| Course | NURS 711 Advanced Physiology/Pathophysiology (NURS711) |
|---|---|
| Module/Week | 6 |
| Assignment | Cardiovascular/Pulmonary Case and Practice Guidelines Presentation on Heart Failure With Preserved Ejection Fraction |
| Paper type | Case and practice guidelines PowerPoint (slide text and speaker notes) |
| Length | about 1,139 words, 4 double-spaced pages plus title page and references. Course guide: a PowerPoint case presentation prepared in pairs on an assigned cardiovascular or pulmonary topic, covering pathophysiology, professional practice guidelines, the advanced practice nurse's role and a treatment and management plan with health promotion, submitted through SafeAssign |
| Format | APA 7 student paper |
| Points | 100 |
| School | Liberty University Online |
| Program | DNP |
| Where it sits | Module/Week 6 in Liberty's published NURS 711 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for NURS 711 Week 6
A Stiff Heart in a Busy Life: Case, Pathophysiology, Guidelines and an APRN Management Plan for Heart Failure With Preserved Ejection Fraction
[Student Name]
School of Nursing, Liberty University
NURS 711: Advanced Physiology/Pathophysiology
Cardiovascular/Pulmonary Case and Practice Guidelines Presentation
[Instructor Name]
[Date]
The patient is a composite written for a model case presentation; the guidelines, trials and textbook cited are real.
A Stiff Heart in a Busy Life: Case, Pathophysiology, Guidelines and an APRN Management Plan for Heart Failure With Preserved Ejection Fraction
Slide 1: The Case
- Mrs. Cole, 72: breathless on one flight of stairs
- Obesity (BMI 36), hypertension, type 2 diabetes, paroxysmal AF
- Echo: ejection fraction 60%, enlarged left atrium
Speaker notes: Mrs. Cole is a 72-year-old retired bookkeeper who has told her clinicians for two years that climbing to her own bedroom now means a rest halfway up and that her ankles swell by evening. Each time, it was blamed on her weight. She has hypertension, type 2 diabetes and paroxysmal atrial fibrillation. Her echocardiogram shows a normal ejection fraction of 60%, an enlarged left atrium and raised estimated filling pressures. Our question is simple: does she have heart failure, and if so, what should we do?
Slide 2: How a Heart Fails Without Losing Its Squeeze
- Comorbidities drive systemic inflammation
- Microvascular dysfunction stiffens the ventricle
- Poor filling, high pressures, congested lungs
Speaker notes: When ejection fraction is preserved, the ventricle still ejects a normal share of its volume, but it cannot fill well. McCance and Huether (2019) describe diastolic dysfunction as impaired relaxation and increased stiffness of the left ventricle. Current thinking links Mrs. Cole's comorbidities, obesity, diabetes and hypertension, to a chronic inflammatory state that injures the small coronary vessels. The cardiomyocytes become stiffer and the interstitium fibrotic. A stiff ventricle needs higher pressure to fill, that pressure backs up into the left atrium and pulmonary veins, and her lungs become congested with exertion.
Slide 3: Why Symptoms Come With Effort
- Exercise shortens filling time
- Filling pressures surge, lungs congest
- Atrial fibrillation removes the atrial kick
Speaker notes: At rest, a stiff ventricle can often fill adequately. With exertion, the heart rate rises and the time available for filling shortens, so pressures surge and breathlessness follows. Atrial fibrillation makes this worse, because the atria normally contribute a final push of blood into the ventricle, and in a stiff heart that push matters more. Mrs. Cole's normal ejection fraction is not reassurance; it is the signature of a heart that squeezes well and fills badly.
Slide 4: Making the Diagnosis
- Symptoms and signs of heart failure
- Ejection fraction 50% or higher
- Evidence of raised filling pressures
Speaker notes: The 2022 guideline defines this form of heart failure by symptoms and signs with an ejection fraction of 50% or more (Heidenreich et al., 2022). Supporting evidence includes structural changes, such as an enlarged left atrium or a thick ventricle, raised natriuretic peptides and echocardiographic signs of high filling pressure. Natriuretic peptides run lower in people with obesity, so a modest value should not exclude the diagnosis in Mrs. Cole. The 2023 expert pathway also reminds us to look for conditions that mimic this syndrome, such as amyloid heart disease (Kittleson et al., 2023).
