Module 8: Pediatrics

What’s Happening This Module?

Module 8: Pediatrics is a 1-week module, Week 11, the final week of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact the health of infants, children, and adolescents. You will also examine concepts and principles of pathophysiology across the life span. Lastly, you will take the Final Exam for the course.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 11
Knowledge Check: Pediatrics	Complete by Day 5 of Week 11
Final Exam	Submit by Day 7 of Week 11

 

Go to the Week’s Content

 

Week 11

 

Week 11: Concepts of Pediatrics

Pediatric disorders can present unique challenges to patients, families, and healthcare providers. Disorders in these areas are complicated by the fact that young patients can have difficulties communicating symptoms. Furthermore, the manner in which disease and disorders manifest in children may be unique.

APRNs working to support these patients and their loved ones must demonstrate not only support and compassion, but expertise to communicate and guide understanding of diagnoses and treatment plans. This includes an understanding of disease and disorders at the pediatric level.

This week, you examine pathophysiology in pediatrics. You apply key terms, concepts, and principles in this area to demonstrate an understanding of the impact they have on altered physiology in children.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 14: Cancer in Children, including Summary Review
• Chapter 20: Alterations of Neurologic Function in Children (stop at Childhood tumors); Summary Review
• Chapter 34: Alterations of Cardiovascular Function in Children (stop at Defects decreasing pulmonary blood flow); Summary Review
• Chapter 37: Alterations of Pulmonary Function in Children (stop at Congenital malformations); Summary Review
• Chapter 40: Alterations of Renal and Urinary Tract Function in Children, including Summary Review
• Chapter 43: Alterations of Digestive Function in Children, including Summary Review
• Chapter 46: Alterations of Musculoskeletal Function in Children (stop at Avascular diseases); (start at Cerebral palsy) (musculoskeletal tumors in children); Summary Review
• Chapter 48: Alterations of the Integument in Children, including Summary Review
• Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children, including Summary Review

 

U.S. National Library of Medicine. (2019). Normal growth and development. Retrieved from https://medlineplus.gov/ency/article/002456.htm

 

Document: NURS 6501 Final Exam Review (PDF document)

 

Note: Use this document to help you as you review for your Final Exam in Week 11.

 

 

Required Media

 

Module 8 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 8 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 Knowledge Check and your Final Exam. (3m)

 

Wyatt, K. (2018, February 4). Pediatrics – Growth and development milestones review  [Video file]. Retrieved from https://www.youtube.com/watch?v=ZG60nC3RJwc

Note: The approximate length of the media program is 34 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapter 20, 34, 37, 40, 43, and 46 that relate to alterations in hematological function in children. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Pediatrics

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Growth and development
  • Normal growth patterns
  • Scoliosis (ortho)
  • Kawasaki
  • Alterations in children
  • Congenital (heart syndrome)
  • PDAs
  • Sudden Infant Death Syndrome (SIDS)
  • Asthma
  • Lead poisoning and effects on neurological functioning
  • Sickle cell
  • Hemophilia

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Final Exam.)

Complete the Knowledge Check By Day 5 of Week 11

 

To complete this Knowledge Check:

Module 8 Knowledge Check

 

Final Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 7, 8, 9, 10, and 11. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Final Exam.)

By Day 7 of Week 11

Complete and submit your Final Exam.

To complete your exam:

Final Exam

 

What’s Coming Up?

Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.

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Module 7: Women’s and Men’s Health, Infections, and Hematologic Disorders

What’s Happening This Module?

Module 7: Women’s and Men’s Health, Infections, and Hematologic Disorders is a 1-week module, Week 10 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact women’s and men’s health, including infections and hematologic disorders. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these populations.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 10
Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders	Complete by Day 7 of Week 10
Module 7 Assignment: Case Study Analysis	Submit by Day 7 of Week 10

 

Go to the Week’s Content

Week 10

Week 10: Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.

Understanding these differences in traits and their impact on pathophysiology can better equip acute care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.

This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the life span
• Analyze processes related to women’s and men’s health, infections, and hematologic disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
• Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
• Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
• Chapter 27: Sexually Transmitted Infections, including Summary Review
• Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review
• Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
• Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review

 

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true

Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.

Document: NURS 6501 Final Exam Review (PDF document)

Note: Use this document to help you as you review for your Final Exam in Week 11.

