Name
Chamberlain University
NR-583: Informatics for Advanced Nursing Practice
Prof. Name
Date
Pulmonary edema occurs when excessive fluid accumulates in the alveoli and lung interstitial spaces, impairing gas exchange. The pathophysiology is primarily related to increased hydrostatic pressure in the pulmonary capillaries (e.g., left-sided heart failure), decreased oncotic pressure (e.g., hypoalbuminemia), or increased capillary permeability (e.g., acute respiratory distress syndrome).
Risk factors include heart disease, hypertension, renal failure, sepsis, and high-altitude exposure.
Clinical manifestations often include dyspnea, orthopnea, tachypnea, cyanosis, frothy sputum, crackles on auscultation, and hypoxemia.
A pulmonary embolus (PE) results from obstruction of the pulmonary artery or its branches by a thrombus, fat, air, or amniotic fluid. The pathophysiology involves impaired blood flow to lung tissue, leading to increased pulmonary vascular resistance, ventilation-perfusion mismatch, and possible right ventricular strain.
Risk factors: immobility, surgery, trauma, obesity, oral contraceptives, smoking, and inherited clotting disorders.
Clinical manifestations: sudden dyspnea, pleuritic chest pain, tachycardia, anxiety, cough, hemoptysis, and in severe cases, hypotension or sudden death.
Pneumothorax is the presence of air in the pleural space, leading to lung collapse. It can occur spontaneously, due to trauma, or from mechanical ventilation. The trapped air disrupts negative intrapleural pressure, preventing lung expansion.
Clinical manifestations: sudden chest pain, shortness of breath, decreased breath sounds on the affected side, hyperresonance on percussion, tachypnea, and possible tracheal deviation in tension pneumothorax.
Tuberculosis (TB) is caused by Mycobacterium tuberculosis, which primarily affects the lungs but can disseminate to other organs. Pathophysiology involves inhalation of bacilli, engulfment by macrophages, and granuloma formation (Ghon complex). Reactivation may occur when immunity is compromised.
Incidence: TB remains one of the leading infectious diseases worldwide, particularly in low- and middle-income countries.
Risk factors: HIV infection, immunosuppressive therapy, malnutrition, diabetes, and crowded living conditions.
Clinical manifestations: chronic cough with hemoptysis, night sweats, fever, weight loss, fatigue, and chest pain.
| Disorder | Pathophysiology | Risk Factors | Clinical Manifestations | Treatment |
|---|---|---|---|---|
| Leukemia | Malignant proliferation of abnormal white blood cells | Genetic mutations, radiation, chemotherapy exposure | Frequent infections, fatigue, bleeding, anemia, lymphadenopathy | Chemotherapy, radiation, stem cell transplant |
| Anemia | Reduced red blood cells or hemoglobin | Nutritional deficiencies, chronic disease, genetic conditions | Fatigue, pallor, tachycardia, shortness of breath | Iron supplements, B12/folate therapy, transfusions |
| Pernicious Anemia | Autoimmune destruction of gastric parietal cells leading to vitamin B12 deficiency | Autoimmune disorders, genetics, gastric surgery | Glossitis, numbness/tingling, cognitive impairment | Vitamin B12 injections or high-dose oral supplements |
| Sickle Cell Anemia | Genetic mutation leading to abnormal hemoglobin (HbS) causing RBC sickling | African ancestry, genetic inheritance | Pain crises, jaundice, organ damage, infections | Hydroxyurea, hydration, transfusions |
| Polycythemia Vera | Myeloproliferative disorder causing increased RBC production | Age >60, genetic mutation (JAK2) | Headache, dizziness, pruritus, thrombosis | Phlebotomy, aspirin, hydroxyurea |
Hemoglobin concentration and hematocrit levels are the most commonly used laboratory indicators to evaluate anemia.
Petechiae are small pinpoint hemorrhages under the skin, while purpura are larger, purple-red spots caused by bleeding into the tissues. Both indicate platelet dysfunction or coagulation abnormalities, often seen in leukemia, thrombocytopenia, or clotting disorders.
| Feature | Sympathetic Nervous System | Parasympathetic Nervous System |
|---|---|---|
| Primary function | “Fight or flight” response | “Rest and digest” response |
| Heart rate | Increases | Decreases |
| Respiratory rate | Increases | Decreases |
| Pupils | Dilated | Constricted |
| GI function | Decreased motility | Increased motility |
Age is a non-modifiable risk factor for hypertension, as vascular elasticity decreases with aging.
