XIII. Comprehensive Pathophysiology
PREDISPOSING FACTORS
PRECIPITATING FACTORS
Cigarette Smoker: 7.5
pack years
Heavy alcohol drinker
for 30 years
Diet: High fat foods
Hypertension
Age: Advanced age
Gender: Female
Family History: Stroke
Location of the
Aneurysm
Rupture of left MCA aneurysm
Blood spews out of the damaged blood vessel.
DIAGNOSTIC:
CT Scan
SURGERY:
Emergency Right
Ventriculostomy Tube
Increased ICP, direct pressure on
nearby tissues & blood vessels, and
vasospasm
Reduces blood flow to the brain
causes deprivation of oxygenrich blood other tissues & cells
DIAGNOSTIC:
CXR
Dyspnea, internal & subcostal
retractions noted; connected
to mechanical ventilator via
ET tube with 80% FiO2
- Episodes of tachypnea: RR
ranging from 20-29cpm
- White secretions noted upon
suctioning.
- Crackle noted on the right
lower lung upon auscultation
---INEFFECTIVE AIRWAY CLEARANCE--
DIAGNOSTIC:
CBC
RESULT:
Leukocytes: high (15.88) x 10^9/L
Neutrophils: high (0.92)
Lymphocytes: high (0.6)
LEGENDS:
Risk Factors------------------Pathophysiology------------Surgery----------------------Etiology & Final Diagnosis--Manifestation----------------Diagnostic Test--------------Nursing Diagnosis------------
Cerebral perfusion
Sudden increase
of blood pressure
Altered level of consciousness
Creating a pool of blood in the
subarachnoid space.
(SUBARACHNOID HEMORRHAGE)
- Tachypneic
- NGT feeding noted
- Ventriculostomy tube
with light red drainage
- Partially compensated
respiratory alkalosis
DIAGNOSTIC:
ABG Analysis
RESULT
pH: elevated (7.54)
Bicarbonate: low
(14.50 mmol/L)
---ACID BASE IMBALANCE---
Irritation of the meninges
Inflammation and scarring
of surrounding tissues.
Obstruction of CSF outflow.
Hydrocephalus
Increased
intracranial pressure
Altered level of
consciousness
---ALTERED BREATHING
PATTERN---
- Febrile; skin warm to
touch.
- Diaphoretic
- Temperature ranging
from 37.6 – 38.7 oC
---ELEVATED BODY
TEMPERATURE---
- Skin turgor: > 2sec
- With intact NGT and
OF feeding
- GCS: 5/15
DIAGNOSTIC:
Blood Chemistry
RESULT:
Sodium: high (146.78 mmol/L)
Potassium: low (2.86 mmol/L)
Glucose: high (117.66 mg/dL)
---RISK FOR LESS
THAN NUTRITIONAL
IMBALANCE---