Required Media

 

Module 7 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 7 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 Knowledge Check and your Assignment. (3m)

Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia

Note: The approximate length of the media program is 5 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 24, 26, 28, and 30 that relate to the reproductive and hematological systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Sexually transmitted diseases
  • Prostate
  • Epididymitis
  • Factors that affect fertility
  • Reproductive health
  • Alterations and fertility
  • Anemia
  • ITP and TTP
  • DIC
  • Thrombocytopeni

Complete the Knowledge Check By Day 7 of Week 10

 

To complete this Knowledge Check:

Module 7 Knowledge Check

 

Module 7 Assignment: Case Study Analysis

An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.

Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.  Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ­ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl  Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2  99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.

In your Case Study Analysis related to the scenario provided, explain the following:

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

 

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Sample Paper – Week 10 Case Study Analysis

NURS 6501 Week 10 Assignment – Case study, STDs and Infertility

 

Case study, STDs and Infertility

Student’s Name

Institution of Affiliation

Course Name

Date

Introduction

Infertility is a global concern that accounts for over 9% of women in their reproductive age. In the United States, over 1.5 million are infertile. Infertility is defined as the inability to conceive within a period of 12 months or longer or regular unprotected sex. Infertility is associated with several factors that include tubal, endocrine, cervical, vaginal, pelvic, and peritoneal defects, however approximately 15-30 cases of infertility have not been explained (Tsevat et al, 2017).

STD and Infertility

Chlamydia and gonorrhea have been identified as STDs that can progress to cause infertility around the world. A CDC report indicates that there were over 2million cases of chlamydia and gonorrhea in the United States. They have been the most infectious sexually transmitted infections according to the report. These infections are easily treatable, however, they have few noticeable symptoms, making it harder for people to seek the appropriate care. Approximately 25% of women who present with symptoms show abdominal/pelvic pain, spotting, and unusual discharge. These infections progress to the uterus and the fallopian tubes to cause pelvic inflammatory disease (Tsevat et al, 2017). This leads to inflammation and scarring causing blockage on the fallopian tubes. Tubal scarring causes blockage of the tubes, preventing the eggs from reaching the uterus.

Inflammatory Markers in PID

When conducting laboratory tests for PID, results will indicate elevation on nonspecific markers i.e. white blood cells WBC, endoplasmic sedimentation rate ESR, and C- reactive protein CRP. These markers are usually diagnostic for several conditions that present with cell or tissue inflammation. CA-125 is another inflammatory marker identified in patients with PID. Several studies argue that elevation of CA-125 is an indication of peritoneal involvement and salpingitis (Ahmed et al, 2017). There is a significant correlation between salpingitis and tubal inflammation and levels of CA-125.

Systemic Reaction

In patients with STDs infection is the most common systemic reaction due to the pathogenesis of the disease. The bacteria often spread to the surrounding tissues such as the prostate, cervix, and vaginal walls due to interaction with urine or during sexual intercourse (Krivan et al, 2017). As such these bacteria proliferate and cause infection of the organs, increasing the severity of the condition.

Splenectomy in ITP

Patients diagnosed with ITP have idiopathic destruction of platelets in the body. This destruction is done at the targets located at the spleen. The use of steroids, immunoglobulin, and those drugs that boost platelet production have been identified as the alternative treatments of this disorder. However, splenectomy remains to be the most effective treatment method that removes the targets in the body that destroy these platelets (Chaturvedi et al, 2018). As compared to long-term use of medication, splenectomy treats the condition once through the removal of the targets that destroy platelets.

Anemia

Anemia is a hematologic condition characterized by a decrease in hemoglobin levels. Patients with anemia will present with paleness, confusion, exhaustion, and low appetite. It can be divided into macrocytic, normocytic, and microcytic anemia. Macrocytic anemia occurs when the red blood cells are larger than normal. These large cells will be fewer and carry less hemoglobin hence causing macrocytic anemia. Patients with normocytic anemia have normal size red blood cells that are fewer in the body. They may present tiredness, irritability, and shortness of breath. On the other hand, microcytic anemia presents with small and hypochromic red blood cells in the blood that do not carry adequate hemoglobin necessary to transport oxygen in the body (Weiss et al, 2019). Patients may present with paleness, weakness, irritability, shortness of breath, tachycardia, and pica.

