Answers Lab07 Microcirculation

Answers Lab07 Microcirculation
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NAME ____________________________________
EXERCISE
LAB TIME/DATE _______________________
Frog Cardiovascular
Physiology
Special Electrical Properties of Cardiac Muscle:
Automaticity and Rhythmicity
1. Define the following terms. automaticity: Ability to depolarize spontaneously in the absence of
external stimulation. rhythmicity: Depolarization/repolarization events occur in a regular and
continuous manner.
2. Discuss the anatomical differences between frog and human hearts. The frog heart has a single
ventricle and two atria.
Dorsally there is an expanded area called the sinus venosus. The human heart has two atria and two
ventricles. No sinus venosus ... Show more content on Helpwriting.net ...
Define partial heart block, and describe how it was recognized in the laboratory. When the 1:1 ratio
of atrial to ventricular contractions was replaced by different whole number ratios, e.g. 2:1, 3:1, the
heart was in partial heart block.
13. Define total heart block, and describe how it was recognized in the laboratory. No synchrony
between depolarization waves of atria and ventricle. Impulses not being transmitted from atria to the

ventricle; no whole number relationship between atrial and ventricular contractions was
demonstrated.
14. What do your heart block experiment results indicate about the spread of impulses from the atria
to the ventricles?
In normal heart activity, the ventricles are depolarized by the depolarization wave spreading from
the atria.
Observing the Microcirculation Under Various Conditions
15. In what way are the red blood cells of the frog different from those of the human? Frog RBCs
are nucleated; human RBCs are anucleate. On the basis of this one factor, would you expect their
life spans to be longer or shorter? Longer
16. The following statements refer to your observation of one or more of the vessel types observed
in the microcirculation in the frog's web. Characterize each statement by choosing one or more
responses from the key.
Key: a.
arteriole
b.
venule
c.
capillary
c
1.
smallest vessels observed
a
2.
vessel in which blood flow is rapid, pulsating
c
3.
vessel in which
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Case Studies on Cardiac Function
Case 1
A.O. is an 89–year–old woman with a long history of systolic heart failure secondary to a large left
ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance
with activities of daily living. Even minimal activity was associated with moderately severe dyspnea
and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema
bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin.
Discussion Questions
1. Which type of heart failure (left or right sided) is usually associated with dyspnea?
Left–sided
What other clinical findings are likely to be present with ... Show more content on Helpwriting.net
...
ST depression and T–wave changes may also indicate the development of a non Q–wave MI.
An old MI is evidenced by larger than normal Q waves.
2. What changes in "cardiac enzymes" would be consistent with a diagnosis of MI?
TROPONINS – Markers of choice. Elevated between 4 and 6 hours after the onset of an acute MI
and remains elevated for 8–12 days.
MYOGLOBIN – Levels rise between 1 to 4 hours after the onset of chest pain. Highly sensitive.
CREATINE KINASE – comprises of three isoenzymes. 1. Creatine kinase with muscle subunits
(CK–MM), which is found mainly in skeletal muscle. 2. Creatine kinase with brain subunits (CK–
BB), predominantly found in the brain. 3. Myocardial muscle creatine kinase (CK–MB), found
mainly in the heart.
*CK–MB levels increase within 3 to 12 hours of onset of chest pain.
*Reach peak within 24 hours, and return to baseline after 48 to 72 hours.

*Levels peak earlier if perfusion occurs.
*Sensitivity is approximately 95%, with very high specificity.
3. What is the most common pathophysiologic precipitating event for ACS? What differentiates
USA from MI?
MI plaque rupture followed by thrombus formation at the site as the precipitating event.
4. What is the rationale for using thrombolytics in the management of STEMI?
It binds to the fibrin of fresh clots and the resulting compound converts adjacent plasminogen into

A Case Study In Polypharmacy
A Case Study in Polypharmacy
The case study of Mrs. A has numerous factors that constituted in her health problems and
manifestations. In her symptomatic scenario, the patient has been presenting some indications
comprising of irritability, ostensible obsessive–compulsive behavior, confusion, and fatigue. The
patient's daughter is anxious about her mother's ability to stay independent and wishes to pursue
nursing home admission arrangements and the fear that her mother might progress to dementia
illness. On the other hand, based on her prescribed medications, several conclusions can be
observed.
Congestive cardiac failure (CCF) is a clinical syndrome where the heart is no longer able to
maintain adequate blood circulation to the tissue; and the indications are dyspnea, fatigue, and
physical weakness (Barremo, Bruce, Salander & Sundin, 2008). Osteoarthritis is the greatest
communal form of the degenerative joint disease and the prominent cause of disability in people
over 50 years of age and ... Show more content on Helpwriting.net ...
The vital nursing implementation and considerations are to assess the baseline data, such as the
heart rate and rhythm, blood pressure, and electrolytes prior to administering the initial dose. The
dosage is regulated by the patient's clinical situation and can monitor by means of serum levels of
cardiac glycoside, calcium, potassium, magnesium, and through ECG. Digoxin has been a suitable
aide treatment to improve signs and symptoms of heart failure, the under dosage of digoxin will
cause a continuation of heart failure symptoms, while overdosage may result in toxicity; in cases of
severe digitalis toxicity, digoxin immune Fab can be given intravenously to patients (Faye Felicilda–
Reynaldo,

A Summary Of Heart Failure
When the heart begins to fail, mechanisms are activated to compensate for the impaired function
and maintain the cardiac output. The primary compensatory mechanisms are Frank –Starling
mechanism, neuroendocrine responses including activation of the sympathetic nervous system and
the renin– angiotensin–aldosterone system, and ventricular hypertrophy. Decreased cardiac output
initially stimulates aortic baroreceptors, which in turn stimulate the SNS. SNS stimulation produces
both cardiac and vascular responses through the release of norepinephrine. Norepinephrine increases
heart rate and contractility by stimulating cardiac beta– receptors. Cardiac output improves as both
heart rate and stroke volume increase. Norepinephrine also causes arterial ... Show more content on
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Chest pain (angina) is an indicator of a heart attack (myocardial infarction). A heart attack can cause
sudden death. My patient has congestive heart failure. He has pleural effusion on his lung also
called "water on the lung," which is an excessive buildup of fluid between your lungs and chest
cavity. He also has edema in both legs and feet. The client has shortness of breath while lying and
has to sleep with three pillows at night due to his CHF. The pleural effusion on the lungs causes a
crackle sound in all four of his lobes. During the stay at the hospital my patient received oxygen
treatments once per day. He may possibly get a thoracocentesis or pleural tap in the future. My
patient was on an IV drip, Bumetanide, which inhibits reabsorption of chloride and sodium. This
medication is used to treat his CHF and edema along with another medication

Vincent Van Gogh: A Brief Biography
Vincent Van Gogh lived out these words as he created masterpieces by painting how he perceived
the world. Van Gogh had an eccentric personality, however, continuously suffered from unstable
moods and recurrent psychotic episodes caused by Temporal Lobe Epilepsy and Bipolar Disorder.
Despite his suicide in the end, these illnesses correlate with his inability to form stable relationships
while also enhancing his artwork. Vincent was born on March 30 in Zundert, Netherlands to Anne
Cornelia Carbonates and Reverend Theodours Van Gogh. Growing up in a very religious and
cultural atmosphere with five siblings, Van Gogh was often the quiet child with few artistic qualities
in his earliest years. To help Van Gogh connect with his cultural and religious side, his parents sent
him to boarding school in Zevenbergen and later to another in Tilburg. It was discovered while
Vincent was growing up that he was a very passionate artist, but often doubted himself. This led to
two unsuccessful relationships, after which, he decided to remain in Belgium to study art, with the
determination to give happiness to others by creating beauty. In 1870, at the age of sixteen he was
sent to work for The Hague gallery ran by a French art branch of Goupil & Co. after finishing years
of academics. Following his array of work with the branch, Vincent resettled in London to continue
promoting Goupil & Co. In London, Van Gogh began focusing intensely on his religion, while also
undergoing a negative

