NUR 634 Topic 5 DQ 1

Discussion:  Select one cardiac, peripheral vascular, or lymphatic system condition or disorder.

NUR 634 Topic 5 DQ 1 Assessment Description

Select one cardiac, peripheral vascular, or lymphatic system condition or disorder. Then complete the following:

Briefly discuss the condition/disorder.

Describe the symptoms and physical exam findings associated with the condition/disorder.

Identify appropriate laboratory, imaging, and other diagnostic/screening tools that apply to the disorder and explain how they will help you with your diagnosis.

List two other conditions that could cause a similar presentation (differential diagnoses) and explain how you would “rule out” those differentials.

Support your description with a minimum of two APRN-approved scholarly resources. You may not select a condition or disorder that has already been profiled by another learner; you must select a different one.

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NUR 634 Topic 5 DQ 1 Sample

Hypertensive heart disease (HHD) is a common complication of chronic uncontrolled hypertension. Changes in the coronary arteries characterize the disease and the left atrium and ventricle. Chronic uncontrolled hypertension is associated with an increase in cardiac afterload due to resistance in the ascending aorta. As a result, the ventricular muscles hypertrophy to overcome the resistance while causing narrowing of the cavity (Nemtsova et al., 2023). Changes in the left atrium also enlarge to accommodate more blood as there is less outflow to the left ventricle. In addition, hypertension increases the risk for coronary atherosclerotic changes, predisposing them to coronary artery disease and resultant myocardial ischemia and infarction. As a result, the patients are at a higher risk of acute decompensated heart failure, cardiac arrhythmia, and systolic or diastolic cardiac failure. NUR 634 Topic 5 DQ 1

Patients with HHD mostly present with features of left-sided or congestive heart failure. As a result, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, headaches, palpitations, confusion, fatigue, left-sided chest pain, and bilateral limb edema occur due to reduced perfusion to the central nervous system and kidney or due to fluid accumulation in the lungs (Masenga et al., 2023). Common physical examination findings include central cyanosis, bilateral pedal edema, elevated blood pressure, tachypnea, reduced oxygen saturation, and abnormal pulse rhythm and volume. A chest examination may reveal a hyperactive precordium on examination, a laterally displaced apical pulse, enlarged cardiac margins on percussion, and cardiac murmurs heard in auscultation. It is crucial to note that it is common to hear fine crackles due to pulmonary edema on lung auscultation. NUR 634 Topic 5 DQ 1

Common imaging tests required for hypertensive heart disease include chest radiographs and computed tomography (CT), commonly used to check the extent of hypertrophy and pulmonary edema. Other tests include an echocardiograph and electrocardiogram to check the cardiac electric activity, valve activity, and ejection fractions (Ismail et al., 2023). On the other hand, a complete blood count, cardiac biomarkers, and renal function test can be used as adjuncts to imaging.

Common diseases that may present similar to HHD include aortic stenosis and hypertrophic cardiomyopathy. The echocardiograph is thus crucial in evaluating differentiating between HHD and aortic stenosis through valve evaluation, where in HHD, valve function is normal (Ismail et al., 2023). On the other hand, a chest CT is crucial in differentiating HHD and hypertrophic cardiomyopathy, as all cardiac chamber walls are hypertrophied in hypertrophic cardiomyopathy.

NUR 634 Topic 5 DQ 1 References

Ismail, T. F., Frey, S., Kaufmann, B. A., Winkel, D. J., Boll, D. T., Zellweger, M. J., & Haaf, P. (2023). Hypertensive Heart Disease—The Imaging Perspective. Journal of Clinical Medicine, 12(9). https://doi.org/10.3390/jcm12093122

Masenga, S. K., & Kirabo, A. (2023). Hypertensive heart disease: Risk factors, complications and mechanisms. Frontiers in Cardiovascular Medicine, 10. https://doi.org/10.3389/fcvm.2023.1205475

Nemtsova, V., Vischer, A. S., & Burkard, T. (2023). Hypertensive Heart Disease: A Narrative Review Series—Part 1: Pathophysiology and Microstructural Changes. Journal of Clinical Medicine, 12(7). https://doi.org/10.3390/jcm12072606  NUR 634 Topic 5 DQ 1