A variety of models for making decisions are available. Three of these models are paternalistic, informative, and shared decision making.
Based on your assigned readings and lecture materials this week, engage with your peers and me by initiating a thread or responding to another peer’s thread or one of my threads. You should post a minimum of three times.
Based on your assigned readings and lecture materials this week, engage with your peers and me by initiating a thread or responding to another peer’s thread or one of my threads. You should post a minimum of three times.
Use the uploaded files for the work with all instructions included. SECTION A & B.($25 each) multiply by 7.
Hello, everybody. I am Katte Gabriela Peña Morales. I am the ARMP today for Mr. Aragon, and the condition that he has is my guardian infraction. Okay, I’m going to start the PowerPoint. Let’s see. Okay, so we have Mr. Alexander Aragon. He’s 58 years old, has a diagnosis of MI. social background will be participating in family dinners he often need fast food because he doesn’t have time he’s very close to his family but very limited socialization outside the family because he’s always busy working he smoked for 25 years and has been a non-smoker for the last five years we find him alert and oriented times four he does have fatigue dizziness and some sweating he’s hyper He has chest pain for the last three days. Also has pain in the jaw, radiation to the left arm. The EKG shows an ST elevation. He also complains about nausea. He has not vomit. He has no diarrhea. His lungs are clear. But in the heart auscultation assessment, he had A .R.S.4 atrial gallop. medical, past medical history will be hyperlipidemia, hypertension, obesity, and diabetes type 2. We can see his laps for Mr. Aragon and the education that I am preparing for him. I will tell him, Mr. Aragon, the most important, one of the most important symptoms here is your laps. You have something called torporins are elevated. His TKMB is elevated as well. He has inflammation process going on with his CRP elevated as well. He has risk of having kidney damage because creatine is also elevated with 1.3. He has elevated WBCs and has a great hemoglobin. Has good platelets as well. I will tell him that the way that we diagnose my cardiac infection is when we do the EKG, if there’s an ST elevation, and if the cardiac enzymes, the troponins, a EKMB, are elevated in trends up in the next two hours, he will have to go quickly to the cardiac ad suite. He has a surgical, his cerepandectomy by laterally replacement, and his vital signs are as follows. This is 160 over 95, hypertensive. His heart rate is 102. His respiratory is 24, a little bit altered. His BMI is elevated. He is obese. And his oxygen saturation is 95 arumina. I will explain to Mr. Aragon that how this happened. How do you get a heart attack myocardia infection all of the sudden? So an arteloscleric plaque rupture or trombose forms, and this one will block one of the cardiac arteries. Let me see, you create a block clot and will partially or completely will occlude the blood flow to the heart. A sudden blockage of coronary blood flow leads to ischemia and subsequent necrosis of the myocardia tissue. That’s very painful. That’s why you’re having that chest pain. Mycardia ischemia can happen if we wait too long and he doesn’t get any treatment. We can also tell him that the lack of oxygen may disrupt the ATP production, leading to anaerobic metabolism, lactic acid buildup, and loss of normal electrolyte imbalance. So not only his heart can get damage, also other parts of his body. We also explain, we’ll explain him. If blood flow is not restored quickly, myocardias, cells undergo irreversible necrosis, leading to impair contractility, arrhythmias, heart failure, or cardiogenic shock. It’s very important that we get treatment quickly for this type of patients. The clinical manifestations of this condition is that Aragon is already presenting it. He’s presenting with chest pain that radiates to the arm, the jaw. He didn’t complain of back pain or showness of breath. He did complain of not. He did complain of Nausea. Autonomic nervous system symptoms, patients might experience are faredic, nausea, vomiting, dizziness, and anxiety due to the body’s stress response. Mr. Ragon is already experiencing nausea. Some patients can have hypotension. In this case, my patient is having hypertension. It could be due to the anxiety or just the process that he’s going through with the blockage of his artery. A complication of an MI can be very severe and includes heart failure, aridemia, cardiac shock. It’s very important that his history of diabetes smoking in obesity and his sedentary lifestyle is also a bad factor for having a myocardia infection. All these things get together and that’s how it blows up. Okay. how we diagnose the conditions with an EKG with some blood work he does has a ST elevation EKG when we did it he has elevated troponins elevated cardiac enzymes imaging studies we didn’t do in this case but we can do a CTA to see how bad is the plague is but that calls him score in his body. He’s already presenting with symptoms, so we will go straight to the AKG and labs to see if he qualifies to go to the cardiac heat really quick to prevent any more damage to his heart. Okay, these are my references. I hope everybody enjoy. Bye-bye.
