Precipitating factor Predisposing factor

smoking 20 pack yearsmale

betle nut chewing age 71
family History of HPN
cardiac dysrhythmia

Smoking Betle nut chewing

tine plaque deposition on the blood Ct scan:

vessels Arecoline is being released
atherosclero
sis

Activation of
Narrowing of the blood vessel
parasympathetic
nervous system

Hypoperfusion to
vital organs

Muscarinic Muscarinic
Decreased heart rate
Vasodilation

Decreased conduction of SA node and AV node

Hypotensio
Reduce contractility of cardiac muscle

Hypoperfusion to vital organs

Decreased cardiac
output Kidney compensatory mechanism

Fluid retention Activation of RAAS

related increased
Na+

Increased cardiac Hypertensi

output on

Increased pressure on the blood vessel walls

Rupturing of
atheroma
Damage to blood vessels

Formation of Increased platelet

atheroma aggregation
 Clot may occlude delicate organs
Amlodipine Losartan

Nausea & Hypotension

Cerebrovascular area vomiting
hypotension

Decreased perfusion on the cerebellum

Ischemic stroke
Decreased perfusion to the kidney
(hypoperfusion)
Imbalance nutrition:
Ct scan: less than body
ischemia on the requirement related
cerebellar area Renal ischemia
to nasogastric tube
feeding
Unresolved
Impaired Kidney injury
physical mobility

Chronic kidney disease stage 4

Increased Fluid retention
circulating fluid
volume
Edem
a Serum creatinine:
Increased 2.10 mg/dl
cardiac output (high)
Vasoconstriction

Fluid and
Impairment in the
Impaired neuronal activity
physical Impaired
electrolyte
mobility peripheral tissue
imbalance
perfusion

nce in the cation and anions in the extracellular

Heaviness on Coldintracellular
and clammy
the lower extremities
extremity

equilibrium in the repolarization and depolarization of neurons

Neurons are irritable

Erratic release of neurotransmitters

Mood swings Organisms enters

delirium the respiratory
depression tract by
 Lose effectiveness
of defense
mechanism

Microorganisms
infects Type 2
alveolar cells

Microorganisms multiply and spread from alveolar to alv

Release of damaging toxins

Hypermetabolic state

Activates inflammatory cascade

Increase in body core temperature

Release of chemical mediators

Mood Delirium Hyperthermia

swings Vasodilation
depression

Vasodilation Increase capillary

permeability

Irritation of Irritation of
Increase mucus
airway airway
production

Flooding of exudation in the

alveoli

Fluid shifting from alveoli to

Lung
interstitial space
consolidation

Pulmonary Airway constriction

congestion Activity
intolerance r/t
Pulmonary edema Difficulty
decrease in
oxygen