NUR 631 Topic 9 DQ 2

Sample Answer for NUR 631 Topic 9 DQ 2 Included After Question

Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

  1. Explain the underlying pathophysiology associated with hypertensive conditions. What are the associated pathological complications?
  2. Detail a common congenital defect associated with the cardiovascular system of a pediatric patient.

A Sample Answer For the Assignment: NUR 631 Topic 9 DQ 2

Title: NUR 631 Topic 9 DQ 2

Explain the underlying pathophysiology associated with hypertensive conditions. What are the associated pathological complications?

Hypertension is the overall increase of systemic arterial blood pressure and is categorized into primary, secondary, and complicated disease processes. Hypertension is defined as having a systolic blood pressure (SBP) of 130 mmHg or greater or a diastolic blood pressure (DBP) 80mmHg or greater, it used to be greater than 140/90 but the metrics allow for prompt and early interventions to prevent complications (McCance et.al, 2019). High blood pressure is a disease, but it can also be a symptom of another pathophysiological process or acute complication, clinical manifestations and symptoms will help in determining what kind of hypertension a patient is experiencing.

Essential hypertension can be prevented by modifying lifestyle and dietary risk factors, it is common in patients with comorbidities such as diabetes, renal issues, and stress. Environmental and genetic factors play a role in the development of hypertension. Other risk factors include alcohol and drug consumption, stressors, sleep disturbances, a sedentary lifestyle, smoking, high sodium and fat diet, obesity, and glucose intolerance. Hypertension is caused by an increase in systemic vascular resistance, basically, the arteries are clamped down and tightened causing an increase in cardiac output, heart rate, and stroke volume (McCance et.al, 2019).

Genetics and environment can affect the sympathetic nervous system, the renin-angiotensin-aldosterone system, and brain natriuretic peptides, leading to vasoconstriction and renal salt and water retention, causing increased peripheral resistance and an increase in blood volume, which causes a sustained hypertensive state (McCance et.al, 2019). Associated pathophysiological complications include vascular remodeling, the risk of strokes, myocardial infarctions, blurry vision with retinal changes, coronary artery disease, and encephalopathy. Treatment of hypertension is dependent on what is causing the changes in blood pressure in the first place. This could mean dietary changes, lifestyle changes, and prescription ACE inhibitors to reduce blood pressure over time. 

Detail a common congenital defect associated with the cardiovascular system of a pediatric patient.

Congenital heart defects are noted as the leading cause of death during the first year of an infant’s life, with over 35 known congenital heart defects, it is important to advocate for early pregnancy check-ups to monitor heart growth and function. The causes of congenital heart defects are usually environmental, genetic, and prenatal factors, this includes uncontrolled diabetes or hypertension, illicit drug use, teratogenic drugs, alcohol consumption, and advanced maternal age (McCance et.al, 2019). Congenital heart defects are classified by shunt direction and specific defects.

For example, Tetralogy of Fallot is a right to left shunt defect, so lesions end up decreasing pulmonary blood flow which is presented with cyanosis (McCance et.al, 2019). Tetralogy of Fallot is an interventricular defect in which the pulmonary artery is narrowed and there is an absence of a ductus arteriosus. This is the most common heart defect in children and intervention is required within the first year of life. Symptoms of this condition are not usually found right away, but over time affected children will experience respiratory distress, a prominent heart murmur, a systolic thrill, and cyanosis (Diaz-Frias & Guillaume, 2022). Surgical repair is the treatment for Tetralogy of Fallot.

References:

Diaz-Frias J, Guillaume M. Tetralogy of Fallot. [Updated 2022 Jan 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513288/

McCance, K. L., Huether, S. E., Brashers, V. L., Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children (Eighth ed.). Elsevier.

A Sample Answer For the Assignment: NUR 631 Topic 9 DQ 2

Title: NUR 631 Topic 9 DQ 2

Explain the underlying pathophysiology associated with hypertensive conditions. What are the associated pathological complications?

Secondary hypertension refers to high blood pressure that is caused by an underlying medical condition or a specific cause. Unlike primary hypertension, which has no identifiable cause, secondary hypertension can be attributed to various factors. The pathophysiology of secondary hypertension depends on the underlying disease or condition responsible for the elevated blood pressure.

There are numerous causes of secondary hypertension, including:

Renal causes: Kidney diseases such as chronic kidney disease, renal artery stenosis, polycystic kidney disease, and glomerulonephritis can lead to secondary hypertension.

Endocrine causes: Hormonal disorders like primary hyperaldosteronism (Conn’s syndrome), Cushing’s syndrome, pheochromocytoma, and hyperthyroidism can contribute to secondary hypertension. These conditions affect the hormonal balance in the body, leading to increased blood pressure.

Medications and substances: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, decongestants, and some antidepressants, can cause elevated blood pressure. Additionally, substances like cocaine and amphetamines can also lead to secondary hypertension.

Coarctation of the aorta: This is a congenital heart defect characterized by a narrowing of the aorta, which obstructs blood flow and increases blood pressure.

Sleep apnea: Obstructive sleep apnea, a disorder characterized by pauses in breathing during sleep, is associated with secondary hypertension. The intermittent hypoxia and sympathetic activation during apnea episodes contribute to elevated blood pressure.

Pregnancy-related hypertension: Conditions such as preeclampsia and gestational hypertension can cause high blood pressure during pregnancy. These conditions typically resolve after delivery.

The treatment of secondary hypertension involves addressing the underlying cause. Managing the primary disease or condition often leads to better blood pressure control. Identifying the specific cause of hypertension is crucial for appropriate management and prevention of complications associated with elevated blood pressure.

Detail a common congenital defect associated with the cardiovascular system of a pediatric patient.

Tricuspid atresia is a complex congenital heart defect characterized by the absence or severe underdevelopment of the tricuspid valve, which separates the right atrium from the right ventricle. This defect leads to abnormal blood flow and mixing of oxygenated and deoxygenated blood within the heart.

In tricuspid atresia, the blood in the right atrium cannot pass through the tricuspid valve into the right ventricle. Instead, it typically flows through an atrial septal defect (ASD) or a ventricular septal defect (VSD) into the left side of the heart. This results in a mixing of oxygenated and deoxygenated blood, leading to reduced oxygen saturation levels in systemic circulation. The severity of tricuspid atresia can vary, and additional defects often accompany the condition. These may include an underdeveloped or hypoplastic right ventricle, an enlarged mitral valve and left ventricle, and varying degrees of pulmonic stenosis, which is a narrowing of the pulmonary valve or artery. Due to the complex nature of tricuspid atresia, treatment typically involves a series of staged surgical procedures. The ultimate goal of treatment is to improve blood flow and oxygenation in the body. The specific surgical interventions depend on the individual’s anatomy and the presence of other associated heart defects.

The initial treatment for tricuspid atresia usually involves creating or enlarging an atrial septal communication to allow blood to flow from the right atrium to the left atrium. This can be achieved through the placement of a systemic-to-pulmonary artery shunt, such as a modified Blalock-Taussig shunt, to improve blood flow to the lungs. Subsequent surgeries aim to redirect blood flow and establish a connection between the systemic and pulmonary circulation. These procedures may include the Glenn procedure or the Fontan procedure, which involve rerouting venous blood directly to the pulmonary arteries, bypassing the right ventricle. The timing and extent of these surgeries depend on the individual’s overall health, age, and specific anatomical considerations. Regular medical follow-up and monitoring are essential to assess heart function, oxygen saturation levels, and potential complications throughout the patient’s life.