Creative Project: Inspired To Paint Analysis
Creative Project: Inspired to Paint When I began my project, I envisioned myself using oil paint on
canvas. I've always admired oil paintings, when the paint is thickly applied and layered. I researched
my artists and learned about their techniques. It seemed easy enough, and I felt confident to give it a
try. Unfortunately, things did not work out like I planned, and I found that I have a lot to learn. Van
Gogh layered his paint with short thin brush strokes using different colors in Starry Night. I learned
that the colors must set before you can layer them, so the colors do not smudge together. Also,
during my research I found out that Monet would only paint for one hour at a time, and now I
understand why. I found myself getting frustrated

Clinical Trials And Observational Studies
The efficacy of ACE–I has been widely evaluated in clinical trials and observational studies. In
1983, Captopril multicenter research group investigated the efficacy of Captopril in a 92 cohort with
heart failure refractory to digitalis and diuretic therapy. In this randomized, double blind trial, 50
patients were assigned to Captopril and 42 were assigned to placebo group. Over 2–week dosage
titration and 10–week evaluation period, the Captopril group revealed improvement in exercise
tolerance and specific symptoms of heart failure, including dyspnea, fatigue and orthopnea, and the
reduction of edema. Captopril therapy were concluded as an effect adjunctive treatment to digitalis
and diuretic drugs for patients with refractory heart failure. (14) Later on, other ACE–I, such as
Enalapril, were shown to be effective in treating patients with congestive heart failure, by reducing
left ventricular dimension, in randomized clinical studies.(15–17) The Heart Outcomes Prevention
Evaluation Study Investigators conducted a factorial study to evaluate the ACE–I, Ramipril, for
improving outcomes among patients with high risk for cardiovascular events, but without left
ventricular dysfunction or heart failure. Ramipril significantly reduced the rates of death,
myocardial infarction, and stroke in a broad range of high–risk patients who are not known to have
heart failure. (18) Cattran et al. performed a registry study in Toronto Glomerulonephritis in patients
with severe immunoglobulin

Who Is Vincent Van Gogh's Wheatfield With Crows?
Van Gogh's Wheatfield with Crows: Scholarly Article Analysis
The Impressionist and Post–Impressionist eras have produced many great painters that are still
relevant to this day. Among these painters is Vincent Van Gogh, who created hundreds of paintings
in a span of a short ten–year career. The three articles by Friedman, Schapiro and Bhattacharyya all
analyze Van Gogh's Wheatfield with Crows based on the artist's physical and mental state, but differ
in their approaches (Fig. 1). The painting Wheatfield with Crows is a great example of the style that
Vincent Van Gogh is knows for. The short, seemingly carefree brush strokes form the sky, the field
and the three roads. The black crows add movement to the scene and provide ground for future
disagreements among scholars. The colors in the painting are very vibrant, with a strong contrast
between the dark stormy sky and bright yellow fields. ... Show more content on Helpwriting.net ...
Some even think that it was Van Gogh's last painting. Such claim, if true, tremendously elevates the
importance of the painting. It would no longer be looked at as "one of Van Gogh paintings" but as a
painting that could provide insight into what Van Gogh felt in the last days before his suicide.
Though it most definitely would be an important finding, it would also cause the painting to be
analyzed only through the lens of Van Gogh's physical and mental state. Such constrictions
significantly limit the analysis. Therefore it is better to look at Wheatfield with Crows as "one of
Van Gogh's last

Case Study
This is the first case study that is required for the class. Please submit a paper (doesn't have to be
long; you could even give me bullet–point answers to the questions listed below) that answers all of
the questions posed after Case Study 1. I have included an easy second case study which, if you
complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and
responding to Case Study 1 is required work for the course. The extra credit, which is not required,
will be worth a total of 10 points. Please check the syllabus for the due date.
Case 1
A.O. is an 89–year–old woman with a long history of systolic heart failure secondary to a large left
ventricular ... Show more content on Helpwriting.net ...
Tropopins elevated between 4–6 hours after the onset of an acute MI and remains elevated for 8 to
12 days. Myoglobin levels rise within 1–4 hours after the onset of chest pain. Creatine kinase –MB
increase within 3 to 12 hours of onset chest pain, reach peak within 24 hours and return to baseline
after 48 to 72 hours. 3. What is the most common pathophysiologic precipitating event for ACS?
What differentiates USA from MI?
Unstable angina. Unstable angina is a warning sign that a heart attack may happen soon and MI is a
heart attack. 4. What is the rationale for using thrombolytics in the management of STEMI?
To try an break up the clot before it can cause a massive heart attack possibly leading to death. 5.
Why are morphine and nitroglycerin used to manage ischemic chest pain?
Morphine reduces anxiety and catecholamine secretion and is a preload reducer. Nitroglycerine
causes relaxation of vascular smooth muscle, which decreases preload and reduces

Review Sheet Exercise 6 Cardiovascular Physiology Essay
REVIEW SHEET
EXERCISE 6
Cardiovascular Physiology
NAME:
LAB TIME/DATE:
1. Define each of the following terms:
autorhymicity– The heart is autorhythmic. This means it generates its own rhythmic action potential
independent of the nervous system.
sinoatrial node– is the impulse–generating (pacemaker) tissue located in the right atrium of the
heart, and thus the generator of normal sinus rhythm.
pacemaker cells– are specialized cells that cause involuntary muscles and tissues to contract or
dilate.
vagus nerves– carry a wide assortment of signals to and from the brain, and they are responsible for
a number of instinctive responses in the body.
2. The sympathetic nervous system releases the neurotransmitter– ... Show more content on
Helpwriting.net ...
This allows your cardiovascular centres in your brain a little bit more latitude as far as controlling
your heart rate. If you were to remove a beating heart from someone's body you would find that the
heart is no longer being suppressed by the parasympathetic nervous system and it will accelerate to
the same pace as the sinoatrial node. The SA node generates action potentials approximately 100
times per minute due to the physiology of the heart, its own permeability to sodium and calcium via
its channels, and a host of other things. Anywhere between 80 to 100 beats per minute is normal for
the SA node.
7. What are two key differences between cardiac muscle and skeletal muscle?
cardiac is involuntary, skeletal is voluntary cardiac is unstriated, skeletal is striated
8. What is the difference between the effective refractory period and the relative refractory period?
The effective refractory period is the time in which the cell is incapable of responding to a second
stimulus between the phases of 0–3.5, while the relative refractory period is the time in which the
cell is making preparations to receive stimulus between phase 3.5–4.

