a diagnosis of Heart failure and this number continues to rise with increasing age (Kemp & Conte, 2012). It is reported that there is 500,000 new diagnosis of heart failure each year, and is responsible for 1 out of 3 deaths (Kemp & Conte, 2012). Heart failure is a leading cause of hospitalization, 30 day re-hospitalization, resulting in 10-38 billion dollars in healthcare costs yearly (Kemp & Conte, 2012). Pathophysiology The heart is a muscle that is responsible to pump blood that is full of oxygen, nutrients, hormones and cells throughout the circulatory system. This ensures organs are receiving what they need to function properly. Many environmental, social, and genetic factors that contribute to heart disease include age, obesity, smoking, substance abuse, diabetes, kidney failure, hypertension, myocardial infarction, coronary artery disease, congenital abnormalities, and infections. Heart failure is a progressive disease that initiates in the setting of heart disease, resulting in an injury or strain to the myocardial muscle. Heart failure can occur from prolonged myocardial strain or an event resulting in injury, thus decreasing the hearts ability to pump effectively and maintain cardiac output (McCance & Huether, 2014). Cardiac output is defined as the amount of blood pumped through the systemic and pulmonary systems (McCance & Huether, 2014). Cardiac output is affected by preload, afterload, contractility, and heart rate.
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Pathopharmacological Foundation 3 Decreased cardiac output creates a domino effect the heart is unable to generate the pressure required to pump oxygen rich blood throughout the system to all vital organs, increasing the heart rate to compensate. When the pump isn’t working this directly affects preload and afterload. Increased afterload, leaves blood in the ventricles which will lead to ventricular remodeling (McCance & Huether, 2014). As the heart compensates the myocardial muscle continues to stretch and begins to hypertrophy continuing to change the contractility of the heart. Venous and pulmonary congestion will occur as the as the heart is weaker and unable to manage preload (McCance & Huether, 2014). As the heart begins to fail, the human body works to preserve tissue perfusion by compensating. Compensation is seen through the Frank – Starling mechanism, and neurohormonal activation (Kemp & Conte, 2012). When there is a decrease in cardiac output and a decrease in blood pressure the body engages the sympathetic nervous system to restore balance through the release of catecholamine.
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  • Nursing, diastolic heart failure, Pathopharmacological Foundation

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