Running Head: part b scholarly paper concept Map: Scholarly Paper Part B

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Concept Map: Scholarly Paper Part B

Jennifer Maza

810 097 238

Monday, March 16, 2015

Professor Wendy Chow

A.O 48 year old male with past medical history of Cirrhosis of the liver, ETOH x 25 years, hypertension was admitted to medical unit with ascites and mild shortness of breath on exertion. A.O also has generalized edema, pedal pulses palpable bilaterally. Jaundice throughout with vital signs of 37.5, 122, 26, 162/74, 02 Sat 92% on RA. For this essay I will focus on the pathophysiological priority of impaired liver function and its clinical manifestation of high blood pressure, along with examples of nursing interventions onto how manage them appropriately.

The liver is a vital organ that helps our body function properly in many unique ways. The Liver works as a storage that contains essential vitamins and minerals needed to supply to the tissues of our body. It also plays an important role in digestion by breaking down fats and utilizing protein for energy. In correlation of metabolizing carbohydrates, lipids and proteins to help produce ATP as source of energy. Most importantly, it also works as a detoxification by using enzymes to get rid of any toxic and unwanted substances from our bloodstream. Due to the significant role of the liver, my highest priority of pathophysiological for A.O is impaired liver function. A.O has a history of cirrhosis of the liver due to alcohol usage for 25 years and is the reason why he has jaundice throughout, and generalized edema. Impaired liver function has a lot of complications and with proper management, treatment, dietary and lifestyle changes can minimize the risk of further damaging to liver.

According to A.O’s vital signs, it is evident that he has hypertension with a reading of 162/74 for blood pressure and a heart rate of 122 beats per minute. Treating high blood pressure is important to avoid potential risks of stroke, heart attack, heart failure and chronic renal failure. A possible complication of having cirrhosis of liver is having portal hypertension. This happens when vessels in the liver is potentially blocked due to liver damage in which makes it difficult to receive blood flow through the liver from organs around like the stomach, pancreas and intestines. Not being able to have proper blood flowing through the liver causes increased pressure in the portal veins as this maybe the underlying cause of A.O’s ascites and general edema. Without proper treatment of impaired liver function, a possible chance of kidney disease may develop into secondary hypertension. Nevertheless, A.O’s short of breath with a respiration of 26 is due to exertion and having impaired liver function because the ascites cause abdominal distention making it harder to use accessory muscles to help breathe effectively.

Nursing interventions to manage High Blood pressure includes the ability encourage bed rest and activity restrictions to A.O because it would prevent shortness of breath, as he is prone to having high respirations on exertion. Referring A.O to a dietician will enlighten him onto having a healthier diet. Guidance from a dietician will lead him to make better food choices when it comes to his diet intake. Recommend foods such as fruits, vegetables, nuts, fish, whole grains. A diet with low sodium intake and an increase in potassium in take by eating bananas, spinach, potatoes, and dark leafy greens. An increase in potassium intake will help lower the chances of heart disease because potassium helps/prevents vessel walls from thickening. Also, A.O should be suggested to avoid caffeine as it has an effect on increasing blood pressure, this is critical and should be avoided especially prior to any exercise or any activity that may trigger A.O’s short of breath on exertion.

Having a disease can be a burden and stressful for a person. Every individual has different ways to cope and it’s important to encourage the patient to have positive outlook in their life as it will benefit them mentally, emotionally and physically. It is important for A.O to reduce stress because a lot of it can gradually cause high blood pressure and heart disease. And based on A.O’s history of ETOH x 25 years, it’s important that he copes with stress positively and not abuse substances like alcohol to help him get through his condition. Stress management for A.O can be achieved by providing adequate therapeutic nurse-client relationship. This can be accomplished by giving A.O the chance to express his concerns, and feelings to help reduce anxiety. Client teaching about his condition to help him get a better understanding and be more accepting of his body changes due to his illness to help cope positively. Assist client by helping him achieve realistic goals, validation of his feelings and build his self-esteem to help him overlook the physical side effects of Jaundice. Fostering his feelings and needs by supporting him or suggesting him to available resources such as dieticians or therapist will aid him onto a positive mind state and a healthier body.

In conclusion, high blood pressure is critical to manage to help body function as a whole mentally and physically because without proper treatment, essential body organs like the liver and heart will fail leading to chronic illness, or worse death.

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