9. When the heart is externally stimulated just after the start of the contraction cycle, why does this
have no affect on heart rate?
This is because once a contraction has started, the action potential has already fired, stimularing the
muscle fibers. Once they

Cardiac Overloads
Abstract
Cardiac output is the amount of blood the heart pumps in 1 minute and depends on heart rate,
contractility, preload, and afterload. Understanding the supply and the practical relevance of each of
these four components is important in interpreting the values of cardiac output.
Afterload is the intraventricular pressure sufficient to open the aortic valve allowing ejection of the
ventricular contents, Or the load against which the ventricle contracts or otherwise stress the wall
during ventricular ejection.
On the right side, it is expressed as Pulmonary Vascular Resistance (PVR) and on the left side as
Peripheral Vascular Resistance (SVR). The greater the afterload, the lower the cardiac output, the
greater the pressure of the right atrium.
The higher the aortic pressure, the higher the LV afterload. It is usually measured at the end of
systole. The most common influence on afterload is vascular tone or resistance to blood flow. In
addition, other factors, such as valve stenosis or blood viscosity, can affect the afterload. Vascular
resistance is controlled and manipulated with drugs to increase or decrease afterload.1–2
When considering post–load equivalent to systolic stress, an interrelation and interdependence
between preload and afterload are revealed.
The increase in afterload ... Show more content on Helpwriting.net ...
Diuretics and digitalis constitute conventional therapy for congestive heart failure, but systemic
vasodilators offer an innovative approach in acute and chronic heart failure by decreasing the
increase in systolic wall ventricular stress by reducing aortic and/or impedance reduces cardiac
venous return. As a result, vasodilators increase cardiac output (CO) by decreasing peripheral
vascular resistance (PVR) and/or decrease left ventricular end–diastolic pressure (LVEDP) by
decreasing venous

Fast Or Abnormal Heart Disease: Tachycardia
Tachycardia may be defined as the increased heart rate than normal. Fast or abnormal heart rate may
be caused due to several reasons. For example increased blood pressure, heart disease (like
atherosclerosis, cardiomyopathy, valve disease) and some drugs (i.e. caffeine, alcohol) can increase
blood pressure. Tachycardia may cause no symptoms or complications for some cases but it can
disrupt cardiac function, increase the risk of stroke or heart attack1.
Treatment options:
Primary target of the treatment is to control the heart rate or remove the disease contributing factor.
Digitalis alkaloids, β–blockers (i.e. propranolol, atenolol, metoprolol etc.), calcium channel blockers
(i.e. amlodipine, nifedipine etc.) or amiodarone could be used to

Heart Disease: Peripartum Cardiomyopathy
Peripartum Cardiomyopathy
A lot of people in this world are unknown to the heart disease called peripartum cardiomyopathy.
This heart disease is a uncommon heart disease. It's a heart failure that happens in some women in
the last month of their pregnancy. With this heart disease the heart cannot pump enough blood to the
body's vital organs. Which then causes organ failure if not caught. PPCM is still being studied
doctors still don't know what exactly triggers the heart failure. They say it may be from
autoimmunity, immune system micronutrient. In the beginning phase of PPCM it causes
inflammation in the heart. The heart muscle cells start to become damaged. After the heart muscle is
damaged scar tissue begins to form. Which makes it hard ... Show more content on Helpwriting.net
...
There are several medications that the doctor can prescribe to you for PPCM. It depends on how
sever the condition is. A heart can still live for a long time with damage. If it is beyond damaged
patient will be put on heart transplant list. In some cases, doctors may implant a heart balloon heart
pump. The medication taken are beta blockers, digitalis, and diuretics. Low salt diet may be needed
to manage blood pressure. Beta blockers are used to cause the heart to beat more slowly to help the
heart to recover in time. The beta blockers may cause dizziness, weakness, fatigue, dry mouth,
headache, diarrhea, and constipation in some cases. Digitalis side effects are nausea, vomiting,
feeling weak, headache, anxiety, and mild skin rash. Diuretics most common effects are too little
potassium in the blood, low sodium level, headache, thirst, increased blood sugar, and muscle

Heart Failure Research Paper
The following research paper details the medical and surgical treatment and nursing care of patients
with heart failure and includes information specific to left–sided heart failure.
Description of the Condition
Heart failure is a complex clinical syndrome in which the heart is unable to pump sufficient amounts
of blood to meet the body's metabolic demands. Specifically, the left side of the heart receives
oxygen rich blood from the pulmonary veins and is responsible for systemic oxygenation by
pumping this blood through the aorta to the rest of body. The left ventricle provides most of the
heart's pumping power; it has a thick muscular wall . When the left ventricle weakens and becomes
inefficient in its ability to.... the left side ... Show more content on Helpwriting.net ...
Digitalis and inotropic medications increase the force and contractility of the heart making each beat
more efficient. Vasodilators, ACE inhibitors, ARBs, and calcium channel blockers all work using
different methods to lower blood pressure and vascular resistance easing the overall work load on
the heart. Please refer to Table 1 for a comprehensive list of common medications used for treatment
of LSHF.
The most important nursing intervention with any medication is monitoring vital signs and trends
especially blood pressure, pulse, and condition before administering cardiac medications such as
ACE inhibitors, ARBs, digoxin, and beta blockers. These medications often come with set
parameters set by the physician and is specific to the patient. It is also critical that the nurse evaluate
how well the patient is tolerating the current medication regime and to never withhold a medication
without the physician's input with justification (Ackley & Ladwig, 2014).
Complications and

The Death Of Heart Failure
Based on Goodman and Fuller (2015), it was estimated that the annual population in the United
States with (CHF) congestive heart failure is about five hundred fifty thousand, and approximately
five million male and female elderly individual (65 years old and above) is the leading cause of
hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death
rate and fifteen percent survival rate of patients diagnosed with CHF (Bocchi, Vilas–Boas, Perrone,
Caamaño, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al.,
2005).
CHF renders the heart to become inefficient pump. As a result, the patients develop a decline with
blood pressure, reduced cardiac output and blood ... Show more content on Helpwriting.net ...
Furthermore, digitalis is also beneficial for patients with atrial fibrillation and with systolic CHF, it
promotes to function the left ventricle and controls the heart rate with low ejection fraction (
Caccamo & Eckman, 2011; Katzung, 2012).
Pharmacodynamics/ mechanism of action of DG Digoxin and numerous substance of digoxin are
the only active metabolite in a small fraction that occurs in the stomach, liver, as well as their
metabolic passageway has been recognize (Gault, Longerich, Dawe, M., & Fine, 1994). DG and
other glycosides drugs for the heart help to elevate an involuntary action by producing more
intracellular calcium absorption (Ciccone, 2016).
The intensity and immediate contraction of the myocardium are high due to the result of the
inhibiting activity of the sodium and potassium ions opposite to the myocardial nucleic cells by the
intricacy with the (ATP) adenosine triphosphate; the improvement of the calcium flow and increase
elimination of the free ionic calcium inside the cells of the myocardium thus, automatically
heightened the contractility of myocardial function (Drugs.com., n.d.) . There is a reduced amount
of conductivity and higher effectivity of the temporary response to the time period of the (AV)
atriventricular node which is significant to the secondary response from the conduction of the
parasympathetic strength and probably from a decline in sympathetic strength (Goldsmith, Simon &
Miller, 1992;

