F.

PATHOPHYSIOLOGY

Precipitating Factor: Predisposing Factor:

* Unhealthy Lifestyle (Fatty diet and alcoholic) * Family Health History of Hypertension
* Occupation: Driver (prolonged sitting) * Family Health History of Arthritis
*Lack of exercise * Age: 46

Increased pressure in the blood vessels

Wear and tear in the endothelial cells

Vascular endothelium dysfunction

Thickened Artery Wall Isosorbide Mononitrate 1 tab OD

Vasoconstriction
Amlodipine 10 mg 1 tab OD
Narrow Lumen Increased Cardiac Output Blood Pressure: 170/90
mmHg

 Blood and Oxygen in the HYPERTENSION

Kidney

Contraction is More Forced

Heart contracts harder to pump
Ischemic Injury to Nephrons more blood
Growth of Cardiomyocyte
Cells are overworked → Heart is not
Glomerular Permeability
Enlarged Muscle able to pump efficiently

Macromolecules filtration Blood enters into the veins that take

CT Ratio: 0.59
blood through the lungs

 Pressure into the blood vessels

 Nursing Diagnosis: Impaired gas exchange
Nephrotoxic Remodeling related to alveolar-capillary membrane changes Fluid is pushed into air spaces in
secondary to pulmonary congestion the lungs

Glomerulosclerosis Fluid collection in the left

pleural cavity Decreased normal movement of
DOB oxygen through the lungs
CHRONIC KIDNEY DISEASE SPO2- 90% - 91%; RR: 21 cpm
Salbutamol q4 3 doses PULMONARY CONGESTION

Kidney damage  erythropoietin Buildup of toxic substances

production

Creation of AVF for Dialysis

 Stimulation of bone marrow leads  Red Blood Cell Survival
to  Red Blood Cell Production
High-pressure blood flow
from the artery

SYMPTOMATIC ANEMIA SECONDARY TO CKD

Hemoglobin – 79 g/L Vein stretches→it enlarges

Hematocrit – 0.24 L/L
Red Blood Cell Count- 2.77
Venous insufficiency
Ferrous Sulfate 1Tab BID
Nursing Diagnosis: Risk for Infection
related to inadequate primary and Decreased venous return and
secondary defenses increased backflow of the blood

 Hydrostatic Forces
  Transmural pressure in post
capillary vessels

Capillary dilatation and

Increased vessel permeability

Protein rich exudate

accumulates in interstitial space

Grade 2 Edema Right Arm

Edema Grade 4 Edema Left Arm

Nursing Diagnosis: Excess Fluid

VENOUS HYPERTENSION, Volume related to compromised
regulatory mechanism
CENTRAL VENOUS STENOSIS Left
secondary