Question

Case Scenario: Your patient has cardiovascular disease (CVD) and has been admitted with these vitals: BP 190/90, HR 100, RR 35. When asked about symptoms, the patient states, “I have a very bad headache and feel light headed.” History reveals he has had one heart attack three years ago. He is a pack a day smoker and often drinks more than one drink per day.

1. Question: Explain how vasoconstrictor hormones affect blood pressure. State the hormone and the direct cause and effect. Support your answer using specific facts, data, examples, and other information drawn from the textbook and at least one other supplemental source.

Case Scenario: Using the above patient, when doing your morning assessment, you find a dime sized wound on his lower leg. The wound is open in the center and red around it. When asked, the patient states his feet and legs are cold much of the time and he no longer walks long distances because of pain in his legs.

2. Question: What is the most immediate concern for this patient and why? Include in your answer specific facts, data, examples, and other information drawn from your textbook and at least one other supplemental source.

Answer 1

• Effects of vasoconsctrictor hormone on blood pressure

Hyperosmolarity, Angiotensin and sympathetic stimulation lead hypothalamus to stimulate posterior pitutary, thus release vasopressin. This will result in blood vessel constriction leading to increased systemic vascular resistance thus increase pressure

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Cause and effect of vasoconstrictor hormone:

These hormones may increase stretch activated ion channels leading to depolarisation. It will cause increase in intracellular calcium and increase voltage gated sodium channel. They also decrease ATP gated potassium channel. Vasoconstrictor hormone will increase the receptor to Angiotensin receptor 1. They will promote the reception in endothelial receptor on endothelium leading to endothelin production.

Cutaneous vasoconstriction occurs as a result of exposure to cold. Endogenous factors that triggers vasoconstriction include Stimulants, Antihistamines etc. The headache or light headed symptom presented by the patient may as a result of revesible cerebral vasoconstriction syndrome.

Vasoconstriction is body's negative feedback mechanism to restore hemostasis.

For example vasoconstriction is a preventive measure in which the blood vessel constrics and blood will move with a high pressure to prevent hypoxia. ATP is used to increase the pressure here. If the hemostasis then restored by this, the blood pressure will get regulated.

• The immediate patient concern in this case may be Pneumatic pressure therapy speedup because the circulation has to be enhanced. A pneumatic leg pump therapy may sometimes suggested.

The poor circulation can often caused by arteriosclerosis, venous insufficiency or other clotting and circulatory disorders.

Ulcer on legs can also even caused by medical conditions like diabetes. Diabetic wound healing is a crucial one in this case.if patient is found to be diabetic. History of smoking either current or past also should be considered as one of the cause here.

The ulcers are usually affected on those patients with a history of swelling, Vericose veins and blood clotting.

the wounds may usually located at increased pressure points most commonly on bottom of feet.

Neutrophilic type of ulcers are occur in patients who have diabetes.Those ulcers can may or may not be painful,