Fusion Constipation Research Paper
Introduction This is a review of Fusion Health Constipation tablets, which are presented by the
manufacturer as a vegetarian/vegan combination of Chinese herbs which have been used for
thousands of years to relieve the unpleasant symptoms of constipation and stimulate healthy bowel
function. Read on to discover more about this laxative to decide if this is a product that will work
for you. Ingredients Rheum officinale (Rhubarb root) 7.5mg Trichosanthes kirilowii seed (Chinese
cucumber) 500mg Rehmannia glutinosa (Foxglove root, otherwise known as Digitalis) 500mg
Citrus aurantium (Bitter Orange root) 400mg Angelica polymorpha (Dong Quai fruit) 400mg
Glycyrrhiza uralensis (Licorice root) 250mg Dosage Recommended, adult dosage is one to two
tablets, one to two times daily, following meals and water. An additional dose may be ingested to
accelerate a bowel movement and as directed by your physician. It is not recommended for children
younger than 12 years of age. ... Show more content on Helpwriting.net ...
If you are experiencing gastrointestinal upset or abdominal pain, vomiting or diarrhea do not use
this medication and contact your physician as these symptoms may be indicative of a serious
problem. Also, continued use may cause serious complications and bowel

Heart Failure Research Paper
Victor Hulsey
Course Professor: Jason Valdez
EMSP 2544: Cardiology
03 August 2014
Treatment of Heart Failure
Abstract: With the numerous discoveries and advances in pharmaceuticals and mechanical
implantation devices, heart failure continues to be the leading cause of hospitalization in patients
over the age of 65 in the United States and other developed countries. Advances in science and
modern medicine have pushed heart failure to the forefront of an emerging crisis in developed
countries around the world. The increase in heart failure cases appears to be directly related to the
increasing average age within these countries. Richard E. Klabunde's PhD, research estimates that
there are "more than 15 million new cases of heart failure each ... Show more content on
Helpwriting.net ...
With the advancement microchip technology, many of modern day treatments are including cardiac
assist devices to supplement the pharmacological treatments. Although these treatments can be more
invasive and the overall prognosis remains poor, these treatments have been shown to increase ones
expected life span an average of ~8.5 years.
Despite many new advances in patient care, drug therapy and cardiac assist devices, the prognosis
for chronic heart failure remains very poor. One year mortality figures are 50–60% for patients
diagnosed with severe heart failure, 15–30% in mild to moderate failure, and about 10% in mild or
asymptomatic failure. With gene therapies, and cell implantation/regeneration just on the horizon,
the prognosis for heart failure patients is much more promising than just 20 years ago.
Researchers at the Cardiovascular Research Center at Icahn School of Medicine have successfully
tested a powerful gene therapy known as "SUMO–1" that is delivered directly into the myocardium
to reverse heart failure in large animal models. Although this treatment has yet to be proven in
human clinical trials, it may be one of the first treatments that can actually shrink hypertrophied
myocardium tissue; thereby significantly improving the damaged heart's life–sustaining function.

Blood Of Plasma And Formed Elements
Conclusion:–
Blood consists of plasma and formed elements. Erythrocytes transport mainly oxygen to all body
tissues. Leukocytes protect the body against pathogens by direct attack or by forming antibodies.
Platelets play an important role in blood clot formation. The heart is divided into four chambers. It
acts as a double pump system. The pulmonary circuit, which provides for gas exchange, is served by
the right atrium and right ventricle of the heart. The systematic circuit, which supplies blood to all
body tissues, is served by the left atrium and left ventricle of the heart. For each heartbeat, the P
wave indicates the atrial depolarization, the QRS complex reflects the ventricular depolarization,
and the T wave reflects the ... Show more content on Helpwriting.net ...
Discussion:–
Lab 4: blood consists of two major components: plasma, which is 90% water and nonliving fluid
matrix, and formed elements, which are living cells suspended in the plasma. Erythrocytes,
Leukocytes, and platelets are the three types of the formed elements. Erythrocytes, or red blood
cells, contains hemoglobin molecules and plays an important role in oxygen (and small amount of
carbon dioxide) transportation. Leukocytes, or white blood cells, helps defending the body and are
part of the immune system; there are five types of Leukocytes: neutrophils, eosinophils, basophils,
lymphocytes, and monocytes. Each type has a unique function in defending the body against any
pathogens. Neutrophils are the most abundant, monocytes are the largest, lymphocytes are the
smallest, and basophils are the least abundant leukocytes. Platelets play an important role in blood
clot formation. The heart consists of four chambers: right atrium, right ventricle, left atrium, and left
ventricle. The heart acts as a double pump. The pulmonary circuit is served by the right atrium and
ventricle, they pump the deoxygenated blood, coming from all body tissues through the superior
vena cava and inferior vena cava, to the lungs to unload carbon dioxide and upload oxygen, and
then enter the left atrium of the heart. The main function of the pulmonary circulation is to allow for
gas exchange. The systematic circulation carries the oxygenated blood from the left side of the heart
and pump

Cor Pulmonale: A Case Study
"Cor pulmonale is defined as an alteration in the structure and function of the right ventricle caused
by a primary disorder of the respiratory system" (Sovari, 2014). Right–sided heart failure usually
occurs when pulmonary arterial pressure equals systemic blood pressure; pulmonary hypertension
that contributes to the enlargement (hypertrophy, dilation, or both) of the right ventricle (McCance,
2010).
It is estimated that in the US alone, cor pulmonale accounts for 6–7% of all types of adult heart
disease in addition to 10–30% of decompensated heart failure–related admissions. The incidence of
cor pulmonale varies globally depending on the prevalence of risk factors for various lung diseases
including but not limited to cigarette smoking ... Show more content on Helpwriting.net ...
On percussion, hyperresonance of the lungs may be a sign of underlying COPD; ascites can be seen
in severe disease. Examination of the lower extremities reveals evidence of pitting edema which is
strongly associated with hypercapnia. Complications of cor pulmonale include syncope, hypoxia,
pedal edema, passive hepatic congestion, and death (Sovari, 2014) (McCance, 2010).
Diagnosis
Diagnosis of cor pulmonale starts with a generalized approach consisting of routine laboratory tests,
chest radiography, and electrocardiography. While high–resolution echocardiography and magnetic
resonance imaging are accurate methods to measure pulmonary pressure; right heart catheterization
is considered the most precise albeit invasive method for diagnosis (Sovari, 2014).
The following modalities are also used as needed:
Pulmonary function tests
Ventilation/perfusion (V/Q)

Cardiac Physiology
Module 5 CARDIAC PHYSIOLOGY Case No. 1 Melvin Rodriguez was admitted at the intensive
care unit. On the first hospital day, he developed hypotension, BP of 70/40, cardiac rate of 100 beats
per minute, rales all over lung fields, respiratory rate of 24 breaths per minute. Pertinent physical
examination showed patient was dyspneic, distented neck vein. Patient was on left ventricular
failure with pulmonary congestion. Questions 1. What is the Frank starling law of the heart? The
Frank–Starling law of the heart (also known as Starling's law or the Frank–Starling mechanism or
Maestrini heart's law) states that the stroke volume of the heart increases in response to an increase
in the volume of blood filling the heart (the end ... Show more content on Helpwriting.net ...
Digoxin enhances myocardial inotropism and automaticity but slows impulse propagation through
the conduction tissues. Digitalis reciprocally facilitates calcium entry into the myocardial cell by
blocking the Na K adenosine triphosphatase pump. This calcium influx may account for its positive
inotropic action because this inotropic response is not catecholamine– or beta receptor– dependent
and is therefore effective in patients taking beta–blocking drugs. Digitalis was expected to increase
contractility and return the Frank–Starling relationship toward that seen in a normal ventricle. 5.
Why was he sent home on a low sodium diet? Sodium is usually limited to prevent fluid
accumulation. A low sodium diet was recommended to reduce extracellular fluid volume and blood
volume, and to prevent subsequent episodes of pulmonary edema. Case No. 3 Theresa Camantiles
was a 38 year old home maker and mother of 4 children. Keeping house and driving the children to
activities kept her busy. To stay in the shape, she took aerobics classes at the local community
center. The first sign that Theresa was ill was vague; she fatigued easily. However, within 6 months,
Theresa was short of breath, both at rest and when she exercised, and she had swelling in her legs
and feet. She then sought medical consult. On physical examination, she had distended jugular vein,
liver was enlarged and had ascites in her peritoneal cavity and edema in her legs. A fourth

