Concepts of Cardiovascular and Respiratory Disorders
Which cholesterol is considered the “good” cholesterol, and what does it do?
When the body has excessive LDL cholesterol, the LDL cholesterol builds up on the walls of blood vessels, forming plaque. The vascular lumen narrows and might obstruct when plaque accumulates over time. This constriction prevents blood flow to and from the coronary artery, as well as to and from the heart and other organs.
When blood flow to the heart is obstructed, it can result in angina which is chest pain or a heart attack. Cholesterol circulates in the blood on proteins known as lipoprotein. Two forms of lipoproteins transport cholesterol throughout the body: LDL and HDL. LDL (low-density lipoprotein), often known as bad cholesterol, accounts for the majority of the body’s cholesterol. High LDL cholesterol levels increase your risk of heart disease and stroke (CDC, 2020).
HDL (high-density lipoprotein) is the beneficial cholesterol that absorbs and transports cholesterol back to the liver. It is subsequently eliminated from the body through the liver (CDC, 2020). High HDL cholesterol levels can reduce the risk of heart disease and stroke.
An LDL cholesterol level of 130–159 mg/dl is borderline high, while a level of 160–189 mg/dl is considered high. A result of at least 190 mg/dl is considered extremely high. If the patient has an LDL of 166, this is considered high (Zafari, 2021). Nitroglycerin is still used to treat angina pectoris and acute myocardial infarction. Nitroglycerin works by producing nitric oxide, which induces vasodilation and increases blood flow to the myocardium (Zafari, 2021). Dieting and exercises are also major contributors to lowering LDL.
How does inflammation contribute to the development of atherosclerosis?
Low levels of inflammation over time irritate the blood vessels. Inflammation can encourage plaque formation and release of plaque in the arteries and generate blood clots, which are the leading cause of heart attacks and strokes (Hopkinsmedicine, 2021). Inflammation is important in all stages of atherosclerosis.
Stable plaques have a persistent inflammatory infiltration, whereas susceptible and ruptured plaques have an active inflammation that causes the fibrous cap to weaken, predisposing the plaque to rupture. The presence of several types of susceptible plaques implies that atherosclerosis is a widespread inflammatory process (Hopkinsmedicine, 2021).
Morphologic and molecular indicators can distinguish between stable and fragile plaques, allowing individuals at high risk for acute cardiovascular and cerebrovascular events to be stratified before clinical symptoms arise.
Because of the result of a pleural friction rub, what does the APRN recognize?
A pleural friction rub is characterized by a raspy breathing sound produced by inflammation of the tissues around your lungs. When these two layers of pleural membranes become irritated or lose their lubrication, the patient feels discomfort and a pleural friction rub. A pleural friction rub might signify a more serious lung problem (Squires, 2022).
The APRN detects a scraping, scratchy sound after breathing and the start of exhaling. It originates in the region right above the pleural irritation. An APRN may be able to detect a pleural effusion based on a reduction in breath sounds and a change in their quality (Squires, 2022).
Given the history of the patient, explain what contributed to the development of a deep venous thrombosis (DVT)
According to Virchow’s triad of hypercoagulability, venous stasis, and vascular wall damage give a paradigm for understanding many of the risk variables that lead to the onset of thrombosis. As Salahudheen (2018) notes, there is venous endothelial damage induced by surgery, venous stasis owing to perioperative immobilization, and hypercoagulability resulting from postoperative fibrinolytic shutdown in patients who have complete hip or knee replacement surgery, for example.
However, a significant minority of individuals have unexplained DVT that lacks “clinical” risk markers such as endothelium damage or venous stasis, as well as identified thrombophilias that produce hypercoagulability. Undoubtedly, some of these individuals have unidentified thrombophilias, although the DVT is now classified as idiopathic.
There is a clear relationship between emphysema and COPD, explain the pathophysiology of emphysema and the relationship to COPD.
COPD is a chronic respiratory disease that causes dyspnea, coughing, and sputum production. Expiratory flow restriction is the physiological cause of dyspnea. COPD lungs exhibit alveolar breakdown, expansion, and inflammation of the lung parenchyma and airways (Higham et al., 2019). Emphysema etiology can be caused by increased alveolar wall cell death and lack of alveolar wall maintenance.
Chronic inflammation and elevated oxidative stress, according to the research, contribute to greater damage and poorer lung maintenance and repair in emphysema (Higham et al., 2019). Because clinically severe emphysema affects only a small percentage of smokers, genetic factors may play a key role in susceptibility or resistance to cigarette smoke.
References
CDC. (2020). LDL and HDL cholesterol: “bad” and “good” cholesterol. Centers for Disease Control and Prevention. Accessed 16th June 2022 from https://www.cdc.gov/cholesterol/ldl_hdl.htm
Higham, A., Quinn, A. M., Cançado, J. E. D., & Singh, D. (2019). The pathology of small airways disease in COPD: historical aspects and future directions. Respiratory Research, 20(1), 49. https://doi.org/10.1186/s12931-019-1017-y
Hopkinsmedicine. (2021). Fight inflammation to help prevent heart disease. Hopkinsmedicine.Org. Accessed 16th June 2022 from https://www.hopkinsmedicine.org/health/wellness-and-prevention/fight-inflammation-to-help-prevent-heart-disease
Salahudheen, M. (2018). A comprehensive study on incidence and risk factors of deep vein thrombosis in asymptomatic patient after prolonged surgery. Stanley Medical College, Chennai.
Squires, E. (2022). Assessment and examination of the respiratory system. Practice Nursing, 33(1), 18–24. https://doi.org/10.12968/pnur.2022.33.1.18
Zafari, M. (2021). Myocardial infarction. Medscape.Com. https://emedicine.medscape.com/article/155919-overview
Concepts of Cardiovascular and Respiratory Disorders Instructions
Assignment (1- to 2-page case study analysis-not including title page, references)
In your Case Study Analysis related to the scenario provided, explain the following points:
- The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
- Any racial/ethnic variables that may impact physiological functioning.
- How these processes interact to affect the patient.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references, in APA format. Peer reviewed journal reporting published in last 5 years, classroom textbook. Reserve MerckManuel, StatPearls as resources to support your primary references. At least 3 primary references are needed for submission.
Scenario: 76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now must sleep on two pillows in order to get enough air.
Assignment (1- to 2-page case study analysis-not including title page, references)
In your Case Study Analysis related to the scenario provided, explain the following points:
- The cardiovascular andcardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
- Any racial/ethnic variables that may impact physiological functioning.
- How these processes interact to affect the patient.