Slide 5: The 2022 Guideline at a Glance
- Diuretics for congestion: Class 1
- SGLT2 inhibitor: Class 2a
- Treat hypertension and atrial fibrillation
Speaker notes: For preserved ejection fraction, the 2022 AHA, ACC and HFSA guideline gives a Class 1 recommendation to diuretics when patients are congested, a Class 2a recommendation to SGLT2 inhibitors to reduce heart failure hospitalization and cardiovascular death, and recommends treating hypertension and atrial fibrillation to guideline targets. Mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitors and angiotensin receptor blockers receive weaker, Class 2b recommendations in selected patients (Heidenreich et al., 2022).
Slide 6: The Trials Behind the SGLT2 Recommendation
- EMPEROR-Preserved: 5,988 patients
- DELIVER: 6,263 patients
- Both lowered the composite of CV death or HF events
Speaker notes: Two large trials changed practice. In EMPEROR-Preserved, patients with an ejection fraction above 40% who took empagliflozin had fewer cardiovascular deaths or heart failure hospitalizations taken together, with a hazard ratio of 0.79, largely through fewer hospitalizations (Anker et al., 2021). DELIVER found the same direction of benefit for dapagliflozin on cardiovascular death or worsening heart failure, with a hazard ratio of 0.82 (Solomon et al., 2022). Both drugs also benefit kidney function and glucose, which matters for Mrs. Cole.
Slide 7: Treating the Obesity Phenotype
- STEP-HFpEF: 529 patients with BMI of 30 or more
- Semaglutide improved symptoms and function
- Greater weight loss than placebo
Speaker notes: Obesity is not just a bystander in this condition; it adds blood volume, epicardial fat and inflammation. In the STEP-HFpEF trial, weekly semaglutide improved patient-reported symptoms and physical limitations, increased six-minute walk distance and produced substantially more weight loss than placebo in people with this form of heart failure and obesity (Kosiborod et al., 2023). The 2023 expert pathway discusses weight reduction as part of treatment for patients like Mrs. Cole (Kittleson et al., 2023).
Slide 8: Management Plan, Part 1
- Furosemide to relieve congestion, then lowest dose
- Add empagliflozin 10 mg daily
- Blood pressure goal below 130/80
Speaker notes: For Mrs. Cole, we start a loop diuretic to relieve her edema and breathlessness, then reduce it to the lowest effective dose. We add empagliflozin, which also helps her diabetes and kidneys; we warn her about genital infections, review her other glucose-lowering drugs to avoid hypoglycemia and check kidney function and potassium in one to two weeks. Her blood pressure target is below 130/80.
Slide 9: Management Plan, Part 2
- Atrial fibrillation: rate control and anticoagulation
- Discuss semaglutide for weight and symptoms
- Screen for sleep apnea
Speaker notes: Her atrial fibrillation needs rate control and, given her age, hypertension, diabetes and heart failure, anticoagulation unless bleeding risk forbids it; rhythm control is worth discussing with cardiology. We discuss semaglutide, considering her diabetes, cost and coverage. Because obstructive sleep apnea is common in this group and worsens atrial fibrillation and blood pressure, we refer her for a sleep evaluation.
Slide 10: Health Promotion
- Cardiac rehabilitation or a walking plan
- Sodium awareness and daily weights
- Vaccines: influenza, pneumococcal, COVID-19, RSV
Speaker notes: Health promotion is part of treatment. We refer Mrs. Cole to cardiac rehabilitation or a supervised exercise program, since exercise training improves exercise capacity in this condition. She learns to weigh herself every morning and call us whenever the scale climbs by about three pounds between mornings or five across a week, to limit high-sodium processed foods and to recognize warning signs. We update her vaccines, because respiratory infections often trigger decompensation.
