The selected disease process is heart failure which occurs when the heart muscle cannot pump enough blood to the body. This condition can result from abnormalities of systolic or diastolic function or both. Although a primary abnormality can be a change in cardiomyocyte function, there are also changes in collagen turnover of the extracellular matrix. Cardiac structural defects, rhythm abnormalities, and high metabolic demands can also cause HF. In systolic HF (HFrEF) global LV systolic dysfunction predominates. The LV contracts poorly and empties inadequately, leading to increased diastolic volume and pressure and decreased ejection fraction (≤ 40%), In diastolic heart failure (HFpEF) LV filling is impaired, resulting in increased LV end-diastolic pressure at rest or during exertion and Usually, normal LV end-diastolic volume (McDonagh & Dargie, 2022). The clinical manifestations observed in Janessa’s case that could be explained by the pathophysiological mechanisms of heart failure are shortness of breath and weakness. Shortness of breath occurs when the blood “backs up” in the pulmonary veins because the heart can’t keep up with the supply causing fluid to leak into the lungs. The weakness is that the heart can’t pump enough blood to meet the needs of body tissues. Thus, the body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain. These clinical manifestations can support a diagnosis of heart failure because endometriosis can increase the risk of heart failure.

The first diagnostic test that would be most appropriate for investigating a diagnosis of heart failure is blood tests that look for a specific protein made by the heart and blood vessels. In heart failure, the level of this protein goes up. Another test is X-ray images which show the condition of the lungs and heart. Another test is an electrocardiogram (ECG or EKG) which is a quick and painless test that records the electrical signals in the heart to show how fast or how slowly the heart is beating. Another test is an echocardiogram; sound waves create images of the beating heart. This test shows the size and structure of the heart and heart valves and blood flow through the heart. Another test is ejection fraction is a measurement of the percentage of blood leaving your heart each time it squeezes (Inamdar & Inamdar, 2016). This measurement is taken during an echocardiogram. Another test is exercise tests or stress tests often involve walking on a treadmill or riding a stationary bike while the heart is monitored. Another test is a heart MRI scan which uses magnetic fields and radio waves to create detailed images of the heart. Another test is a coronary angiogram which helps spot blockages in the heart arteries. Another test is myocardial biopsy which is a test where a healthcare professional removes very small pieces of the heart muscle for examination to diagnose certain heart muscle diseases that cause heart failure. Asthma is a chronic lung disease caused by inflammation and muscle tightening around the airways, which makes it harder to breathe. The clinical manifestation of shortness of breath in Janessa’s case can fit asthma. Symptoms of asthma can vary from person to person. Inhaled medication can control asthma symptoms and allow people with asthma to lead a normal, active life.

References

Inamdar, A., & Inamdar, A. (2016). Heart failure: Diagnosis, management and utilization. Journal of Clinical Medicine, 5(7), 62. https://doi.org/10.3390/jcm5070062Links to an external site.

McDonagh, T. A., & Dargie, H. J. (2022). The pathophysiology of heart failure. Oxford Textbook of Heart Failure, 181-192. https://doi.org/10.1093/med/9780198766223.003.0013Links to an external site.

client scenario: 

Janessa, a 41-year-old female client, presents to the NP complaining of shortness of breath, weakness, and dizziness for “about a month.” She denies having a cough or recent illness. She has a history of endometriosis, and her physical assessment reveals her lungs are clear to auscultation bilaterally, and her mucous membranes are pale.  

General Question: What lifestyle or dietary factors would you want to explore further to better understand the root of her symptoms?  

 

• Find a research article related to the care of patients by nurses that does not display data with a graph or chart.
  • For the dependent variable, choose a method for presenting the data and use Excel to display the values given in the article for that variable. Label each axis. Display the illustration using APA 7th edition format for figures. Provide a name for the illustration.
  • Explain your rationale for choosing the method including the level of measurement for the variable (nominal, ordinal, interval, or ratio) and the type of variable (categorical or continuous).
  • Evaluate the illustration in terms of providing sufficient information in the title and each axis, correctly placing the independent and dependent variables on the correct axis, and using the proper scale for each axis.
•  Find a research article related to the care of patients by nurses that includes one of the types of bar graph, pie chart, histogram, or other similar type of illustration.
  • Write the purpose/objective/aim of the study statement exactly as written in the article (include page # in the reference citation). From the purpose statement, identify:
    • The population
    • The independent variable
    • The dependent variable you will focus on
  • Evaluate the illustration on these topics. Explain your rationale for each item.
    • What is the level of measurement of the variable (nominal, ordinal, interval, or ratio)? What is the type of measurement (categorical or continuous)? Is the figure appropriate for the level of measurement and type of variable?
    • Is sufficient information given in the title and for each axis of the illustration?
    • Are the independent and dependent variables placed on the correct axis?
    • Is the proper scale used for each axis?
    • Does the figure help to better understand the content?
  • Choose 2 or 3 variables from the study that are reported with descriptive statistic values in a table. These variables can describe the sample characteristics or the results of the study. Try to use one example of a variable reported as a measure of central tendency and one reported as a frequency.
    • For each variable you choose, provide this information:
      • Name of the variable.
      • Descriptive statistic reported – name the measurement of central tendency or frequency and the measure of variability reported.
      • What is the level of measurement for the variables (nominal, ordinal, interval, or ratio)? What type of variable are each of them (categorical or continuous)
      • Give the values for all the descriptive statistics for the variables you chose.
      • Find an example of where the degrees of freedom (df) are reported and describe how they are presented. What do dfs indicate about the sample?
      • Evaluate the choice of descriptive statistic with the rationale.
      • Interpret what the data values indicate: Examples of possible issues to consider (Only one of these issues probably relates to each variable.): Do the values for two or more groups differ greatly given the range of possible or usual scores? Do the values over time change greatly? Do the values for sample characteristics match what you know about patients that the sample represents?
        • Give specific information based on your clinical knowledge, critical thinking, experience with patients, and previous research to support your interpretation.