 

References

Ahmed, S., Parvin, S., Shaha, D. R., Begum, P., Sanjowal, L., Hassan, M. K., & Arif, K. M. (2017). Clinical Profile of Pelvic Inflammatory Disease (PID). Faridpur Medical College Journal, 12(1), 25-30.

Chaturvedi, S., Arnold, D. M., & McCrae, K. R. (2018). Splenectomy for immune thrombocytopenia: down but not out. Blood, The Journal of the American Society of Hematology, 131(11), 1172-1182.

Krivan, G., Jolles, S., Granados, E. L., Paolantonacci, P., Ouaja, R., Cissé, O. A., & Bernatowska, E. (2017). New insights in the use of immunoglobulins for the management of immune deficiency (PID) patients. American journal of clinical and experimental immunology, 6(5), 76.

Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American journal of obstetrics and gynecology, 216(1), 1-9.

Weiss, G., Ganz, T., & Goodnough, L. T. (2019). Anemia of inflammation. Blood, The Journal of the American Society of Hematology, 133(1), 40-50.

 

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Day 7 of Week 10

Submit your Case Study Analysis Assignment by Day 7 of Week 10

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M7Assgn+last name+first initial.(extension)” as the name.
• Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 7  Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M7Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Module 7 Assignment

 

What’s Coming Up in Module 8?

In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.

Week 11 Knowledge Check: Pediatrics

In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 11 Final Exam: Pediatrics

In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Final Exam, since the resources cover the topics addressed. Plan

 

Next Module

 

To go to the next module:

Module 8

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Module 6: Psychological Disorders

What’s Happening This Module?

Module 6: Psychological Disorders is a 1-week module, Week 9 of the course. In this module, you will examine fundamental concepts of disorders that impact patterns of behavior or psychology that can affect multiple areas of life.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 9
Knowledge Check: Psychological Disorders	Complete by Day 7 of Week 9

 

Go to the Week’s Content

 

Week 9

Week 9: Concepts of Psychological Disorders

Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.

Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.

This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

•  Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 19: Neurobiology of Schizophrenia, Mood Disorders, Anxiety Disorders, and Obsessive-Compulsive Disorder, including Summary Review

 

Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624. Retrieved from https://www.aafp.org/afp/2015/0501/p617.html

Credit Line: Diagnosis and management of generalized anxiety disorder and panic disorder in adults by Locke, A. B., Kirst, N., & Shultz, C., in American Family Physician, Vol. 91/Issue 9. Copyright 2015 by American Academy of Family Physicians. Reprinted by permission of American Academy of Family Physicians via the Copyright Clearance Center.

 

McIntyre, R. S. & Calabrese, J. R. (2019). Bipolar depression: The clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion, 1–14. doi:10.1080/03007995.2019.1636017. Retrieved from https://www.tandfonline.com/doi/full/10.1080/03007995.2019.1636017

Credit Line: Bipolar depression: The clinical characteristics and unmet needs of a complex disorder by McIntyre, R. S. & Calabrese, J. R., in Current Medical Research and Opinion. Copyright 2019 by Librapharm Ltd. Reprinted by permission of Librapharm Ltd via the Copyright Clearance Center.

 

Required Media

 

Module 6 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 6 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 Knowledge Check. (1m)

Generalized Anxiety Syndrome

Osmosis.org. (2016, February 29). Generalized anxiety disorder (GAD) – causes, symptoms, & treatment [Video file]. Retrieved from https://www.youtube.com/watch?v=9mPwQTiMSj8

Note: The approximate length of the media program is 5 minutes.

 

Knowledge Check: Psychological Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Generalized anxiety disorder
  • Depression
  • Bipolar disorders
  • Schizophrenia
  • Delirium and dementia
  • Obsessive compulsive disease

Complete the Knowledge Check By Day 7 of Week 9

To complete this Knowledge Check:

Module 6 Knowledge Check

 

What’s Coming Up in Module 7?

In Module 7, you will analyze processes related to women’s and men’s health, infections, and hematologic disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

 

Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In the Week 10 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 7. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next module:

Module 7

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Module 5: Neurological and Musculoskeletal Disorders

What’s Happening This Module?

Module 5: Neurological and Musculoskeletal Disorders is a 2-week module, Weeks 7 and 8 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact neurological and musculoskeletal systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 7 and 8
Knowledge Check: Neurological and Musculoskeletal Disorders	Submit your Assignment by Day 7
Module 5 Assignment: Case Study Analysis	You are encouraged to work on your Module 5 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 8.