Slide 11: The Advanced Practice Nurse's Role
- Recognize HFpEF behind "it's your weight"
- Prescribe, titrate and monitor
- Coordinate cardiology, rehab, sleep medicine
Speaker notes: The advanced practice nurse's first contribution is diagnostic: recognizing that breathlessness and swelling in an older woman with obesity and hypertension may be heart failure, not deconditioning. Then come prescribing, monitoring laboratory values and adjusting therapy, coordinating with cardiology, rehabilitation and sleep medicine, and teaching self-care. A DNP-prepared nurse can also build systems, such as a clinic protocol that prompts echocardiography and natriuretic peptide testing for patients with these risk factors and symptoms.
Slide 12: Caring for the Whole Person
- Fear, fatigue and loss of independence
- Faith and family as resources
- A plan she can live with
Speaker notes: Mrs. Cole told us her biggest fear was not being able to climb the stairs to her granddaughter's apartment. Paul prayed that God would sanctify believers completely, spirit, soul and body (English Standard Version Bible, 2001/2016, 1 Thessalonians 5:23). Caring for her body with good evidence, while asking about her fears, her faith and her family, is how we care for the whole person. Our plan succeeds if she climbs those stairs again.
References
Anker, S. D., Butler, J., Filippatos, G., Ferreira, J. P., Bocchi, E., Böhm, M., Brunner-La Rocca, H., Choi, D., Chopra, V., Chuquiure-Valenzuela, E., Giannetti, N., Gomez-Mesa, J. E., Janssens, S., Januzzi, J. L., Gonzalez-Juanatey, J. R., Merkely, B., Nicholls, S. J., Perrone, S. V., Piña, I. L., . . . Packer, M. (2021). Empagliflozin in heart failure with a preserved ejection fraction. New England Journal of Medicine, 385(16), 1451-1461. https://doi.org/10.1056/NEJMoa2107038
English Standard Version Bible. (2016). Crossway. (Original work published 2001)
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., . . . Yancy, C. W. (2022). 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. https://doi.org/10.1161/CIR.0000000000001063
Kittleson, M. M., Panjrath, G. S., Amancherla, K., Davis, L. L., Deswal, A., Dixon, D. L., Januzzi, J. L., & Yancy, C. W. (2023). 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction. Journal of the American College of Cardiology, 81(18), 1835-1878. https://doi.org/10.1016/j.jacc.2023.03.393
Kosiborod, M. N., Abildstrøm, S. Z., Borlaug, B. A., Butler, J., Rasmussen, S., Davies, M., Hovingh, G. K., Kitzman, D. W., Lindegaard, M. L., Møller, D. V., Shah, S. J., Treppendahl, M. B., Verma, S., Abhayaratna, W., Ahmed, F. Z., Chopra, V., Ezekowitz, J., Fu, M., Ito, H., . . . Petrie, M. C. (2023). Semaglutide in patients with heart failure with preserved ejection fraction and obesity. New England Journal of Medicine, 389(12), 1069-1084. https://doi.org/10.1056/NEJMoa2306963
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
Solomon, S. D., McMurray, J. J. V., Claggett, B., de Boer, R. A., DeMets, D., Hernandez, A. F., Inzucchi, S. E., Kosiborod, M. N., Lam, C. S. P., Martinez, F., Shah, S. J., Desai, A. S., Jhund, P. S., Belohlavek, J., Chiang, C., Borleffs, C. J. W., Comin-Colet, J., Dobreanu, D., Drozdz, J., . . . Langkilde, A. M. (2022). Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. New England Journal of Medicine, 387(12), 1089-1098. https://doi.org/10.1056/NEJMoa2206286
What the NURS 711 Week 6 instructions ask
The case presentation is a paired assignment in which the student develops a PowerPoint presentation for a case on a designated cardiovascular or pulmonary topic. The guide lists the required content: a discussion of the pathophysiology, the relevant professional practice guidelines, the advanced practice nurse's role, and a treatment and management plan that includes health promotion. The full presentation is submitted through SafeAssign in Module/Week 6, and the pair then presents an abbreviated version at the second WebEx seminar in Week 7. The reading in McCance and Huether for Weeks 5 and 6 covers the cardiovascular and pulmonary systems, which supplies the physiology behind the case.
