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Instructions of NURS 650 2-1 Case Study Analysis
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1) Discussion: Alterations in Cellular Processes > Case Study Scenario
A 16-year-old boy comes to clinic with chief complaint of sore throat for 3 days. Denies fever or chills.
PMH negative for recurrent colds, influenza, ear infections or pneumonias.
NKDA or food allergies.
Physical exam reveals temp of 99.6 F, pulse 78 and regular with respirations of 18. HEENT normal with exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+.
Positive anterior and posterior cervical adenopathy.
Rapid strep test performed in office was positive.
His HCP wrote a prescription for amoxicillin 500 mg po q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips, difficulty breathing with audible wheezing.
911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction.
Using this Case Study, post an explanation of the disease presented. In addition, include the following information:
- Role of Genetics
- Why the patient presented with the symptoms to the ED
- What was the physiology response and why did the response occur?
- Which cell are involved in this process (Strep pharyngitis or Allergic reaction)
- How other characteristics would change your response.
The original response is due Wednesday, November 30th and two colleagues’ responses are due Saturday, December 3rd. Remember the textbook is not accepted as a scholarly resource.
For those of you who would like a Word Document, see the attachment.
2) Practicum Manual Acknowledgment – Complete this regarding the Syllabus and the Practicum Manual – Due Wednesday, November 30t
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
LEARNING RESOURCES
- McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
- Chapter 1: Cellular Biology; Summary Review
- Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
- Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
- Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
- Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
- Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions Download Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls
- Module 1 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)
- Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)
Immunity and Inflammation
- Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune functionLinks to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds
Note: The approximate length of the media program is 37 minutes.
Hyponatremia
- MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalancesLinks to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M
Note: The approximate length of the media program is 15 minutes.
To prepare:
By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
BY DAY 3 OF WEEK 1
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your response.
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your peers’ posting. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Step-By-Step Guide on NURS 650 2-1 Case Study Analysis
Introduction To NURS 650 2-1 Case Study Analysis
In this Owlisdom assignment of NURS 650 2-1 Case Study Analysis, you will analyse a clinical scenario involving a 42-year-old female presenting with increased fatigue and joint pain. Your task is to explain the patient’s symptoms, identify possible genetic associations with the disease, and discuss the process of immunosuppression and its effects on body systems. This comprehensive analysis will deepen your understanding of the interplay between genetic predisposition, immune response, and disease manifestation.
INTRODUCTION
In this section of NURS 650 2-1 Case Study Analysis, we will discuss the Introduction.
- Provide a brief overview of the patient’s case and outline the main goals of the case study analysis.
- Content: Introduce the patient’s symptoms, relevant medical history, and the purpose of the analysis. It clearly states that the analysis will explore the underlying causes of the symptoms, genetic predispositions, and the role of immunosuppression.
Example
A 42-year-old female patient presents to the clinic with symptoms of increased fatigue and joint pain, escalating over the past few weeks. Her medical history reveals recurrent episodes with similar symptoms, including an elevated Erythrocyte Sedimentation Rate (ESR) of 56 mm/hr and a negative Anti-Nuclear Antibody (ANA) test. Given these details, this case study aims to explore the potential underlying causes of her symptoms, discuss genetic predispositions, and elucidate the role of immunosuppression in her condition.
Explain why you think the patient presented the symptoms described.
EXPLANATION OF SYMPTOMS
We will explain symptoms in this section of NURS 650 2-1 Case Study Analysis.
- Discuss the potential underlying causes of the symptoms, focusing on the inflammatory or autoimmune nature of the disease.
- Mention the significance of the elevated ESR and the negative ANA test.
- Explore conditions like Rheumatoid Arthritis (RA), Polymyalgia Rheumatica, and other inflammatory disorders.
Example
The patient’s chief complaints of fatigue and joint pain, accompanied by intermittent chills and fever, suggest an inflammatory or autoimmune nature of the disease. The high ESR indicates an ongoing inflammatory process, although the negative ANA typically rules out common autoimmune conditions like lupus (Wiers-Shamir et al., 2022). The pain pattern, described as worse in the morning and recurring throughout the day, is characteristic of inflammatory arthritis but could also suggest other rheumatologic conditions.
Identify the genes that may be associated with the development of the disease.
GENETIC ASSOCIATIONS
This NURS 650 2-1 Case Study Analysis section will discuss the genetic associations.
