NURS5042 Tut 3

Tutorial Activities Case 1: Hypertension Link to case study A 66-year-old woman was hospitalized for intense dyspnoea . She had a history of arterial hypertension and diabetes mellitus since the age of 56. Upon examination, she was in her regular general state, cyanotic , with a respiratory rate of 40 rpm, heart rate of 110 bpm and blood pressure of 140/100 mmHg and had oedema in lower limbs and lungs. She had a cardiac arrest and died. Autopsy revealed severe left ventricular hypertrophy. There was no evidence of coronary artery thrombosis or myocardial infarction . 1. What is the difference between benign/essential hypertension and malignant/severe hypertension? Primary Hypertension Secondary Hypertension Abnormally high blood pressure that's not caused by a medical condition. E.g. Obesity High blood pressure that's caused by another medical condition. E.g. Diabetes Malignant Hypertension (hypertensive crisis) Benign Hypertension (Hypertensive stage 1/2) Acute, severe and sudden onset. Anything above 120/80 Mild to moderate and progresses slowly but still needs medical attention. 140/90 -179/19 E.g. Atherosclerosis 2. What hypertension did this woman display, give reasons for your answer? Primary benign hypertension  Type 2 diabetes at age 56 (related to lifestyle, not another disease) 3. What complications (others than those listed above) can arise from this type of hypertension? - Kidney, liver, spleen, heart failure  any organ that passes blood which affects BP. - Thyroid problems - Obstructive sleep apnoea - Aneurism (swelling vessel) - Eye problems - Oedema - Thrombus (clots) - Embolus (Blood clot that moves in the vessels) 4. What was a likely cause of death in this woman and why? Left ventricle pumps blood out to the body. During left ventricular hypertrophy, the thickened heart wall can become stiff. Blood pressure in the heart increases. The changes make it harder for the heart to effectively pump blood. Eventually, the heart may fail to pump with as much force as needed. Decompensated heart failure  When cells are under pressure, they change their size (hypertrophy), number (hyperplasia) and type (metaplasia) 5. On a separate note; what is “white coat” hypertension and how is it significant? White coat hypertension, a condition in which a patient's blood pressure readings are higher when taken at the doctor's office compared to other settings  anxiety, stress Causes wrong readings, misdiagnoses

FALSE. Both forms of arrhythmia and are life-threatening. Class Discussion or group based academic writing practice (with referencing) Note: In this section, students will practice using an academic writing style and present the findings at the end of the tutorial (or post it on the Ed Discussion forum, aiming for 400 words). This is to provide practice for assessment two with the opportunity for tutor feedback. Please use APA 7 th edition referencing style as per the assessment instructions. More resources on academic writing style can be found at the following link: https://www.sydney.edu.au/students/writing.html . We would recommend 3-4 references per section and would advise you avoid using general websites or blogs and seek peer reviewed sources primarily. You may choose to work individually or form a small group per condition. Answering the question will require you to look at evidence in class through a combination of MIMs, textbooks and journal articles. If time permits, small groups will be encouraged to produce a summary sheet per condition or a small class presentation to share their findings. Summary sheets can also be uploaded to the Ed discussion forum. Examples of conditions (not limited) in Cardiovascular disease a. Hypertension b. Coronary Heart Disease c. Hear Failure d. Myocardial infraction e. Stroke f. Congenital Heart Disease g. Pericardial disease Things to keep in mind when writing your answer:  What has been altered from normal physiology (e.g. what is not working)  Why is it not working (e.g. pathogenesis of the condition)  What does the patient look like? (e.g.clinical manifestations) Does this change over the time course of the condition? (e.g. early to late stage changes per clinical condition of relevance.  How can we manage the patient as a nurse ? Referencing guide: https://libguides.library.usyd.edu.au/citation/apa7 NOTE: Please avoid using websites and use journal articles or textbook material