How this NURS 711 Week 6 example is built
The deck moves the way a clinician thinks about a new patient. It begins with the case and the clinical question, then explains the pathophysiology of HFpEF in two slides, from comorbidities and microvascular inflammation to a stiff ventricle, high filling pressures and breathlessness. Diagnosis follows, including why a normal ejection fraction does not exclude heart failure. Three slides summarize the guidelines and the trials behind them, and three set out the management plan: decongestion, disease-modifying therapy, comorbidity management and health promotion. The last two slides turn to what the nurse practitioner contributes and to a faith-informed view of caring for the whole person, with speaker notes that cite the evidence for every recommendation. The deck runs to twelve slides so the abbreviated seminar version can use the first eight. The deck runs to twelve slides so the abbreviated seminar version can use the first eight.
NURS 711 Week 6 grading rubric: where the points go
Expect marks for a correct, deep account of the mechanism, the correct use of current professional guidelines with their recommendation strength, the completeness and safety of the management plan, the inclusion of health promotion, the clarity of the advanced practice nurse's role, slide quality and APA. Graders look for a plan that follows logically from the case details, so each recommendation should answer something in the patient's history or findings. Citing the trial evidence behind guideline recommendations, rather than the guideline alone, shows doctoral-level understanding. Presenting the abbreviated version smoothly at the Week 7 seminar depends on having built this full deck carefully first. Presenting the abbreviated version smoothly at the Week 7 seminar depends on having built this full deck carefully first.
NURS 711 Week 6 help: mistakes that cost points
Common problems include a pathophysiology section that describes systolic heart failure, a plan that copies reduced-ejection-fraction therapy into a preserved-ejection-fraction case, and guidelines cited without the class of recommendation. Others crowd the slides with text or leave health promotion to a single bullet about diet. Some pairs ignore the comorbidities that drive this condition. Make sure the mechanism fits the specific type of heart failure, state the guideline class for each therapy, tie every part of the plan to the case, include practical health promotion such as activity, sodium, weight and vaccination, and keep the slides lean with the evidence in the notes.
Related NURS 711 sample papers
Other NURS 711 weeks
- NURS 711 Week 1: Discussion Board Forum 1
- NURS 711 Week 3: Neuro Paper: Trigeminal Neuralgia
- NURS 711 Week 4: Neuro Presentation
- NURS 711 Week 5: Discussion Board Forum 2
More DNP sample papers
NURS 711 Week 6 questions, answered
What is the NURS 711 Cardiovascular/Pulmonary Case Presentation?
A 100-point paired PowerPoint in Module/Week 6 on an assigned cardiovascular or pulmonary case covering pathophysiology, guidelines, the APN role and a management plan.
Where can I find a free NURS 711 Week 6 sample paper?
Every slide and speaker note of the NURS 711 Week 6 HFpEF case presentation appears on this page without charge, followed by the full reference list.
What is heart failure with preserved ejection fraction?
Heart failure with an ejection fraction of 50% or higher, in which a stiff ventricle fills poorly and raises pressures in the heart and lungs.
What do current guidelines recommend for HFpEF?
Diuretics for congestion, an SGLT2 inhibitor as a 2a recommendation in the 2022 guideline, and treatment of comorbidities such as hypertension, atrial fibrillation and obesity.
Does semaglutide help HFpEF with obesity?
In the STEP-HFpEF trial of 529 patients, semaglutide improved symptoms, physical limitation and exercise function and produced greater weight loss than placebo.
Use it as a model, or ask for your own
This paper is an original model written by our desk for study. It is not a submitted student paper and not an official Liberty University document. Read it for structure and reasoning, then write your own to the instructions in your Canvas course. If you want a version built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
Ask for a custom NURS 711 Week 6 sample · All NURS 711 weeks · All courses