Question

Case study

Ahmad is a 74 year old male patient who has been admitted to the medical ward with acute fatigue, severe shortness, orthopnea and productive cough with hemoptysis. Ahmad's health conditions started to deteriorate since he had an acute myocardial infarction (MI) five years ago. He also presented with lower limbs edema including ankles and feet. According to Ahmad, the edema has started about 1 year since he had the MI. Ahmad also has a history of hypertension and type 2 diabetes mellitus, which have been controlled with oral pharmacological agents. Ahmad was only discharged from hospital last week after he had been treated from a severe chest infection. Ahmad used to smoke one pack per day for 40 years but has given it up six years ago. Ahmad’s vitals were as follows: BP 90/50 mmHg, HR 95 beats/m, RR 28 breaths/m, temperature 38c and SpO2 85% (on room air). Ahmad was reviewed by the doctor and blood samples were taken and sent to the lab for CBC analysis. Ahmed also had a chest x-ray and was sent for an Echocardiogram. The blood results showed: WBC 12,500, platelets 350, 000, and Hgb 8 g/dl. Chest x-ray results revealed pulmonary edema with right lower lobe consolidation and a small pleural effusion in the right lower lobe. During the physical examination, the lung auscultation revealed diminished breath sounds in the right lower lobe and absence of breath sounds at the base with wheezes in the bronchial area.

Q1.  Based on Ahmad’s Blood pressure of 90/50, explain the body response to maintain or raise blood pressure. You should first define the blood pressure component, and then explain the body response for low blood pressure.

Answer 1

Blood pressure is the pressure exerted by the circulating blood in the walls of the blood vessels.In response to pain from a heart attack can trigger a vasovagal response in the nervous system.it causes a drop in blood pressure and fainting.The body quickly responds to the low blood volume and pressure which results in hypertension.Patient have increased WBC rate that is,12,500 which results in hypertension.

When the heart is not able to pump efficiently,blood can back up into the veins that take blood through the lungs.As the pressure in these blood vessel increases,fluid is pushed into the air spaces in the lungs,that is the hypertension cause pulmonary edema.