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Assignment Left-Sided Heart Failure Concept Map

Assignment: Left-Sided Heart Failure Concept Map

Left-Sided Heart Failure Concept Map: Pathophysiology template
Disease: Ischaemic stroke affecting the dominant left cerebral hemisphere

Definition: An ischaemic stroke is the death of brain tissue resulting from an occluded artery caused either by an atherosclerotic obstruction or embolus that interrupts the blood supply to the area of the brain supplied by the occluded artery. The sudden loss of blood circulation results in a corresponding loss of neurologic function (Jauch, 2014).

AETIOLOGY:

A depletion of blood flow in a cerebral artery resulting from a:

· Thrombus –atherosclerotic plaque that has ruptured in a cerebral artery

· Embolus

· from heart e.g. left atrial thrombus, left ventricular thrombus, atrial fibrillation

· from carotid artery (Craft &Gordon,2011)

Left Sided Heart Failure Concept Map

PATHOGENESIS:

· Interruption of blood flow to cerebral tissue initiates a biochemical ischaemic cascade.

· Mitochondrial production of ATP ceases depolarisation  influx of sodium and calcium and efflux of potassium. Passive inflow of water into cells causes cytotoxic oedema and destruction of cells in infarct core.

· Membrane depolarization also stimulates the release of neurotransmitters. Glutamate release excessive calcium influx into nearby neurons (exocitotoxicity) destruction of cells by lipolysis, proteolysis and free radicals.

· Mitochondria break down releasing toxins and apoptotic factors.

· Injured brain tissue triggers inflammatory response release of inflammatory mediators cell death and oedema

destruction of cells in infarct core necrosis

ischaemic penumbra around core has diminished blood flow but preserved cellular metabolism.

Areas of necrotic tissue are not able to conduct nerve impulses so functions such as initiating and conveying motor impulses, receiving and interpreting sensory information and speech control will be interrupted.

(Bautista, 2014; Craft & Gordon, 2011; Maas & Safdieh,2009). Left Sided Heart Failure Concept Map.

CLINICAL MANIFESTATIONS:

Just superior to the medullary junction, 90% of axons in the left pyramid cross to the right right motor dysfunction.

The middle cerebral artery supplies the frontal, temporal and parietal lobes as well as the basal ganglia and internal capsule. (Tocco,2011).

Left Sided Heart Failure Concept Map. Therefore specific clinical manifestations include:

· Hemiplegia and weakness on right side of body

· Sensory loss on right side

· Inability to see the right visual field of each eye

· Aphasia

· Apraxia

· Dysarthria

· Impaired reasoning

· Behavioural changes

· Problems with memory

(Bautista, 2014; Craft & Gordon, 2011).

DIAGNOSIS

· Complete history

· Physical and neurological examination

· Brain MRI or CT scan – Essential in differentiating cerebral haemorrhage from ischaemic stroke. MRI is superior as cerebral ischaemia can be identified within minutes and can identify small areas of stroke.

· Other tests for vascular imaging can be used e.g. CT angiography, magnetic resonance angiography

(Silverman & Rymer, 2009). Left Sided Heart Failure Concept Map.

TREATMENT

The emphasis of ischaemic stroke treatment is placed on salvaging potentially reversible ischemic penumbra brain tissue, preventing secondary stroke and minimising longterm disability. (Jaunch, 2014).

· Reperfusion

· thrombolytic agent (e.g.tPA)

Assignment Left-Sided Heart Failure Concept Map

Assignment Left-Sided Heart Failure Concept Map

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS:Assignment: Left-Sided Heart Failure Concept Map

· intra-arterial technique

· Neuroprotection

-antithrombotic therapy (e.g. aspirin)

· Nursing management

Acute phase

· frequent evaluation of neurological status

· frequent evaluation of vital signs

· Monitor oxygen saturation – administer oxygen if required

· Screen for swallowing deficits and manage appropriate hydration and nutrition strategies

· Manage activities of daily living

· Screen for communication deficits and address appropriate communication strategies

· Prevent complications e,g pressure areas, contractures, DVT

· Assess urinary and faecal continence and address appropriately

Rehabilitation

· begin as early as possible by preventing complications, passive and active movement and mobilizing as early as possible.

· Support and encourage activities provided by physiotherapists, occupational therapists and speech therapists

· Education – e.g. lifestyle modification, adherence to medications

(National Stroke Foundation, 2010).

COURSE OF DISEASE

· With reperfusion – blood is restored to the area and signs and symptoms gradually resolve

· Without treatment – Course is determined by severity of stroke. Ischaemia will extend to penumbra as stroke evolves, signs and symptoms worsen. As cerebral oedema resolves, and with structural and functional reorganisation recovery may continue for 6 months to a year. (peak recovery in about 3 months). Requires rehabilitation to optimise function.

(Teasell & Hussein, 2014).

· Complications

Contractures

Fatigue

Incontinence

Mood disturbances

Falls

Dysarthria and aphasia

PROGNOSIS

· Stroke prognosis is influenced by factors such as age and stroke severity.

· One in five likely to die within one month of suffering ischaemic stroke.

· Of those who recover about 90% will experience some impairment

(Dashe,2014) Left Sided Heart Failure Concept Map.

PREVENTION

Eliminating modifiable risk factors will prevent an ischaemic stroke.

· Don’t smoke

· Diet high in fruit and vegetables, low in fats and salt

· 30 minutes of moderate-intensity physical activity on most days of the week

· Maintain healthy BMI

· Limit alcohol to no more than two standard drinks per day

(National Stroke Foundation, 2010)

If a history of atrial fibrillation – ensure adherence to anticoagulation therapy.

References

Bautista, C. (2014). Disorders of Brain Function. In S. Grossman & C. Porth (Eds),

Porth’s pathophysiology: Concepts of altered health states (9th ed.). (pp489-

524). Philadelphia: Lippincott Williams & Wilkins.

Craft, J. & Gordon, C. (2011), Alterations of Neurological Function across the

Lifespan. In J.Craft, C.Gordon & A. Tiziani (Eds). Understanding

Pathophysiology (pp 188-226). Sydney, Australia:Elsevier Australia.

Dashe, J. F. (2014). Stroke prognosis in adults. UpToDate. Retrieved from:

http://www.uptodate.com/contents/stroke-prognosis-in-adults

Jaunch, E.C. (2014). Ischemic stroke treatment and management, Retrieved from:

http://emedicine.medscape.com/article/1916852-overview

Maas, E.B. & Rymer, M.M. (2009). Ischaemic stroke: Pathophysiology and Principles

of Localization. Neurology 13 .Retrieved from:

http://www.turner-white.com/pdf/brm_Neur_V13P1.pdf

National Stroke Foundation (2010). Clinical guidelines for stroke management

2010. Melbourne Australia.

Silverman, I.E. & Rymer, M.M. (2009). An atlas of investigation and treatment.

Ischaemic stroke. Clinical publishing:Oxford,U.K.

Teasell, R.& Hussein, N. (2014)Brain reorganization, recovery and organizecare.

In Stroke rehabilitation clinician handbook 2014. Retrieved from:

http://www.ebrsr.com/sites/default/files/Chapter%202_Brain%20Reorganization,%20Recovery%20and%20Organized%20Care_June%2018%202014.pdf

Tocco, S. (2011). Identify the vessel recognize the stroke. American Nurse Today

Important information for writing discussion questions and participation

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to.

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

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