Coronary Heart Failure Research Paper
"His heart is over flooded...." used to be the term for fluid overload or congestion associated to
ailment of the heart. It is one of the phrases with which congestive coronary heart failure (CHF) was
described in the Ebers papyrus written in 1550 BC, at some point of the reign of Amenhotep III,
Pharaoh of the Eighteenth Dynasty, according to Saba et al.6 In a assessment of coronary heart
failure (HF) by means of Katz,7 he describes the Hippocratic Corpus, which describes rales already
in the 4th century BC. Then Katz takes us through the history of HF with the aid of Galen who lived
in the Roman Empire, who noticed the coronary heart distributing warmness in an ebb and flow.
This was believed till 1628 when William Harvey described the circulation in animals as, "pulsatile
movement", and created the groundwork for understanding the circulation. The use of Foxglove
(Digitalis purpurea) was once described via William Withering, an English physician and botanist.
He had discovered from a country woman that tea made from leaves of the foxglove used to be top
for dropsy. ... Show more content on Helpwriting.net ...
In the 1980s and early 1990s, it was once verified that angiotensin –converting–enzyme inhibitor
(ACEi) have been associated with enchancment in the clinical effects for HF patients. Then
followed the introduction of the present day HF treatments; beta blocker, angiotensin receptor
blockade, mineralocorticoid receptor antagonist, Cardiac Resynchronisation Therapy (CRT), with or
without defibrillation therapy, left ventricular aid device and heart transplantation. Regarding the
diagnostic possibilities, echocardiography has emerged as an vital device to consider HF patients,
alongside with natriuretic peptides (NP). Despite this enchancment in HF medication, the mortality
charge is high. Can tailored HF remedy with the assist of biochemical measures such as NP lead to a
higher consequence for HF

Left-Sided Heart Failure Research Paper
Left–sided Heart Failure
Condition where the left side of the heart is unable to pump an adequate amount of blood to the
body, and can be life–threatening.
Pathophysiology
With left–sided heart failure a patient can suffer from fluid in the lungs, shortness of breath and
pulmonary edema, and fatigue. Since the heart can not pump the adequate amount of blood to the
rest of the body, there is a lack of oxygen in the body and this results in fatigue. Left–sided heart
failure causes an increase in pressure within the vessels in the lungs, which can lead to an
accumulation of fluid within the lungs, which leads to shortness of breath and pulmonary edema.
There is a wide variety of causes of left–sided heart failure with include consuming too much
alcohol, suffering from a heart attack, infections of the heart muscle, increased blood pressure,
hypothyroidism, narrow heart valves, and any disease that can cause damage to the heart muscle.
Left–sided heart failure in children is often caused by birth defects including abnormal ... Show
more content on Helpwriting.net ...
Treatments include changes in your lifestyle such as reducing sodium, avoiding alcohol, and
increasing exercise, taking medication for blood pressure, and possible surgery or carried
cauterization. Patients can also take medications such as beta–blockers, digitalis, diuretics, as well
as others. Beta–blockers can prevent death in some patients, digitalis slows the rhythm of the heart
while increasing the patients heart beat, and diuretics will reduce the amount of fluids retained in the
body. In certain cases pacemakers can be recommended or if medications are unsuccessful on their
own, a patient may receive a heart pump. As a worst case scenario, a patient may require a heart

Cor Pulmonale Research Paper
Cor pulmonale is a condition associated with diseases of the lung (e.g., COPD, fibrosis, etc.), where
either the altered structure or the malfunction of the right ventricle arises from pulmonary
hypertension. In COPD patients, hypoxic vasoconstriction results in increased pulmonary artery
pressure, which causes hypertrophy of the right ventricle and lowers cardiac output. Overall, cor
pulmonale is a chronic condition with a slow onset, despite acute presentations of the condition due
to a failure of the right heart to adapt to an increase in pulmonary arterial pressure due to a
pulmonary embolism. The clinical manifestations of cor pulmonale typically include dyspnea on
excretion, anorexia, exertional angina and syncope, and fatigue. Treatment ... Show more content on
Helpwriting.net ...
Digitalis also decreases the sympathetic response by lowering circulating norepinephrine, which is a
strong predictive of mortality in heart disease. Evaluating the effects of digitalis in patients with cor
pulmonale is difficult because the respiratory component of their disease primarily controls the
outcome. However, Digitalis has been found to be effective in specific subpopulations of cor

Congestive Heart Failure Research Paper
Abnormal heart rhythms, infections in the valves of the heart, and congenital heart disease are other
heart problems that can lead to congestive heart failure.
Some symptoms of heart failure are weight gain, swollen feet and ankles, fast or irregular pulse,
palpitations, fatigue, weakness, loss of appetite, faintness, nocturia, shortness of breath especially
during physical activities or while at rest, enlarged abdomen and liver.
To diagnose congestive heart failure, the healthcare provider will examine the patient for edema,
distended neck, crackles, difficulty with breathing or breathing that is fast, and abnormal heart
sounds.
An echocardiogram and numerous blood test may also be used to identify congestive heart failure.
Self– care and

Effect Of Exercise On Cardiovascular Dynamics
PhysioEx 9.1 Cardiovascular Dynamics Ex. 5 Activities 5 and 6 (3.5 points)
Activity
Question
Answer
#5. Studying the Effect of Blood Vessel Radius on Pump Activity
Explain the effect of increasing the right flow tube radius on the flow rate, resistance, and pump
rate.
Increasing the right flow tube radius increased the flow rate, decreased the resistance and increased
the pump rate.
Describe what the left and right beakers in the experiment correspond to in the human heart
The left beaker corresponded to the blood coming from the lungs, and the right beaker corresponded
to blood heading out to the rest of the body, or systemic circuit.
Briefly describe how the human heart could compensate for flow rate changes to maintain blood
pressure.
The human heart could compensate for flow rate changes to maintain blood pressure by altering
heart rate. When the heart rate increases, so does blood pressure. When the heart rate decreases, so
does blood pressure.
#6. Studying the Effect of Stroke Volume on Pump Activity
Describe the Frank–Starling law in the heart
The Frank–Starling law states that when all other factors remain the same, that the stroke volume
will increase in response to how much the muscle is stretched in the end diastolic volume.
Explain what happened to the pump rate when you increased the stroke volume. Why do you think
this occurred? How well did the results compare with your prediction?
When the stroke volume was increased, the pump rate decreased