Go to the Week’s Content

Week 7

Week 8

Week 7: Concepts of Neurological and Musculoskeletal Disorders – Part 1

Anatomists often use the analogy of a house to explain the human body, with skeletal systems, respiratory systems, and circulatory systems represented as a home’s framing structure, ventilation, and piping, respectively. Such analogies further emphasize the point that relationships between systems can result in complications when issues arise in one system.

With hundreds of diseases that can impact the brain, spine, and nerves, neurological disorders represent a complicated array of issues that present significant health concerns. Disorders such as strokes and Parkinson’s disease not only affect the nervous system, however; they can have secondary impacts in other areas, especially the musculoskeletal system.

This week, you examine fundamental concepts of neurological disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 15: Structure and Function of the Neurologic System
• Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
• Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
• Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
• Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
• Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
• Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

 

Required Media

Module 5 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 5 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 Knowledge Check and your Assignment. (3m)

 

Khan Academy. (2019b). Ischemic stroke . Retrieved from https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

 

Osmosis.org. (2019, June 12). Osteoporosis  – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Neurological and Musculoskeletal Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Stroke
  • Multiple sclerosis
  • Transient Ischemic Attack
  • Myasthenia gravis
  • Headache
  • Seizure disorders
  • Head injury
  • Spinal cord injury
  • Inflammatory diseases of the musculoskeletal system
  • Osteoporosis
  • Osteopenia
  • Bursitis
  • Tendinitis
  • Gout
  • Lyme Disease
  • Spondylosis
  • Fractures
  • Parkinson’s
  • Alzheimer’s

Three basic bone-formations:

• • Osteoblasts
  • Osteocytes
  • Osteoclasts

Complete the Knowledge Check By Day 7 of Week 7

 

To complete this Knowledge Check:

Module 5 Knowledge Check

 

Next Week

 

To go to the next week:

Week 8

 

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.

This week, you continue to examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

 

Learning Objectives

Students will:

• Analyze processes related to neurological and musculoskeletal disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here.

 

Required Readings

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 15: Structure and Function of the Cardiovascular and Lymphatic Systems (stop at Aging and the nervous system)
• Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
• o   Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function; pp. 504–511, pp. 516–530 (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
• Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
• Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
• Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

 

 

Required Media

Khan Academy. (2019b). Ischemic stroke. Retrieved from ttps://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

 

Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and the sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

 

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored in the diagnosis, and you explain the implications to patient health.

 

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

 

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

 

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

Any racial/ethnic variables that may impact physiological functioning.

How these processes interact to affect the patient.

 

Week 8 Case Study:

A 67-year-old man presents to the HCP with a chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair. Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill-rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement. The patient states that he has episodes of extreme sweating and flushing not associated with the activity. Laboratory data unremarkable and the HCP has diagnosed the patient with Parkinson’s Disease.

In your Case Study Analysis related to the scenario provided, explain the following:

• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

Day 7 of Week 8

Submit your Case Study Analysis Assignment by Day 7 of Week 8.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

 

 

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Sample Paper – Week 8 Case Study Analysis

NURS 6501 Week 8 Assignment – Case Study Analysis

Module 5 Assignment: Case Study Analysis NURS 6501 Week 8

Student’s Name:

Institutional Affiliation:

 

Module 5 Assignment

Individuals with Parkinson’s disease exhibit musculoskeletal conditions that occur because of the discrepancy between the exterior load and the human body’s ability to fight biomechanical and physiological strain. When the body experiences an excessive force, this can generate diverse pathophysiological developments which depend on the affected tissues. The role of this paper will be to highlight a case study and indicate the neurological and musculoskeletal conditions that can make the patient exhibit such symptoms. Further, the paper will highlight the racial variables that can hinder the physiological functioning of the individual. Lastly, the paper will indicate how all these factors interact to affect the patient. When individuals present musculoskeletal conditions, they exhibit different symptoms depending on how far the physiological developments have progressed.

Case Study

A 67-year-old man goes to his HCP after experiencing symptoms that point to Parkinson’s disease. The symptoms include tremors in the arms and legs. After analysis, the patient also exhibits a “pill-rolling” movement, and he also exhibits jerky or cog wheeling movement. The patient also exhibits an uneven gait, and he shuffles when he walks with his head or neck hips and knees flexed forward.

