Chapter 35: Alterations of Pulmonary Function

McCance: Pathophysiology, 7th Edition

Chapter 35: Alterations of Pulmonary Function

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Case Study

Marjorie Taylor, age 62, comes to the emergency department with mild respiratory distress, increasing dyspnea, orthopnea, bilateral ankle edema, and sudden weight gain. She states that she has had severe hypertension for many years, and that she has been unable to afford her antihypertensive medication for the past several months.

Answer the questions in the activity below to explore the pathophysiology of Ms. Taylor’s condition.

1. What assessment questions should you ask Ms. Taylor about her hypertension?

2. Why should you ask her if she has had any recent episodes of chest pain or any history of angina or heart attack?

3. Why is it important to determine if Ms. Taylor has fainted or if she has a diminished urine output?

4. Why should you listen to Ms. Taylor’s lungs?

5. Echocardiography leads to a diagnosis of systolic CHF. What is systolic heart failure?

6. Given her diagnosis of systolic heart failure, would you expect her ejection fraction to be normal, decreased, or increased? Explain your answer.

7. Does Ms. Taylor have left, right, or biventricular failure? Explain your answer.

8. Taylor wants to know why she is so short of breath. How should you respond?

9. Taylor says, “They said that I have heart failure. Is that a heart attack?” How should you respond?