Patho week 3

Discussion Prompt #1

How does an understanding of the mechanisms of the heart help you in treatment of
your patient regardless of the illness? How does basic cardiac monitoring factor into caring
for your patient? How do you care for patients with dysrhythmia? Share some of your best
practices.
The heart is a very complicated organ in the body, it supplies our body with nutrients that
we need to function. It also pumps blood from chambers of the heart into our vital organs
like the brain. By understanding the anatomy of the heart and the function, it will help you
recognized and pick up signs a patient is experiencing symptoms. This will also be helpful
when it comes to treatment and care received by the patient in terms of how heart
functions.
The basic cardiac monitoring tells the clinicians the different changes that the patient is
experiencing. For example, basic cardiac assessment at the beginning of the shift helped us
identified changes that was not observed previously. This will help us reflect upon what
changed and what treatment needs to be initiated. The basic cardiac monitoring will
decrease the length of stay and also decrease mortality rates ( Copstead & Banasik, 2014).
For patient with dysrhythmia, it is important to get a full history about the patient. If they
had a recent MI, or if any procedure was done prior. What kind of medication were they on
and how does it affect the heart rhythm. After you identified the cause of the dysrhythmia,
you would also identified what is the best treatment for the patient. After the treatment was
given, continuous monitoring is also very important to observe for changes

Copstead-Kirkhorn, L., Banasik, J.L.(2014). Pathophysiology, 5th Edition

Review the following case study and discuss the questions that follow.

CC is a previously healthy 27-year-old man admitted to the critical care unit

after an accident in which he was hit by a car and dragged along the
pavement for nearly 100 feet. He suffered a frontal contusion, fractured
clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and
buttocks. On admission, he was tachycardic, hypotensive, unresponsive, and

ventilating poorly. He was placed on a mechanical ventilator and given IV

fluids for the treatment of his shock. CC responded well to fluids, with an
increase in blood pressure and an improvement in urine output.
1.

Based on his case history and responsiveness to fluid therapy, what type of shock
was CC experiencing?
2.
What other clinical findings would be helpful in confirming the type of shock? Why?
3.
Because of his many open wounds and invasive lines, CC is at risk for sepsis and
septic shock. What clinical findings would suggest that this complication has
developed?
4.
What is the link between sepsis and multiple organ dysfunction syndrome (MODS)?

CC is experiencing hypovolemic shock. Hypovolemic shock is defined as loss of blood volume

through blood loss or excessive loss of extracellular fluid (Copstead & Banasik, 2014). Some
symptoms of hypovolemic shock includes alter level of consciousness, cool and clammy skin,
hypotension, tachycardia. Some very late signs of hypovolemic shock would included worsening
changes in the LOC , coma, marked tachycardia. We as nurses needs to be vigilant of presenting
symptoms, because vitals signs sometimes do not change until 30% of the circulating blood
volume is lost (Kelly , 2005). Some healthful clinical finding that would help confirm
hypovolemic shock is return of urine output after fluid therapy. The reason behind this is because
if the body is not profusing due to hemorrhage, they are going to shunt the blood to the vital
organs. Kidney is not a vital organ so urine function will shut down thus cause decrease of urine
output.
Since CC had a traumatic injuries with various lines he is at risk for infection and sepsis. Some
clinical findings that would suggest sepsis is elevated temperature, heart rate, respiration rate and
WBC level. Monitoring his vital signs and clinical symptoms is very important to avoid
progression of sepsis to septic shock. The link between sepsis and MODS is that MODS is the
end result of septic shock if left untreated. MODS is characterized by two or more organ failure,
due to bodys inability to maintain a homeostatic environment. This is the reason why constant
monitoring of patient status is very important in patient with sepsis (Copstead & Banasik, 2014)

Kelley, D. M. (2005). Hypovolemic Shock. Critical Care Nursing Quarterly,28, 1, 2-19.

Copstead-Kirkhorn, L., Banasik, J.L.(2014). Pathophysiology, 5th Edition.

Complete your week 3 required discussion prompts. You must complete:

Discussion Prompt 1

If a leader uses a different style of leadership with each of his followers, how
might that lead to perceptions of favoritism? What could a leader do to avoid
such impressions while still being adaptable to follower needs?
Everyone has their own perceptions and ways of thinking. Because of the
way they are treated vs how others are treated they might they that the
leader is favoring the other person. In reality, the leader is just trying to be
flexible and adapt to needs of different individuals. An example that was
provided by Northouse, if your followers are very low in competences,
situational leadership prescribes a directing style for you as a leader. On
contrast if your follower appears to be competent but lack of confidence, the
situational approach suggests that you lead with a supporting style.
In order to come off as not favoring another party, the leader must be a good
communicator and listener. He/she must be fair with the response that is
provided to the team. The leader should also assessed the needs of its
followers and based off his response based on their personality and their
needs.
Northouse, P. G. (2015). Leadership: Theory and practice (7 th ed.). Thousand Oaks, CA:
Sage Publications

Discussion Prompt 2

In weeks 17, you will be working toward developing a Leadership Portfolio

by completing a leadership questionnaire each week, and then reflecting on
the results. Click here to complete the Path-Goal Questionnaire. Fill out the
leadership form, score your results, and attach it to your discussion post.
Then, respond to the following: What area did you score highest on in the
Path-Goal Questionnaire? Why do you think that is? What area did you score
lowest on? How can you improve your weakest area?

The Pal- goal theory is about how leaders motivates follower to accomplish designated
goal(Northouse, 2015). I scored in the high range for directive , participative, and achievement
oriented leadership style. I scored the lowest in supportive style. I think I scored high in those
area of leadership style because I am a very goal oriented person with a clear timeline and
instruction in my mind. I always asked myself and others to achieved the highest quality of work
as possible. But at the same time I was able to involved the team in the decision making process.
To be an effective leader I think those are very good traits to have, but I would like to work on
more of supportive leadership. Supportive leadership is defined as a leader who is friendly and
approachable. This is very important because if your followers are not able to expressed their
concerns and needs, it will affect the quality of work. I have been told that sometimes I just look
really mean, but in reality I am not how I look. Some of the ways I can improve on this area, is
trying to be more approachable, friendly, and present less serious face.
Northouse, P. G. (2015). Leadership: Theory and practice (7 th ed.). Thousand Oaks, CA:
Sage Publications