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BIOL204 HowardCC Heart Cardiovascular Involvement Case Study

BIOL 204 Case Study Assignment

Grading

This is an individual assignment worth a total of 30 points. Answers should be in the form of a complete sentence and will be graded for correctness and completeness. Each question is worth a specified number of points. Three points will be deducted from the final score for each day after the due date that the submission is received. Submissions will not be accepted more than one week after the due date.

References

A list of at least two scholarly sources cited in APA style must be included. Each source listed in the bibliography must also be cited in the text of the answers, where appropriate. Use only scholarly sources. That is, use only sources that have been written and reviewed by experts in the field. Your text book is a good example of a scholarly source. Wikipedia is not a scholarly source. However, Wikipedia pages often contain lists of references which are scholarly sources. Search out those sources for the relevant information and cite from there. Materials presented by major medical or scientific organizations such as the American Cancer Society (www.cancer.org (Links to an external site.)Links to an external site.) or the American Physiological Society (www.the-aps.org (Links to an external site.)Links to an external site.) are acceptable but may not provide a sufficient level of detail to thoroughly answer the questions in the assignment. Points will be deducted for incorrect or missing citations. View the links below to find more information about scholarly sources and APA style.

https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_style_introduction.html (Links to an external site.)Links to an external site.http://www.library.illinois.edu/ugl/howdoi/scholarly.html (Links to an external site.)Links to an external site.

http://www.millsaps.edu/academics/heritage_how_to_indentify_scholarly_sources.php (Links to an external site.)Links to an external site.

Academic honesty

Students are permitted to discuss the assignment. However, each individual must submit their own document written in their own words. Copying directly from other students or other sources including websites constitutes plagiarism. Every submission will be checked by VeriCite and reviewed by the instructor. Detection of plagiarism may result in a grade of 0 and formal citation for infraction of the HCC code of conduct. For more information on HCC’s policies on academic honesty, please see the student handbook.

http://www.howardcc.edu/students/student_handbook/handbook.html (Links to an external site.)Links to an external site.

Note:

When submitting your document, be sure not to include any of the text from the case study or the questions as listed below. Simply number your answers according the questions. Answers should be complete sentences.

Heart Case Study

BIOL 204-508/509 Spring 2019

Part I – Emergency

Mrs. Wright came in through the front door of her house with an armful of groceries. She put the bag down on the kitchen counter and called to her husband. “Sean, I’m home! Are you ready for lunch?” She didn’t get an answer, so she walked to the living room and found Mr. Wright lying on the floor. “Sean! Are you okay?” she asked as she grabbed his shoulder. Mr. Wright responded weakly while clutching his chest. Mrs. Wright frantically called 911. It only took EMS a few minutes to arrive and the paramedics transported Mr. Wright to the hospital. Upon admission to the hospital, Mr. Wright vital signs were recorded as follows:

Vital sign

Mr. Wright

Normal

Systolic blood pressure (mm Hg)

90

90 – 120

Diastolic blood pressure (mm Hg

52

60 – 80

Oral temperature (°F)

98.9

97.8 – 99.1

Heart rate (beats per minute)

120, irregular

60 – 80

Respiratory rate (breaths per minute)

33, labored

12 – 20

Oxygen saturation

89%

95 – 100%

Questions

  1. Which of Mr. Wright’s vital signs and lab values were abnormal? (1 p)
  2. What additional medical tests would you order for Mr. Wright? In other words, what other information would be useful? (2 pts)
  3. What component of blood is responsible for transporting oxygen throughout the body? (1 pt)

Part II – Cardiac Involvement

Mr. Wright was admitted to the hospital with chest pains and shortness of breath. His wife was panicked since her 72 year-old husband had a history of heart disease. After examination and further testing, Dr. Buda spoke with Mrs. Wright. “I’m very sorry, but your husband has had another heart attack resulting in valve failure. A papillary muscle that controls a valve in his heart has been severely damaged and is no longer working.”

Questions

  1. Describe blood flow through the heart starting with blood entering the right side of the heart and including all chambers and valves. (4 pts)
  2. What is the function of heart valves? (2 pts)
  3. What is the function of papillary muscles? (2 pts)

Part III – Cardiovascular Involvement

Dr. Buda called Nurse Amaya from the patient’s room and confided, “Mr. Wright is in bad shape. His left posteromedial papillary muscle was damaged from his heart attack. The papillary muscle is no longer able to maintain closure of the valve, and this has resulted in mitral valve prolapse. With decreasing cardiac output, this patient is in for a fight for his life.” Nurse Amaya knew that maintaining cardiac output was necessary for adequate blood flow through the body. As Dr. Buda walked away, Nurse Amaya composed herself to tell Mrs. Wright the bad news and returned to the patient’s room. Nurse Amaya explained to Mrs. Wright that her husband had left-sided heart failure and that his blood pressure was slowly and steadily decreasing.

Questions

  1. Define mitral valve prolapse. (1 pt)
  2. Define ejection fraction. (1 pts)
  3. Explain how mitral valve prolapse causes a decrease in cardiac output. (3 pts)
  4. What effect might a prolapsed mitral valve have on Mr. Wright’s ejection fraction? Briefly explain. (3 pt)
  5. Explain how cardiac output determines blood pressure. (3 pts)

Part IV – Pulmonary Involvement

Mrs. Wright was very upset with the news of her husband’s condition. As the day progressed, she noticed that Mr. Wright’s breathing was increasingly difficult. He could barely speak without losing his breath. Mrs. Wright called the nurse to her husband’s room. “My husband can’t breathe! What is wrong? I thought he had a heart attack not a respiratory condition!” Nurse Amaya auscultated the patient’s chest listening to Mr. Wright’s respirations, which were rapid and wet, producing rales or crackling sounds. Nurse Amaya calmly informed Mrs. Wright, “I’m sorry. Your husband’s condition is worsening. The damage to his heart is causing his respiratory problems.”

Questions

  1. Does pulmonary blood pressure increase or decrease with left-sided heart failure? (1 pt)
  2. Consider the factors that determine net filtration pressure in capillaries. Does this change in pulmonary blood pressure (from #12) cause an increase or decrease in capillary filtration in the lungs? Briefly explain. (3 pts)
  3. How is left-sided heart failure causing Mr. Wrights breathing to become rapid and wet? (3 pts)

Part V – Resolution

Dr. Buda rushed Mr. Wright into surgery for valve replacement. Mrs. Wright waited anxiously in the waiting area for family for hours until she saw Nurse Amaya coming toward her with a big smile. “Your husband is in the recovery room. He’s going to be just fine.” Mrs. Wright sighed with relief and gave Nurse Amaya a big hug.

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