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Hypertension
Pathophysiology
Hypertension (HTN) can be caused by damage to renal pressure natriuresis, which controls the blood pressure and keeps it low.
Manifestations
A person with hypertension can experience headaches, apnea, pain in the chest, and a bleeding nose. Yet, it is important to remember that often the condition is unnoticeable and develops gradually.
Diagnostics
When diagnosing a patient, risk factors for HTN must be assessed these are smoking, advancing age, sedentary lifestyle, poor diet, and heavy drinking. HTN is more prevalent in women aged 55 and older. Other factors are obesity, family history, a high Na diet, and glucose intolerance. A BP of 140+/90+ is hypertensive. Labs find a higher serum Na is a sign of HTN or a risk of HTN (Wheeler, 2020).
Nursing care
HTN can be treated with beta-blockers, diuretics, ACE inhibitors, and calcium channel blockers. Anticoagulants can also be prescribed because HTN increases the risk of blood clots forming due to the high pressure, causing platelets to touch more often and possibly starting a clotting cascade. HTN requires a lifestyle change of a lower sodium diet and exercise to help lower the patient’s BP. Antihypertensives can also be taken long-term to bring the BP to a safer range and lower the risk of developing embolisms.
Atrial Fibrillation
Pathophysiology
The atria of the heart do not make a full contraction; they beat irregularly, rapidly, and out of synch with ventricular contractions. This leads to turbulent blood flow in the atria and may cause the platelets to begin a clotting cascade. A clot made this way may lead to a stroke, pulmonary embolism, heart attack, and other conditions caused by an embolism occluding a blood vessel.
Manifestations
A patient with this condition may feel weakness, fatigue, heart palpitations, and shortness of breath. AFIB is often associated with other heart diseases like CAD, HTN, HF, and cardiomyopathy.
Diagnostics
The condition of atrial fibrillation can be diagnosed using the process of electrocardiography to produce an electrocardiogram (EKG), which will contain records of the electrical activity of the patient’s heart. Yet, to achieve a clear result, the patient has to experience atrial fibrillation while undergoing the procedure. If the person has a condition that is intermittent, then they may have to wear an EKG device which will record their heart activity for several hours.
Nursing care
Preventing blood clots from forming is important considering AFIB increases the risk of one forming in the heart. This is treated with calcium channel blockers (to control the rhythm of the atria) and anticoagulants such as Warfarin (to prevent clots from forming) (Wong et al., 2021). The patients are monitored closely to ensure blood clots are not forming too easily (anticoagulants slow the time it takes for a clot to form).
Type 2 Diabetes
Pathophysiology
Type two diabetes mellitus causes the body to become resistant to insulin, meaning the cells of the body cannot use the sugars in the blood for energy. This leads to the body starving and eventually breaking down fats to produce ketones, which the cells use instead of sugar. The unused sugars stay in the blood and increase its viscosity, meaning blood travels slower and inhibit healing.
Manifestations
High blood sugar in diabetics can lead to nerve damage. Obesity and inactivity are the two most common risk factors for type two diabetes. People with this condition may experience frequent thirst, hunger, increased fatigue, problems with vision, and urination.
Diagnostics
Diagnosing type 2 diabetes implies taking the A1C test, which helps the doctors determine the levels of glucose in the blood over the recent period. The results showing that the level of glucose is lower than 5.7% mean that the patient is healthy, while the result of higher than 6.4% indicates that the person has the condition.
Nursing care
The primary task when treating type 2 diabetes is to normalize the levels of glucose in the blood to prevent complications from developing, thus, the patient will have to receive daily insulin injections (White, 2019). Nurses have to develop an appropriate meal plan for the patient and take into consideration the level of blood sugar.
Pneumonia
Pathophysiology
Pneumonia constitutes an infection process that occurs in the lower respiratory tract and namely affects a segment of the lung called the parenchyma (McConnell, 2020). It is often caused by bacteria, fungi, or viruses, which trigger an inflammatory reaction in the lungs, which eventually leads to a situation when the lungs’ alveoli are filled with fluid, preventing them from functioning normally.
Manifestations
Patients with pneumonia tend to experience symptoms varying in their severity, but the most common ones include coughing, with results in producing yellow or green mucus, occasional fever, and dyspnea. Other symptoms are fatigue and loss of desire to eat, possible vomiting and nausea, and pain in the chest when coughing or breathing.
Diagnostics
To diagnose the condition correctly, the medical professionals have to conduct a chest X-ray procedure to determine whether there is inflammation in the patient’s lungs. Additionally, a blood test can be done to ascertain that the immune system is trying to counter the infection.
Nursing care
All patients with pneumonia can undergo either outpatient or inpatient treatment depending on the severity of their symptoms. Those staying at home can be given antibiotics only if their condition was caused by bacteria, also, they can receive painkillers to relieve fever and pain. Patients treated in a hospital can be administered fluids and provided with oxygen to assist their breathing.
Urinary Tract Infection (UTI )
Pathophysiology
UTI constitutes a condition that involves an infection that can occur in different parts of the urinary system, including the bladder, kidney, or urethra (Sanyal, 2019). There are two types of UTIs, the uncomplicated and complicated, and the most common forms of the disease are pyelonephritis and cystitis, which usually affect adult women.
Manifestations
People with the condition can ignore it for a long time because it can stay unnoticeable and not cause any problems. Nevertheless, when the symptoms start to emerge, they may include frequent desire to urinate, often in small amounts, pain in the pelvis, and when urinating, urine with a strong smell or colored red.
Diagnostics
Determining whether a patient has an infection requires conducting an analysis of their urine to explore whether it contains bacteria that was likely to cause the condition. Moreover, when analyzing the patient’s urine, the professional must assess whether the person has pyuria, which is the presence of an abnormal amount of white cells in urine.
Nursing care
Nurses must ensure that the patient takes the prescribed antibiotics and also can provide them with antispasmodic agents to help relieve pain. The patient has to drink plenty of fluids to remove bacteria from the urinary tract by emptying the bladder every two or three hours.
References
McConnell, T. H. (2020). Study guide for the nature of disease. Burlington, MA: Jones & Bartlett Learning.
Sanyal, S. (2019). Clinical pathology: A practical manual. New York, NY: Elsevier.
Wheeler, G. (2020). Hypertension: New frontiers. New York, NY: Foster Academics.
White, J. R. (2018). 2019 guide to medications for the treatment of diabetes mellitus. Arlington, VA: American Diabetes Association.
Wong, N. D., Amsterdam, E. A., & Toth, P. P. (Eds.). (2021). ASPC manual of preventive cardiology. London: Springer.
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