Obesity
High sodium diet
Sedentary lifestyle
Cardiac output is the volume of blood pumped by the heart per minute, calculated as stroke volume × heart rate. It is essential for tissue perfusion and oxygen delivery. Low cardiac output can lead to organ dysfunction and shock.
Atherosclerosis increases the risk of coronary artery disease (CAD), myocardial infarction, and stroke.
Creatine phosphokinase-MB (CPK-MB) is a cardiac biomarker used to assess myocardial injury, particularly in diagnosing myocardial infarction.
Treatment often includes lifestyle modifications (diet, exercise, smoking cessation), pharmacotherapy (antihypertensives, anticoagulants, beta-blockers, statins), surgical interventions (angioplasty, bypass surgery), and patient education.
Cor pulmonale is right-sided heart failure due to chronic pulmonary hypertension, commonly caused by chronic obstructive pulmonary disease (COPD). It results in right ventricular hypertrophy and systemic venous congestion.
Congestive heart failure (CHF) is the heart’s inability to pump sufficient blood to meet the body’s needs.
Signs and symptoms: dyspnea, fatigue, peripheral edema, orthopnea, paroxysmal nocturnal dyspnea, and weight gain.
Treatment: diuretics, ACE inhibitors, beta-blockers, lifestyle modifications, and in severe cases, ventricular assist devices or transplantation.
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Pulmonary edema occurs when excessive fluid accumulates in the alveoli and lung interstitial spaces, impairing gas exchange. The pathophysiology is primarily related to increased hydrostatic pressure in the pulmonary capillaries (e.g., left-sided heart failure), decreased oncotic pressure (e.g., hypoalbuminemia), or increased capillary permeability (e.g., acute respiratory distress syndrome).
Risk factors include heart disease, hypertension, renal failure, sepsis, and high-altitude exposure.
Clinical manifestations often include dyspnea, orthopnea, tachypnea, cyanosis, frothy sputum, crackles on auscultation, and hypoxemia.
A pulmonary embolus (PE) results from obstruction of the pulmonary artery or its branches by a thrombus, fat, air, or amniotic fluid. The pathophysiology involves impaired blood flow to lung tissue, leading to increased pulmonary vascular resistance, ventilation-perfusion mismatch, and possible right ventricular strain.
Risk factors: immobility, surgery, trauma, obesity, oral contraceptives, smoking, and inherited clotting disorders.
Clinical manifestations: sudden dyspnea, pleuritic chest pain, tachycardia, anxiety, cough, hemoptysis, and in severe cases, hypotension or sudden death.
Pneumothorax is the presence of air in the pleural space, leading to lung collapse. It can occur spontaneously, due to trauma, or from mechanical ventilation. The trapped air disrupts negative intrapleural pressure, preventing lung expansion.
Clinical manifestations: sudden chest pain, shortness of breath, decreased breath sounds on the affected side, hyperresonance on percussion, tachypnea, and possible tracheal deviation in tension pneumothorax.
Tuberculosis (TB) is caused by Mycobacterium tuberculosis, which primarily affects the lungs but can disseminate to other organs. Pathophysiology involves inhalation of bacilli, engulfment by macrophages, and granuloma formation (Ghon complex). Reactivation may occur when immunity is compromised.
Incidence: TB remains one of the leading infectious diseases worldwide, particularly in low- and middle-income countries.
Risk factors: HIV infection, immunosuppressive therapy, malnutrition, diabetes, and crowded living conditions.
Clinical manifestations: chronic cough with hemoptysis, night sweats, fever, weight loss, fatigue, and chest pain.