Neurological and Musculoskeletal Pathophysiological Processes

Parkinson’s disease, also known as “atypical Parkinson’s” or “Parkinson’s syndrome,” is a disorder where the patient displays some of the signs related with Parkinson’s disease include tremor, rigidity, bradykinesia, and postural instability. According to DeMaagd and Philip (2015), the disease arises because of the damage of numerous transmitters, which in most cases, is dopamine. The signs of the disease deteriorate with time because more cells become affected by the disease become lost. The disease always affects the nerve cells in the brain that are responsible for movement. The primary function of dopamine is to convey chemical messages from one nerve cell to a different one through a synapse, which is the space between the presynaptic cell and the postsynaptic receptor. When the dopamine-producing cells die, symptoms such as tremors, stiffness, and balancing problems are exhibited in the patient.

Racial and Ethnic Variables Impacting Physiological Functioning

Parkinson’s disease (PD) affects individuals of all races and ethnicity across the globe. Parkinson’s disease’s origin is thought to be multifactorial as such caused by a continuum of factors such as genetics and environmental factors. As such, Sauerbier et al. (2018) believe that sociocultural and geographical differences can impact nutrition and environmental issues between diverse societies. Therefore, it is not uncommon to have a varying prevalence of Parkinson’s disease between the different ethnicities worldwide. However, the relationship between Parkinson’s disease and race remain controversial, with studies suggesting that African-Americans are less likely to have Parkinson’s disease than their white counterparts (Dahodwala et al., 2009). A study conducted to investigate the prevalence of PD indicated that it was lower in Asian countries than in North America (Sauerbier et al., 2018). However, most studies agree that the prevalence of PD increases with age, irrespective of ethnic and geographical background.

Interaction of Processes to Affect Patient

Certainly, the Parkinson’s disease arises because of a confluence of myriad factors that can range from racial and ethnic variables to the individual’s neurological and musculoskeletal processes. In this case, all these processes such as environmental issues arising from the ethnicity of the individual and the neurological and musculoskeletal process, like damage of neural transmitters, might have interacted to make the 67-year-old-man depict symptoms of Parkinson’s disease such as slowed movement, stiffness, and pill-rolling movement.

Conclusion

The above analysis has highlighted the processes that characterize Parkinson’s disease. Further, the paper has indicated that race does not significantly influence the probability of an individual contracting the disease. However, race can affect an individual’s knowledge of the disease to diagnosis and, finally, treatment of the affected individuals.

 

References

Dahodwala, N., Siderowf, A., Xie, M., Noll, E., Stern, M., & Mandell, D. (2009). Racial differences in the diagnosis of Parkinson’s disease. Movement Disorders, 24(8), 1200-1205. https://doi.org/10.1002/mds.22557

DeMaagd, G., & Philip, A. (2015). Parkinson’s disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. PubMed Central (PMC). Retrieved 16 October 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517533/.

Sauerbier, A., Aris, A., Lim, E., Bhattacharya, K., & Chaudhuri, K. (2018). Impact of ethnicity on the natural history of Parkinson disease. Mja.com.au. Retrieved 16 October 2020, from https://www.mja.com.au/system/files/issues/208_09/10.5694mja17.01074.pdf.

 

 

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M5Assgn+last name+first initial.(extension)” as the name.
• Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M5Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 8

To participate in this Assignment:

Module 5 Assignment

 

What’s Coming Up in Module 6?

In Module 6, you will identify processes related to psychological disorders. You will also examine the neurobiology of various psychological issues and consider variables that may impact physiological functioning and altered physiology.

Week 9 Knowledge Check: Psychological Disorders

In the Week 9 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 6. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

 

Next Module

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Module 4: Endocrine Disorders

What’s Happening This Module?

Module 4: Endocrine Disorders is a 1-week module, Week 6 of the course. In this module you will examine fundamental concepts of diseases and disorders that impact endocrine systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 6
Knowledge Check: Endocrine Disorders	Complete by Day 5 of Week 6
Midterm Exam	Complete by Day 7 of Week 6

 

Go to the Week’s Content

 

Week 6

Week 6: Concepts of Endocrine Disorders

Endocrine disorders are complex matters, and there is not always a one-size-fits-all treatment. Particularly in matters requiring the adjustment of hormone levels, treatment may require a custom approach tailored to individual patients. An understanding of these complications is essential to supporting these individual treatment plans.