Creativity And The Mad Genius
Creativity and the Mad Genius On July 2, 1961, Ernest Hemingway put a gun to his head. Seventy–
one years earlier, on July 29, 1890, Vincent van Gogh shot himself in the abdomen while painting a
wheat field. Robin Williams hung himself on August 24, 2014, less than two centuries after Vincent
van Gogh. Along with Ludwig von Beethoven, who died of natural causes in 1827, four of the
greatest creative minds each suffered from bipolar disorder, depression, or epilepsy, usually
suffering from other physical ailments as well. Ernest Hemingway was the only one to seem to have
a genetic disposition towards mental illness. None of these men led similar lives. Van Gogh only
saw one of his paintings sold, while Beethoven was an acclaimed composer by the age of twenty–
nine. Hemingway was friends with some of the greatest literary minds of the day, and Robin
Williams was one of the most successful comedians to date. The common link, besides their mental
illnesses, is the idea that each of these men were searching for something more within their
respective arts. Four fields of fine arts that require the constant creation of something new claimed
the lives of four men who gave it all they had, some losing, and some finding themselves along the
way. Over the past sixty years, facts about depression and the reality of it have come to light;
however, there are still negative stigmas concerning the mental illness and how people ought to
endure through the pain. Despite these negative

Vasodilator Therapy
The treatment options for NOMI are medical management and emergency surgery. If complications
such as secondary peritonitis and sepsis co–exist, the treatment plan should be tailored accordingly.
Other existing complications and incidental findings for treatment regarding Mr. S.'s case will be
covered in this section.
Medical Management. Most cases of CI are resolved without surgical intervention in the absence of
perforation or necrosis (Brandt et al., 2014, p. 36). Treatment starts with removing the possible
cause of vasoconstriction or treating hypotension. To improve mesenteric perfusion, infusion of
vasodilators such as papaverine may be beneficial (Tilsed et al., 2016, p. 262). Vasodilator therapy is
contraindicated if surgical intervention is indicated, which will be discussed below. Papaverine is
chosen over other vasodilator agents because studies found that it reduced mortality rates in the
setting of NOMI (Tilsed et al., 2016, p. 262). Drugs that may cause vasoconstriction or contradict
include digitalis, kayexalate, NO–Xplode, and nonsteroidal anti–inflammatory drugs (NSAIDs)
(Brandt et al., 2014, p. 25). A ... Show more content on Helpwriting.net ...
Patients with a new ostomy need psychosocial support regardless of their background or culture. It
is a change that affects an image. This patient needs education and ostomy care training by wound,
ostomy, and continence nurses' society (WOCN) certified nurse. Studies have shown that when
patients consult a WOCN–certified nurse, there is a reduction in complications and readmission
(Hendren et al., 2015, p. 381). A WOCN–certified nurse is consulted to educate Mr. S. Based on his
needs, home health care will be considered upon discharge. Mr. S. also needs a follow–up
appointment with a general surgeon for reversal operations evaluation. Regarding the timing of
ostomy reversal surgery, studies suggest it is safe to perform reversal surgery as early as three weeks
or later (Hendren et al., 2015, p.

Van Gogh Theory
Another theory about the life of Van Gogh was that he did not actually commit suicide but was
murdered. A biography of Van Gogh written in 2011 by Steven Naifeh and Gregory White Smith
claimed that Van Gogh was actually shot by a teenage boy named Rene Secretan. Apparently, Rene
and his brother would torment Van Gogh very frequently, ranging anywhere from putting salt in his
coffee to throwing snakes in his sandbox. On July 27th, while these two boys were out playing with
a faulty pistol, a shot went off and struck Van Gogh's abdomen. This writer believes that Van Gogh
claimed that the gun shot wound was self–inflicted because, in Van Gogh's mind, this young boy
was putting him out of his misery. Van Gogh was extremely depressed and felt as though he was a
financial burden to his brother, Theo, so by getting shot, and Van Gogh felt as though his absence
would make the world a better place. This theory is widely debated, but more people seem to agree
with the theory that Van Gogh ended his own life and was not in fact murdered. Some believe that
Vincent van Gogh did not actually cut off his own ear in an act of insanity. Two German historians
strongly believe that Van Gogh lost his ear during a sword fight with the famous artist that he had a
fall out with, Paul Gauguin.
Others have doubt about the theory that Van Gogh cut off his ear in response to a blowout with the
painter Paul Gauguin. According to a new theory, Van Gogh may have actually chopped off his ear
after

Verapamil Study
More than 100 years ago, Mackenzie noted the therapeutic effect of digitalis by slowing the heart
rate in atrial fibrillation patients (1). Digoxin was the cornerstone for atrial fibrillation until
verapamil was discovered in1967; which shown to be effective in slowing the ventricular rate in
atrial fibrillation by Bender and colleagues (2). Klein and colleagues wrote a letter to the editor, in
1980, to report his experience with verapamil–digoxin interaction to result in increased serum
digoxin concentrations (SCD) by 58% (3). The first randomized study was published in The Lancet
by Belz and colleagues in 1981. (12). Verapamil co–administration with digoxin resulted in average
of 77% increase in digoxin, which later the range was between (5)(12). In 1981, Pedersen showed
34% reduction in total digoxin clearance and 23% reduction in digoxin volume of distribution
induced by verapamil (6). Hedman et al. proved that digoxin biliary is the main inhibitory
mechanism for verapamil (25). Pedersen and colleagues found that ... Show more content on
Helpwriting.net ...
studied verapamil–digoxin interaction in cirrhotic patients. The study found 98% increase in the
AUC and Cmax of digoxin and 23% decrease in digoxin renal clearance. (21). Verapamil–digoxin
interaction in chronic hemodialysis patients was studied in 1990. Rendtorff and colleagues study
showed great inter–individual variation in the influence of verapamil on SDC in chronic
hemodialysis patients. (24). Two case reports of asystole, one third degree AV block and two deaths
for verapamil–digoxin interaction. (15–18). Gordon, et al. published a case series in, 1986,
suggested lower digoxin doses for elderly and avoiding their concomitant use with verapamil.
Finally, a case report in 2003 for Japanese male was found dead in his room. The cause of death was
documented as cardiac failure due to medications overdose. Kinoshita, et al. suggested that drug
toxicity was potentiated by verapamil–digoxin and metoprolol interactions.

Cardiac Dysrhythmias : Medical Careers
Eduardo Cardenas
Cardiac Dysrhythmias: Supraventricular Tachycardia
N254: Medical Surgical Nursing II
Mr. Decker
Medical Careers Institute
Date of Submission
1/7/2016
Cardiac Dysrhythmias: Supraventricular tachycardia
Supraventricular tachycardia is increase in heart rate over 150 bpm due to do the over firing or
redirected firing of the SA Node conduction above the ventricles. With supraventricular tachycardia
the patient can have an abrupt onset and termination of rhythm, flattened or retrograde conduction P
waves and narrow QRS waves specifically less than 0.08 second (Kyle, 2012).
Clinical Manifestations and Pathophysiology The clinical manifestations of supraventricular
tachycardia are palpitations, dizziness, ... Show more content on Helpwriting.net ...
The nurse should also palpate pulses, noting rate, regularity, amplitude, and symmetry. This is done
to differentiate in equality, rate, and regularity of pulses that are indicative of the effect of altered
cardiac output on systemic or peripheral circulation (Vera, 2013). Another nursing management is to
monitor vital signs. Assess adequacy of cardiac output and tissue perfusion, noting significant
variations in BP/pulse rate equality, respirations, changes in skin color, temperature, and level of
consciousness. The rationale although not all dysrhythmias are life–threatening, immediate
treatment may be required to terminate dysrhythmia in the presence of alterations in cardiac output
and tissue perfusion (Vera, 2013).
The nurse should also administer supplemental oxygen as indicated, Insert and maintain IV access,
reduce patient stimulation, tell the patient to splash cold water on their face, or to do a vagal
movement to help decrease heart rate (Kyle, 2012). Adenosine (Adenocard) is the drug of choice of
to treat supraventricular tachycardia if vagal maneuvers have not worked due to its short half–life
and minimal side effects. Other medications that can be used to suppress supraventricular
tachycardia can be

