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Week 9-10: Blood Pressure Capillary Exchange

Terms in this set (124)

One of the most important jobs of a health professional is to predict and identify complications - new problems that can arise as a result of a patient's original ailment. Many patients die of complications that went unrecognized because the health professionals thought only about the original diagnosis and not how the patient's problem was linked to other body systems.In this case study, the doctor identifies a developing complication of a very common lung disease.Mr. V is in the emergency room for severe shortness of breath; you are taking his history. He tells you he has smoked a pack a day for forty years, and his primary diagnosis is chronic obstructive pulmonary disease (COPD), which he treats with an inhaled bronchodilator.Mr. V presents as an overweight 60-year-old with a barrel-shaped chest. His breath sounds are reduced, and his lips and fingertips are bluish. His hands and wrists look puffy, and his watchband is very tight. You ask him if this is normal, and he says it has been that way for a while, but he keeps forgetting to go to the jeweler and have another link put in it. His heart rate is 90 bpm, blood pressure is nearly normal at 125/90 mm Hg, and respiratory rate is a little high - 26 breaths/min. - with audible wheezing. His pulse oximeter is low, reading 85% even though he is breathing supplemental oxygen. His temperature is 101.6∘F∘F.The doctor orders sputum cultures to check for a respiratory infection. She also examines Mr. V's legs. His ankles are bluish and swollen, and the doctor says she is worried about pulmonary hypertension (high blood pressure).

Why is the doctor worried about hypertension (high blood pressure) when Mr. V's blood pressure is only a little bit above normal? To understand this, you need to analyze the diagnosis. The doctor has mentioned pulmonary hypertension. Let's review what the pulmonary circuit is and how pulmonary blood pressure might be different from the blood pressure you measure in someone's arm.To start, review the path blood takes through the body and lungs.