This week, you examine alterations in the endocrine system and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 21: Mechanisms of Hormonal Regulation, including Summary Review
• Chapter 22: Alterations of Hormonal Regulation, including Summary Review
• Chapter 23: Obesity and Disorders of Nutrition, including Summary Review

American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33

Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393-overview

Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349

Document: NURS 6501 Midterm Exam Review (PDF document)

Note: Use this document to help you as you review for your Midterm Exam in Week 6.

 

Required Media

Module 4 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 4 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 Knowledge Check and your Midterm. (3m)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 21 through 23 related to the endocrine system and disorders. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Optional Resources

The following source provides various tutorials related to maximizing your time management and managing stress. Feel free to access this resource to support you as you move through this course.

Walden University. (2019). ASC success strategies interactive tutorials. Retrieved from https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies

Knowledge Check: Endocrine Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Diabetes
  • Hyper- and hypothyroidism
  • Adrenal disorders
  • Parathyroidism (hyper and hypo)
  • Checks & balances / negative feedback
  • Syndrome of Inappropriate Antidiuretic Hormone
  • Pheochromocytosis
  • Diabetes insipidus
  • Diabetic ketoacidosis

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm Exam.)

Complete the Knowledge Check By Day 5 of Week 6

 

To complete this Knowledge Check:

Module 4 Knowledge Check

 

Midterm Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm exam.)

To prepare:

To help you review for your midterm exam, access the Midterm Exam Review document found in this week’s Learning Resources as well as any Knowledge Check feedback you might have received. (Note: You will also need to review all of your materials from each of these weeks to also help you better prepare for your midterm.)

By Day 7 of Week 6

Submit your Midterm Exam.

To complete your exam:

Midterm Exam

 

What’s Coming Up in Module 5?

In Module 5, you will analyze processes related to neurological and musculoskeletal disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

In the Week 7 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 5. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

 

To go to the next Module:

Module 5

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Module 3: Gastrointestinal and Hepatobiliary Disorders

What’s Happening This Module?

Module 3: Gastrointestinal and Hepatobiliary Disorders is a 1-week module, Week 5 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact gastrointestinal and hepatobiliary systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 5
Knowledge Check: Gastrointestinal and Hepatobiliary Disorders	Complete by Day 7 of Week 5

Go to the Week’s Content

 

Week 5

Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders

Patients of gastrointestinal and hepatobiliary disorders often face life-altering changes, including changes to diet, new treatment regimens, and more. For some disorders, treatments can include surgery.

Gastrointestinal conditions, such as ulcers, diverticulitis, and pancreatitis, often cause varying levels of pain and discomfort. Hepatobiliary conditions can also bring significant changes to patient routines and well-being.

This week, you examine fundamental concepts of gastrointestinal and hepatobiliary disorders. You explore common disorders in these categories, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the life span

Learning Resources

Required Readings

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 38: Structure and Function of the Renal and Urological Systems including Summary Review
• Chapter 39: Alteration of Renal and Urinary Function (stop at Fluids and electrolytes); Summary Review
• Chapter 41: Structure and Function of the Digestive System (stop at Tests of digestive function); Summary Review
• Chapter 42: Alterations of Digestive Function (stop at Cancer of the digestive track); Summary Review

 

Osna, N. A., Donohue, T. M., Jr., & Kharbanda, K. K. (2017). Alcoholic liver disease: Pathogenesis and current management. Alcohol Research: Current Reviews, 38(2), 7–21

Document: NURS 6501 Midterm Exam Review (PDF document)

Note: Use this document to help you as you review for your Midterm Exam in Week 6.

 

Required Media

 

Module 3 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 3 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 Knowledge Check. (2m)

Liver Function Tests

MedCram. (2013, April 14). Liver function tests LFTs explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=bFdTgty0T0I

Note: The approximate length of the media program is 11 minutes.

Liver Diseases

MedCram. (2019, May 15). Diagnosis of key liver diseases: Hepatitis A, B C vs. alcoholic vs. ischemic (AST vs ALT labs) [Video file]. Retrieved from https://www.youtube.com/watch?v=ZZRHA2JvCGA

Note: The approximate length of the media program is 13 minutes.

