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Ch. 38

Ch. 38. C. Matthews RN, MSN. Heart Failure. Your text refers to heart failure as “pump failure…the inadequacy of the heart to pump blood throughout the body.” (p. 749) Here’s an analogy…instead of blood, let’s consider nursing students going through the LSCC program….

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Ch. 38

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  1. Ch. 38 C. Matthews RN, MSN

  2. Heart Failure • Your text refers to heart failure as “pump failure…the inadequacy of the heart to pump blood throughout the body.” (p. 749) • Here’s an analogy…instead of blood, let’s consider nursing students going through the LSCC program…..

  3. First yr. classrooms are the left atrium. • Second yr. classrooms are the left ventricle. • The first yr. students have taken pre-reqs (like the blood goes to the lungs and gets oxygen) and now they are ready to enter the first yr room (L atrium) and learn first year material – once they pass those classes, they are ‘pushed’ by an instructor named Mitral into the 2nd yr. classrooms (L ventricle).

  4. In the 2nd yr. classrooms, they learn some more and when they are ready to graduate, they are ‘pushed’ out of the classroom and into applying for graduation (arteries) by an instructor named Aortic.

  5. If this process gets slowed down or stopped up somehow…everything starts to back up. • The 2nd yr. classrooms are already full of students ready to graduate but Ms. Mitral is pushing the 1st yr students up to 2nd yr. • Because there’s no room for any more students in the 2nd yr classroom, the 1st yr classroom still has students in it when Mrs. Dunlap informs Ms. Mitral that another group of first year students have arrived!

  6. Pretty soon, there’s a line of students going out the building all the way back to the pre-req classes. • Now Dr. Osteen and others have their classrooms clogged up!

  7. Heart Failure • The circulatory system is filled with blood. Just like the LSCC education system (hopefully) is filled with students in every step of nursing education. • If the heart fails as a pump, the blood doesn’t move as it should…but it has to go somewhere!

  8. Heart Failure • On page 750 the text states that most heart failure begins with failure of the left ventricle – [which pushes blood into the aorta and out to the arterial system to the body]. • Failure of the L ventricle is like Ms. Aortic not being able to push the 2nd yr. students who are ready to go apply for graduation. (They love us some much they don’t want to leave. )

  9. The first place to miss the potential graduates (oxygenated blood) is the line at graduation. • The brain is waiting atop the carotids for its blood…it is going to miss it very quickly. • Meanwhile the R ventricle has pushed more blood into the lungs just like Mrs. Pate recruits people to get into the pre-req classes.

  10. Once the blood is ready it enters the L atium – but if the L ventricle cannot push what is already in there on out, the blood has to sit and wait in the L atrium. • The R ventricle pushes more blood into the lungs but now it cannot get into the L atrium because of the back-up. The lungs get congested. • If the lungs are congested to the point that the R ventricle is having trouble sending any more blood there, then R sided failure begins.

  11. Now the 2nd yr, 1st yr, newly admitted nursing students and hopeful nursing students in pre-req classes are backed up! • From the R heart, blood begins to back up into the venous system. Considering where the superior and inferior vena cava come from…that means overful veins that come from the head (hence JVD) and the liver, etc…eventually ending up pooling in the periphery (edema).

  12. The brain starts to panic…[just like the local nursing workforce would panic if all of the sudden there were only a trickle of nsg. Graduates]. • The brain wants and needs oxygen and sugar and the only way to get them is from that blood the L ventricle sends up. It will do whatever it takes to get that blood!

  13. The brain starts to set the compensatory mechanisms into play (starting on page 750) – hopefully the problem is solved by these mechanisms and is taken care of….otherwise, that’s when the trouble really starts!

  14. More to follow…

  15. References • Berkowitz, A. (2007). Clinical pathophysiology made ridiculously simple. MedMaster Inc., Miami, Florida. • Ignatavicius, D.D. & Workman, M. L. (2006). Medical-Surgical Nursing. (5th Ed.) Elsevier-Saunders, St. Louis, Missouri.

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