| Disorder | Pathophysiology | Risk Factors | Clinical Manifestations | Treatment |
|---|---|---|---|---|
| Leukemia | Malignant proliferation of abnormal white blood cells | Genetic mutations, radiation, chemotherapy exposure | Frequent infections, fatigue, bleeding, anemia, lymphadenopathy | Chemotherapy, radiation, stem cell transplant |
| Anemia | Reduced red blood cells or hemoglobin | Nutritional deficiencies, chronic disease, genetic conditions | Fatigue, pallor, tachycardia, shortness of breath | Iron supplements, B12/folate therapy, transfusions |
| Pernicious Anemia | Autoimmune destruction of gastric parietal cells leading to vitamin B12 deficiency | Autoimmune disorders, genetics, gastric surgery | Glossitis, numbness/tingling, cognitive impairment | Vitamin B12 injections or high-dose oral supplements |
| Sickle Cell Anemia | Genetic mutation leading to abnormal hemoglobin (HbS) causing RBC sickling | African ancestry, genetic inheritance | Pain crises, jaundice, organ damage, infections | Hydroxyurea, hydration, transfusions |
| Polycythemia Vera | Myeloproliferative disorder causing increased RBC production | Age >60, genetic mutation (JAK2) | Headache, dizziness, pruritus, thrombosis | Phlebotomy, aspirin, hydroxyurea |
Hemoglobin concentration and hematocrit levels are the most commonly used laboratory indicators to evaluate anemia.
Petechiae are small pinpoint hemorrhages under the skin, while purpura are larger, purple-red spots caused by bleeding into the tissues. Both indicate platelet dysfunction or coagulation abnormalities, often seen in leukemia, thrombocytopenia, or clotting disorders.
| Feature | Sympathetic Nervous System | Parasympathetic Nervous System |
|---|---|---|
| Primary function | “Fight or flight” response | “Rest and digest” response |
| Heart rate | Increases | Decreases |
| Respiratory rate | Increases | Decreases |
| Pupils | Dilated | Constricted |
| GI function | Decreased motility | Increased motility |
Age is a non-modifiable risk factor for hypertension, as vascular elasticity decreases with aging.
Obesity
High sodium diet
Sedentary lifestyle
Cardiac output is the volume of blood pumped by the heart per minute, calculated as stroke volume × heart rate. It is essential for tissue perfusion and oxygen delivery. Low cardiac output can lead to organ dysfunction and shock.
Atherosclerosis increases the risk of coronary artery disease (CAD), myocardial infarction, and stroke.
Creatine phosphokinase-MB (CPK-MB) is a cardiac biomarker used to assess myocardial injury, particularly in diagnosing myocardial infarction.
Treatment often includes lifestyle modifications (diet, exercise, smoking cessation), pharmacotherapy (antihypertensives, anticoagulants, beta-blockers, statins), surgical interventions (angioplasty, bypass surgery), and patient education.
Cor pulmonale is right-sided heart failure due to chronic pulmonary hypertension, commonly caused by chronic obstructive pulmonary disease (COPD). It results in right ventricular hypertrophy and systemic venous congestion.
Congestive heart failure (CHF) is the heart’s inability to pump sufficient blood to meet the body’s needs.
Signs and symptoms: dyspnea, fatigue, peripheral edema, orthopnea, paroxysmal nocturnal dyspnea, and weight gain.
Treatment: diuretics, ACE inhibitors, beta-blockers, lifestyle modifications, and in severe cases, ventricular assist devices or transplantation.
Prolonged stress activates the sympathetic nervous system, increasing heart rate and blood pressure, which may worsen congenital heart defects and raise the risk of arrhythmias or heart failure.
Untreated hypertension leads to chronic damage of target organs including the heart (hypertrophy, heart failure), kidneys (nephropathy), brain (stroke), and eyes (retinopathy).
Intermittent claudication refers to cramping pain in the legs during exercise due to peripheral arterial disease. It results from insufficient blood flow and improves with rest.
| Early Sign | Rationale |
|---|---|
| Tachycardia | Compensatory mechanism to maintain cardiac output |
| Cool, clammy skin | Peripheral vasoconstriction to preserve core circulation |
| Altered mental status | Reduced cerebral perfusion |
Tetralogy of Fallot: Includes four defects—VSD, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta—causing right-to-left shunting.
Atrial Septal Defect (ASD): A hole in the atrial septum allows left-to-right shunting of blood, increasing pulmonary circulation.
American Heart Association. (2023). Heart disease and stroke statistics. Circulation.
Centers for Disease Control and Prevention. (2024). Tuberculosis data and statistics. https://www.cdc.gov/tb
Huether, S. E., McCance, K. L., & Brashers, V. L. (2020). Understanding pathophysiology (7th ed.). Elsevier.
National Heart, Lung, and Blood Institute. (2023). Blood diseases and conditions. https://www.nhlbi.nih.gov
World Health Organization. (2024). Global tuberculosis report. WHO.