- Discuss the genetic factors that could predispose the patient to autoimmune or inflammatory conditions.
- Mention specific genes, such as HLA-DR4 and HLA-DR1, and their roles in immune system function.
Example
Given the negative ANA and elevated ESR, conditions such as Rheumatoid Arthritis (RA), Polymyalgia Rheumatica, and possibly other non-autoimmune inflammatory disorders like infections or malignancies should be considered. RA, for example, can present with similar symptoms and morning stiffness, although it usually shows positive serology. Polymyalgia rheumatica typically presents in older patients but should not be discounted given the elevated ESR and symptomatology.
While the ANA test is negative, ruling out many common autoimmune diseases, the patient might still have a genetic predisposition to other forms of autoimmune or inflammatory conditions. Genes like HLA-DR4 and HLA-DR1 have been associated with Rheumatoid Arthritis, even in seronegative cases (Dedmon, 2020). These genes contribute to immune system function and could predispose individuals to develop RA by presenting autoantigens in a way that promotes an autoimmune response.
Explain the process of immunosuppression and the effect it has on body systems.
PROCESS OF IMMUNOSUPPRESSION
In this section of NURS 650 2-1 Case Study Analysis, we will discuss the process of immunosuppression.
- Describe how immunosuppression occurs naturally in disease progression or through therapeutic intervention.
- Discuss how it reduces immune system activity, decreases inflammation, and alleviates symptoms.
- Highlight potential side effects, such as increased susceptibility to infections.
Example
Immunosuppression plays a complex role in inflammatory diseases. It can be both a natural disease progression and a treatment modality. In autoimmune and inflammatory conditions, the immune system mistakenly attacks body tissues, leading to symptoms such as joint pain and fatigue. Chronic inflammation can lead to tissue damage and further exacerbate immune dysregulation, creating a cycle of inflammation and symptom flare-ups.
Immunosuppression, whether naturally occurring within the disease or as part of therapeutic intervention, aims to reduce this immune response. Medications such as corticosteroids or disease-modifying anti-rheumatic drugs (DMARDs) are often used to achieve immunosuppression (Isaacs & Burmester, 2020). These drugs help by reducing immune system activity, thus decreasing inflammation and its associated symptoms. However, immunosuppression can also render the body more susceptible to infections and may impact the functioning of other body systems, such as the cardiovascular or gastrointestinal systems.
CONCLUSION
We will discuss the conclusion in this section of NURS 650 2-1 Case Study Analysis.
- Recap the potential diagnosis, genetic factors, and the role of immunosuppression.
- Emphasise the importance of a comprehensive diagnostic workup and personalised treatment approach.
Example
To sum up, in this case, the patient’s symptoms and history suggest an underlying inflammatory condition, possibly a seronegative rheumatoid arthritis or another similar disorder. The absence of specific autoantibodies (ANA) complicates the diagnosis but does not rule out an autoimmune aetiology. Genetic factors such as HLA-DR alleles may predispose the patient to such conditions even without typical serological markers. Further diagnostic workup, including more specific antibody tests, imaging, and possibly a trial of immunosuppressive therapy, will be crucial in clarifying the diagnosis and guiding treatment. Understanding the role of immunosuppression not only in therapy but also as part of the disease’s pathophysiology is essential for managing the patient’s symptoms and improving her quality of life.
CLOSING
By following these owlisdom guidelines of NURS 650 2-1 Case Study Analysis, students can effectively analyse the case study, demonstrating a comprehensive understanding of the genetic and physiological factors involved in the patient’s condition. This structured approach ensures a thorough and coherent analysis, supported by evidence and aligned with the course objectives. In the next module of NURS 650, we will explore the 3-1 Concept Map Template.
REFERENCES
Dedmon, L. E. (2020). The genetics of rheumatoid arthritis. Rheumatology, 59(10), 2661–2670.
Isaacs, J. D., & Burmester, G. R. (2020). Smart battles: Immunosuppression versus immunomodulation in the inflammatory RMDs. In Annals of the Rheumatic Diseases (Vol. 79, Issue 8, pp. 991–993). BMJ Publishing Group Ltd. https://ard.bmj.com/content/79/8/991.abstract
Wiers-Shamir, K., Simpson, J., & Chang, C. (2022). The evaluation and treatment of autoimmune diseases. In Allergic and immunologic diseases (pp. 863–886). Elsevier. https://www.sciencedirect.com/science/article/pii/B9780323950619000321