What Really Happened To Martin Pugh?
With Dennis on his right and Jenn on his left they managed to get Marty out of the restaurant. The
chauffeur guided him into the back seat and Jenn slid in next to him. Once the door was closed she
buckled him in. She didn't strap herself in. She would need every advantage once the drug took full
effect. A calm swept over her. It was done. The life of this vicious killer had finally come to an end,
and he was completely unaware. Whatever happened next was gravy as far as she was concerned.
The drive to her own apartment seemed endless, but knowing it was the last time she'd have to lay
eyes Martin Pugh made it that much sweeter. When the car halted outside her building, she gave an
inward sigh of relief. "I'd kiss you good night but I don't ... Show more content on Helpwriting.net
...
She had had to rent apartment and get a real job or Marty's suspicions would have been raised. The
one room studio she found on the edge of the University of Washington campus on Brooklyn
Avenue North East was the answer. It gave off the just the right desperate, broke, bookish vibe.
Campus was two blocks away. It was an easy walk to the bus, restaurants, or campus The perfect
cover was barista with modeling aspirations. Seattle was full of them. This time she was on her own.
Jenn couldn't use any of the safe houses or other resources Langley made available to their agents.
No back –up, and no extraction squad. She had to be on guard at all times and couldn't trust anyone.
Who would they send to track her? Would they find her and have a sharpshooter take her out? That
was the one scenario she couldn't prepare for. She would never see it coming. With any luck Bobby
Pugh and his personal army wouldn't locate her either, but the chances of her survival were slim to
none. No matter how she sliced it her days were numbered, and if they were going to take her down
she wasn't going down without a

Consuelma's Dilemma Case Study Summary
(A) Describe the problems Consuela and the client's family are having dealing with this situation
–Consuela is not communicating effectively with Allie.
–Consuela is not considering Allie's feelings about transitioning.
–The family and Allie are not collaborating effectively to facilitate care.
–The staff is not setting boundaries with the client.
–The relationship could be unhealthy, due to the client's current mental status.
(B) Discuss how it would be best to handle this, including the best outcome for the client. The best
outcome for the client is to focus on her own needs and not get deeply involved in a relationship.
The case manager should be providing support, appreciative responses, building trust, inviting
collaboration, and providing positive feedback for the client. The case manager can ask the client
what she thinks about leaving the home. If ultimately agreed upon, the case manager can provide
resources to complete a transfer. In addition, the case manager can implement a plan for intervention
that consists of family therapy. A case manager should be a reflective listener and try to their ...
Show more content on Helpwriting.net ...
There can definitely be an issue with this patient being seen by several physicians. In this case, I
would assume no one had the time to accurately collaborate on the best treatment for the client. The
new physician the patient is seeing probably is missing out on essential information about the
patient's health history and background. Gui's over–the–counter medications could be counteracting
with his heart medications. I would recommend Gui needs go to necessary follow–ups, so his
symptoms can be addressed and possible side effects can be monitored carefully. As a case manger,
I would only speak with the son on these issues after my client had signed a release and consented
to me discussing this information. I would refer the client to a health care provider and follow–up on
his regular

A Brief Note On Pharmacology And The Nursing Process
Digoxin
Oluchi Madubuike
University of Texas at Arlington
Pharmacology and the Nursing Process
N3365–001
Sandra Laird
April 1, 2015 OVERVIEW OF DIGOXIN
Origin
Digoxin is a drug gotten from the leaves of a digitalis plant ("Digitalis," 2015, para. 1). We
commonly refer to this plant as foxglove but we also use its botanical name, which is Digitalis
purpurea when discussing it ("Digitalis," 2015, para. 2). Foxglove is a popular flower that can be
found growing along the roadsides and in meadows or waterlogged areas usually in the western
region of the United States ("Digitalis," 2015, para. 2). Although this plant can now be found in
America, European immigrants originally brought Foxglove into the United States centuries ago
("Digitalis," 2015, para. 2). William Withering first described the therapeutic effect of this plant in
1785 ("Digitalis," 2015, para. 4).
Drug Class
Digoxin is grouped under a class of drugs known as cardiac glycosides (Lilley, Collins, & Snyder,
2014, p. 387). Cardiac Glycosides are a class of drugs known as cardiac drugs (Lilley, Collins, &
Snyder, 2014, p. 387). They are the oldest group of cardiac drugs that are recognized to have
beneficial effects on people with failing heart and help in controlling the heart's ventricular rate
(Lilley, Collins, & Snyder, 2014, p. 387). These drugs help make the heart beat stronger and with a
more regular rhythm. In previous years, cardiac glycosides (digoxin) were used as the first line
drugs for heart

Atrial Fibrillation: A Case Study
It's known that atrial fibrillation (AF) is the most common sustained cardiac arrhythmia representing
abnormal rapid and irregular ventricular rates with deterioration of atrial mechanical function
resulted by disorganized atrial electrical activity classified as acute, chronic, paroxysmal,
intermittent, constant, persistent, or permanent and when a patient has 2 or more episodes, AF is
considered recurrent(1). During the last decade, it accounted for approximately one third of hospital
admissions for cardiac arrhythmias with progressive increases in the worldwide prevalence and
incidence(1,2). It is more common in patients with cardiovascular problems such as hypertension,
valvular heart disease, congestive heart failure (CHF) or coronary ... Show more content on
Helpwriting.net ...
Rate control is the older therapeutic strategy but it is still a primary therapy for AF. Beta–blockers
and calcium channel blockers are both effective and well resistant therapies which can be used in a
wide range of acute and long–term clinical conditions, as well as both contribute in controlling
hypertension. It's investigated that oral beta–blockers are more favorable than calcium channel
blockers for patients with ischemic heart disease, CHF and depressed left ventricular function.
Digoxin is effective for controlling heart rate especially in sedentary elderly and concomitant CHF
patients due to its effectiveness in improving ventricular function. Other potential advantages of rate
control include less adverse drug effects and less hospitalization. However, it has some
disadvantages including risk of toxicity, chronotropic incompetence and difficulties in achieving
dose adjustments in patients with compromised renal function adding that it is not preferred in
younger patients and those with a history of

