Directions For this assessment task, you are required to write a 2000 word report answering the questions from the scenario. You will need to explore the pathophysiology, pharmacology and psychosocial...

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NURBN 2012: Nursing Practice 3 - Pathophysiology and Pharmacology Applied to Nursing Assessment Task 2 – Clinical Scenario Assignment
Introduction
The study describes the case scenario of a patient who is predicted to experience heart failure. Considering his medical history and current health issues, certain diagnoses have been outlined. Based on this, the study highlights the specificity and progression of heart failure in alignment with several other conditions that can trigger heart failure in the patient.
Question 1 (10 marks) 200 words Your buddy nurse asks for an ECG. Explain the rationale for the ECG request (5 marks). Why would the nurse also ask you to prepare for a blood test? (2 marks) Why do both ECG and a blood test? (3 marks)
An ECG request includes looking for the cause of cheats pian, as well as to evaluate the issues that may be heart-oriented such as shortness of breath (Sanders et al., 2019, p. 572). Moreover, for Deep, ECG may be helpful in identifying irregular heartbeats, thereby, determining the complete health of the heart prior to certain procedures such as surgery or endocarditis. Deep has a history of myocardial infarction and a request for ECG will help the physicians to understand whether the heart medicines are working or not. The nurse has asked for troponin and a CK-MB blood test. A troponin test helps in measuring the troponin level in blood as troponin is not normally present in blood and is only sent to the bloodstream during heart muscle damage. Thus, the troponin test will help in understanding the intensity of heart damage (Evans et al., 2018, p. 187). A high level of troponin in blood will determine that Deep recently encountered heart failure. Additionally, a creatine kinase-MB (CK-MB) test will be utilized as a follow-up test to identify an increased CK level in blood due to heart damage (Fan et al., 2017, p. 427). The CK-MB test is generally recommended for those individuals who have chest pain or shortness of breath. Both ECG and blood tests are recommended as they will confirm the occurrence of heart damage or heart failure in Deep.
Question 2 (20 marks) 600 words The medical team confirms the diagnosis of heart failure. Describe the pathophysiology of heart failure with reference to causes, progression and outcomes (15 marks). Include links to how heart failure has progressed for Deep (5 marks)
The heart may not generate tissues with sufficient blood concerning metabolic needs during the course of heart failure (Kemp & Conte, 2012, p. 365). Additionally, the cardiac-oriented elevation of systematic and pulmonary venous pressures may lead to organ congestion. This condition is likely to occur from abnormalities of diastolic or systolic function. Moreover, an initial abnormality can be altered in cardiomyocyte function and there are significant changes in collagen turnover considering the extracellular matrix. Cardiac structural defects such as valvular disorders and congenital defects, high metabolic demands concerning thyrotoxicosis, and rhythm abnormalities involving extremely high heart rate are likely to cause heart failure (Jorsal et al., p117).
Besides this, stroke volume (SV) can be influenced by three key factors, namely preload, afterload and contractility. Reload highlights the amount of myocardial fiber stretch during the end of diastole, afterload outline the resistance that needs to be eliminated concerning ventricular blood ejection, and contractility highlights the inotropic state of the heart (Kırali et al., 2017, p. 17). Left ventricular (LV) dysfunction can be segregated into two stages, namely systolic dysfunction, also referred to impaired ventricular contraction and ejection, and diastolic dysfunction, also known as the impaired relaxation and ventricular filling. A significant loss of functional myocardium considering infarction and ischemic disease is evident to be the usual cause of LV systolic dysfunction. Moreover, uncontrolled hypertension causes extreme pressure overloads that lead to heart failure (Jorsal et al., p117). Besides this, volume overload concerning valvular incompetence, as well as impaired contractility from cardiotoxic drugs and cardiotoxins are potential contributors to heart failure. The outcome of LV dysfunction is reduced cardiac output that triggers global hypoperfusion. Additionally, LV dysfunction leads to an elevated amount of ventricular blood, thereby, enhancing both end-diastolic and end-systolic volumes. This is likely to cause an enhancement in LV end-diastolic pressure (LVEDP) that triggers elevations in left atrial pressures (Fine, 2020). It is additionally evident to increase capillary pressure in the lungs. Hence, the elevated pressure within the lungs generally forces the fluid out of the pulmonary capillaries. This triggers pulmonary congestion, as well as crucial clinical symptoms of dyspnea (Kırali et al., 2017, p. 18). On the other hand, the most usual cause of right ventricular (RV) failure is LV failure. An increase in ventricular blood is evident when the RV fails which causes an increase in pressure of the vena cava system and right atrial pressure that is likely to disrupt the venous drainage from the body. Hence, elevated pressure in the gastrointestinal tract, liver and the lower portions add to the clinical symptoms of abdominal pain, peripheral edema and hepatomegaly.
Heart failure has progressed for Deep in all the following stages as mentioned beforehand. Additionally, Deep’s past medical history suggests myocardial infarction in 2017 in association with stable angina, hypertension, hypercholesteremia, and Type 2 Diabetes (diagnosed in...