Good evening, everyone. My name is Candace Coonrad, and I’m here to present my pathophysiology adventure. My diagnosis was congestive heart failure, and my patient’s name was Mr. Thomas Brown. Good afternoon, Mr. Brown. I wanted to review your recent diagnosis today and answer any questions you may have. You have recently been diagnosed with congestive heart failure. It says here that you’re a retired engineer living at home with your wife. I’m very pleased to see that you have quit smoking and that you and your wife usually enjoy a nice social life. You guys have no drug use and no recent travel. And I see you like to golf, but it doesn’t look like you’ve been doing much golfing lately. You are looking pale, and your vital signs tell me you’ve been struggling lately. I hope that with this diagnosis of interventions, we can get you back on track and able to start enjoying the things that you love to do again. Your lab results, such as your EKG, echo -cardiogram, and B&P reflect your diagnosis. and I also want to stress the importance of taking your cholesterol medication. The good news is that your ejection fraction can improve with treatment and some lifestyle changes. It will be essential to monitor your vital science and blood sugar due to your health history so that it doesn’t exacerbate or worsen your new diagnosis of CHF. Your activity and tolerance and frequent nighttime urination are also linked to your diagnosis of congestive heart failure. I expect these symptoms to improve by improving your baseline condition. How much they improve depends on your compliance with the treatment plan that you and your cardiologist will develop. As you can see, by stopping your cholesterol medication without discussing it with your care providers, your cholesterol is now dangerously high. I don’t want something similar to happen with your CHF condition. And as you can see here, I’ve got your lab results listed for you. We’ll go over those more in detail in just a few minutes. Next, I’d like to discuss the pathophysiology of your condition that led to your congestive heart failure. It occurs differently in patients depending on their medical history. Your previous MI or heart attack, along with your chronic comorbidity such as hypertension, type 2 diabetes, and obesity led to the chronic inflammation that reduced your cardiac output. The decreased cardiac output, or as your heart is pumping blood throughout your body, impaired the ability of your heart to pump this blood, which reduced your ejection fraction. The reduced ability to pump blood can cause structural abnormalities and remodeling or changing of your heart, such as an enlarged atrium, as we saw on your echocardiogram, and inadequate tissue profusion, which is when your body does not have the appropriate amount of blood, pumping to deliver the oxygen to your tissues. And you can experience side effects such as fatigue and shortness of breath like you’ve been complaining about. And here I’ve listed some basic ways that congestive heart failure causes all the symptoms that you’re having. Next, let’s talk about clinical manifestations of the condition of congestive heart failure. These should look familiar to you because you’ve been complaining about several of the symptoms. Left-sided heart failure causes a patient to become short of breath and causes an increase in the rate of breathing due to increased pressure and possible fluid in the lungs. Right-sided heart failure can affect the kidneys, causing the body to retain water and causing swelling in the lower extremities, which we call edema, like you have now. Eventually, patients can experience weight loss and muscle wasting as the disease progresses. In chronic congestive heart failure, a patient can expect the liver and abdomen to become swollen due to fluid backing up in the larger veins. This also causes edema, like we discussed, and an increased heart rate because your body is working harder than usual to perform its basic tasks. Heart failure can impact all of your organ systems. This is why you must take care to monitor your body closely. Finally, I’d like to discuss how we diagnosed your condition. We looked at several factors to diagnose you with heart failure, including your lab results, medical history, and imaging tests. Your blood test showed a higher than normal ENP level, which was 350, which suggests heart stress. Your EKG showed sinus tachycardia and left ventricular hypertrophy, indicating that your heart is working harder than normal. The echocardiogram that we did showed that your heart’s pumping ability or ejection fraction that we discussed earlier is reduced to 32% along with mild to moderate diastolic dysfunction and mitrovalfalph problems. Your medical history of high blood pressure, diabetes, coronary artery disease, and past heart attack put stress on your heart. These findings, along with your symptoms of tiredness, difficulty doing everyday activities like golfing, helped confirm the diagnosis of congestive heart failure. I’m going to refer to a cardiologist for any further testing they feel you might need, such as a cardiac catheterization and a stress test, which we have not done yet. But still, with the above test results, I can state confidently that your diagnosis is correct. But you and your cardiologist will work together and formulate a treatment plan to hopefully mitigate the symptoms of your disease and hopefully prevent it from worsening and get you back living the life that I know you love to live. Thank you.