Animal Experimentation Essay
Every year, over a million animals are tested on across the world. Animal experimentation is one of
the most controversial issues. Animal testing is the use of non–human animals in research and
development projects, especially for purposes of determining the safety of substances such as foods
or drugs. Some people believe that animal testing is unnecessary and there are more efficient
alternatives. Others believe that animal testing is crucial to the development of new products and
cures. According to the Science of Toxicology, "Research involving laboratory animals is necessary
to ensure and enhance human and animal health and protection of the environment"(1). Animal
testing should be stopped because animals do not react the same way as ... Show more content on
Helpwriting.net ...
One example of this is Thalidomide. The National Center for Biotechnology (NCBI), Thalidomide
is one of the greatest cases in history of a drug disaster tragedy caused by animal research.
Thalidomide is a synthetic drug formerly used as a sedative and hypnotic but withdrawn from the
market when found to cause abnormalities in developing fetuses. It was was found to act as an
effective tranquilizer and painkiller. Thalidomide was tested on animals extensively prior to its
marketing and was deemed safe for human use. Thalidomide is responsible for over 10,000 human
birth deformities (1–2).
Animal testing potentially prevents useful drugs from reaching the market. Penicillin is poisonous to
Guinea Pigs (NPG 1). Penicillin is an antibiotic with powerful bactericidal action, used to treat
many types of infections, including pneumonia, gonorrhea, and infections caused by streptococci
and staphylococci. Penicillin causes fatal diarrhea and convulsions in guinea pigs (GuineaLynx 1). It
is attributed to the toxins absorbed from the intestines. Digitalis can kill dogs, but helps save
humans. Digitalis is the dried leaves of the Digitalis purpurea plant that is used in medicine as a
heart stimulant. It is therefore often prescribed for patients in atrial fibrillation (Lindberg 1).
Morphine is a stimulant for cats, goats, and horses but is a sedative for humans.
Alternatives to animal testing are often more accurate. Cell culture is the

Congestive Heart Failure Research Paper
Melissa Philippi
Health and Human Diseases
Congestive Heart Failure
Description Congestive Heart Failure or CHF means that your heart doesn't pump blood efficiently
enough for all your body's tissues and organs to work properly. This causes fluid retention and
swelling in the legs and ankles and also congestion in the lungs.
Etiology
Congestive Heart Failure (CHF) can develop quickly, but most of the time it develops slowly over
time. CHF develops as a result of other things that damage the heart. Common conditions are:
untreated high blood pressure, coronary artery disease, heart attack, cardiomyopathy (disease of the
heart muscle), myocarditis (inflammation of the heart muscle), endocarditis (infection of the inner
lining of the heart ... Show more content on Helpwriting.net ...
Nonsurgical treatment usually involves medications such as diuretics, ACE inhibitors, angiotensin II
receptor blockers (ARBs), nitrates, digitalis, potassium, aspirin, calcium channel blockers, blood
thinners, and beta blockers. Some surgical treatments include pacemakers, implantable cardioverter
defibrillators (ICDs), intra–aortic balloon pump, ventricular assist devices (VADs), an implantable
artificial heart, angioplasty and coronary bypass surgery, heart–valve surgery, heart transplantation,
and myocardial replacement therapy. Some alternative medicines include antioxidants,
homocysteine metabolism, magnesium, taurine, carnitine, essential fatty acids, diet, herbs,
acupuncture, massage, biofeedback, and

Vincent Van Gogh's Accomplishments
Abstract
Early childhood, failed career paths and art as a profession.
Vincent van Gogh was born in a small village in Holland on March 30, 1853. This date is significant
as van Gogh's dead brother was born exactly one year before him. His parents could not deal with
the trauma of losing their first son, as a result this left a lasting impression on the second Vincent.
Van Gogh's older sister, described his adolescence as "intensely serious and uncommunicative...he
was a stranger to himself" (Butterfield, 1998). The artist himself was aware of his own deviating
behavior, in a letter he wrote to his brother, he expresses: "my youth was gloomy, cold and sterile"
(Butterfield, 1998). During the later part of his life van Gogh's paintings exhibited a common theme
of yellow hues ; he was personally concerned with his self–image; and increasingly became
dependent on foxplate flowers as a means of treating the epileptic seizures. During the last two
years of his life, Vincent is taken in and out of asylums and receives treatment with little success. He
suffers from several more psychotic episodes and ultimately commits suicide.
Vincent van Gogh's is known for his imaginative and creative paintings, which speak volumes about
his talent and mental illness. Although there are many hypotheses ... Show more content on
Helpwriting.net ...
In of his letters to Theo, he states: "and without your friendship I would be driven to suicide...I
would finally do it" (Blumer, 2002). The dependent state can be a result from van Gogh's unstable
interpersonal relationship with parents. His relationship with his mother was one that lacked an
emotional connection, because she experienced trauma after losing her first son (Blum, 2009). In
contrast, the relationship between van Gogh and his father was tense, since he rejected calvinism
and a career as a minister (Blum, 2009). Thus, Vincent fulfills this symptom for borderline
personality

Tissue Transplantation Paper
transplantation is done at an advanced stage when cardiac function is unresponsive to medical, or
surgical interventions (Grossman & Porth, 2014).
The loop diuretic Lasix can be prescribed to Mr. S.K. for his lower extremity edema along with a
potassium supplementation (diuretic cause further potassium loss through urine) and captopril can
be prescribed for his hypertension. The beta blocker can also be added to the treatment plan for Mr.
S.K. to reduce the cardiac workload. Health education is provided to S.K. about the importance of
sodium and fluid retention and the importance of weight management is also emphasized. Oxygen is
delivered through an oxymask for S.K. to maintain a saturation above 92% on room air.
Drug Related Issues
There are numerous contraindications ... Show more content on Helpwriting.net ...
The drug phosphodiesterase inhibitors are contraindicated in the presence of allergy to these drugs,
to prevent hypersensitivity reactions. These drugs are also contraindicated in severe aortic or
pulmonic valvular disease, acute MI, fluid volume deficit, and ventricular arrhythmias (Karch,
2013). This drug should be used with caution in elderly and during pregnancy and lactation. The
adverse effects with phosphodiesterase inhibitors include ventricular arrhythmias, hypotension, and
chest pain (Karch, 2013). GI effects include nausea, vomiting, anorexia, and abdominal pain.
Thrombocytoenia is another adverse effect seen with milirone and inamrinone. The hypersensitivity
reactions with these drug include vasculitis, pericarditis, pleuritis, and ascites (Karch, 2013). These
drugs should not be combined as solutions with furosemide because this will form precipitates.
Burning at the intravenous injection site is also a frequent side effect. ACE inhibitors are
contraindicated in the presence of allergy to prevent hypersensitivity reactions and with impaired
renal function (Karch,

Understanding Heart Failure
Understanding Heart Failure
Heart failure is a condition in which the heart muscle is unable to pump enough blood through the
heart to meet the body's need for blood and oxygen. Coronary artery disease is a form of heart
disease that effects the chambers of the heart. There are four chambers in the heart. The upper
chambers consist of a right and a left atrium and the lower chamber consists of the right and left
ventricles. The flow of oxygen rich blood travels from the lungs to the left atrium and into the left
ventricle where it is pumped into the rest of the body. When the heart functions properly, all four
chambers beat and pump blood effectively in an organized way. The Virtual Medical Centre (Centre,
2008) newsletter states that "Management, ... Show more content on Helpwriting.net ...
A cardiologist could be a primary medical provider to help diagnose heart failure. The test
performed help the doctor diagnose the condition but also the type of heart failure. The medical
intake would include symptoms, chest exams to estimate the size of the heart, and lab tests to test
thyroid and kidney functions. The Cleveland Clinic (Clinic, 2009)to Heart Failure mentions "that
the advance in medical technology medical providers have tools to help them determine not only
whether you have a heart failure but also pinpoint the cause and severity of the disease" With the
advancement in medical technology how can the condition treated? Treatment like the "diagnosis of
heart failure" includes some various steps that a patient could follow. Medications called diuretics,
beta blockers, and digitalis glycosides are used to help treat heart failure. These medications help the
heart by getting rid of extra water and salt through the body and reduce blood pressure. For severe
cases of heart failure, a patient may have to have a pacemaker or for those worse cases a heart

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