PATHOPHYSIOLOGY

HEALTH ASSESSMENT

PREDISPOSING FACTOR
Modifiable
Sedentary Lifestyle
Prolonged hours of work more
than 8 hours a day
Unhealthy perception and
values
Activity and exercise
Female
25 years old
Not married with 5 children
Former waitress
1month PTC: had a dilatation and curettage
due to abortion
Has 2 confinements PTC
PRECIPITATING FACTOR
1 month PTC, her live-in partner separated
Idiopathic
with her
Physical environmental,
+ chest pain, body weakness, vaginal bleeding
psychosocial stress
lasted for 1 month Post op unsuccessful D&C
Prolonged bleeding lasted a
+ difficulty of breathing, Shortness of Breath
month
while lying down (orthopnea)
Psychosocial stress
+ history of heart attack of her father

Non Modifiable

Family predisposition
 Decreased RBC aggravated by
nutritional deficiency ( FE )

Laboratory exam: Complete Blood

Count

Erythrocytes: 4.13 4.2-5.4

Decreased Hemoglobin (107 g/l ) Decreased Hematocrit ( 0.341 )
Neutrophils: 0.871 0.37-0.72
normal Value 120-140 g/l normal Value 0.38-0.47

Lymphocytes: 0.099 0.20-0.50

Monocytes: 0.026 0.0-0.40

Heart pumps rapidly to Eosinophils: 0.000 0.02-0.06

compensate poor oxygenation of Basophils: 0.004 0.0-0.01

blood due to insufficient RBC as
well as need to support fetal
circulation

Insufficient nutrients and oxygen

given by the mother to fetus via
placenta and umbilical cord.

Fetal hypoxia
 Fetal Death

Signs and symptoms Dilatation & Curettage

Difficulty of breathing
Orthopnea
Unsuccessful Dilatation &
Chest Pain
Curettage leading to prolong
Nursing mgt.
bleeding
Proper positioning
Providing quiet and
peaceful environment Decrease blood volume from the
Encourage to not wear heart
too tight garments
Administration of
oxygen via nasal cannula Ineffective tissue perfussion

as ordered

SNS releases epinephrine and

norepeniphrine
 Activation of Vasoconstriction of the
Release of Renin
neurohormones kidney, release of
Angiotensin I and II
aldosterone in the adrenal
(endothelin, prostacyclin)
cortex

Sodium and Fluid

retention Increase preload and Increase ventricular wall
Fluid overload afterload stress
Fever

Nursing mgt. Increase workload of the Increase heart contractility

heart
Monitoring of I & O
Regularly checking
of IVF
Encourage
Decrease contractility of
ambulation to
myocardial muscle fibers
promote good
circulation
Medical mgt.

Ceftriaxone
Azitromycin
Furosemide Myocardial muscle Ventricular dilatation
Paracetamol stretches

cardiomyopathy

Diagnostic exam:

Decrease supply of Electrocardiography

oxygenated blood to systemic Ultrasonography
circulation
Signs/symptoms:

Orthopnea
Body stimulates heart to Dyspnea

work harder Chest pain

Pitting edema
Pulmonary edema

Heart cannot respond

HEART FAILURE
 If not treated If treated

Further complications may Continuous diagnostic

occur procedures:

Electrocardiography
Chest X-ray
Multi organ dysfunction
CBC
due to ischemia
Angiography

Continuous medications
Death

Heart may return in its

normal condition within
six months