Liver Pathophysiology

MedCram. (2013, April 9). Liver explained clearly: Pathophysiology, LFTs, hepatic diseases  [Video file]. Retrieved from https://www.youtube.com/watch?v=BTGkB8nOu7g

Note: The approximate length of the media program is 14 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 41 and 42 that relate to the hepatobiliary system. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Ulcers
  • Hepatitis markers
  • After HP shots
  • Gastroesophageal Reflux Disease
  • Pancreatitis
  • Liver failure—acute and chronic
  • Gall bladder disease
  • Inflammatory bowel disease
  • Diverticulitis
  • Jaundice
  • Bilirubin
  • Gastrointestinal bleed – upper and lower
  • Hepatic encephalopathy
  • Intra-abdominal infections (e.g., appendicitis)
  • Renal blood flow
  • Glomerular filtration rate
  • Kidney stones
  • Infections – urinary tract infections, pyelonephritis
  • Acute kidney injury
  • Renal failure – acute and chronic

Complete the Knowledge Check By Day 7 of Week 5

To complete this Knowledge Check:

Module 3 Knowledge Check

 

 

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Sample Paper – Week 5 Knowledge Check

NURS 6501 – Knowledge Check

 

 

Check Knowledge Scenarios

Student Name:

Institutional Affiliation:

Check Knowledge Scenarios

Scenario 1 Peptic Ulcer Disease

Question 1

The patients have been using ibuprofen, which is categorized as inflammatory drugs. This drug is the most cause of peptic ulcers. The patient was also reported to have been smoking tobacco, excessive caffeine, drinking alcohol, and psychological stress on managing his families. All these factors may have led to the development of peptic ulcer disease.

Question 2

Ibuprofen drugs contribute to peptic ulcer development by interfering with the patient’s stomach ability to protect itself from gastric acid corrosion. Tobacco smoking destroys gastroduodenal mucosa risking the stomach to PUD, while ethanol in alcohol led to gastric irritation, which may risk the patient to get ulcers (Lanas & Chan, 2019). Caffeine also causes the production of acid in the body, which is a direct cause of PUD.

Scenario 2 Gastroesophageal Reflux Disease (GERD)

GERD is mainly caused by frequent acid reflux. This involves the backwash of stomach acids to the esophageal, causing burning pain (Clarret & Hachem, 2018). His action, such as smoking, can aggravate this problem of frequent acid reflux acid. It can also be facilitated by excessive drinking of certain beverages such as alcohol and coffee. Other factors that risk the people getting GERD is obesity, problem or disorder of connective tissues, etc.

Scenario 3 Upper GI Bleed

GI is a problem that occurs in the digestive tract. Upper GI happens in the esophagus, stomach, or beginning of small interest (Steele, 2020). This problem can range from excessive bleeding, which is life-threatening, to a minor, which can only be identified through conducting the patient stool test. The main cause associated with this disease is peptic ulcers; these are open sores in the intestine lining. It can also be caused by the tearing of veins located in the esophagus, which can result in bleeding. Another factor that can contribute to this problem is the enlargement of veins in the esophagus abnormally, but this is common for liver disease people. Esophagitis is another factor that involves inflammation of the esophagus, and it is the most contributors to this problem.

Scenario 4 Diverticulitis

This problem results from pressure build-up due to a lack of enough fiber diet, which finally leads to constipation. The process repeats continuously while the patient develops pressure and staining, which finally causes diverticulosis (Young-Fadok, 2018). Due to this pressure, the colon gives up the weak pint and gives way causing a protruding marble size pouches in the colon, resulting in diverticula. Finally, this diverticula tend to break, leading to inflammation (diverticulitis) or in some worse case to other infections.

Scenario 5 Portal Hypertension

Cirrhosis is a liver disease that results from excessive drinking of alcohol. The patient has developed portal hypertension, which is associated with cirrhosis. This occurs because, in the body, there is a large vessel that transports blood to the liver, knows as portal vein (Arab, Barrera & Arrese, 2017). When a person develops cirrhosis, it slows the blood flow and subjects the portal vein to stress. Because the heart continues pumping blood, this slow movement of blood in the liver causes high blood pressure, resulting in portal hypertension.

Scenario 5 part 2: Ascites

Ascites is the abnormal accumulation of fluid within the peritoneal cavity. This is caused by conditions such as portal hypotension. This problem involves enlarging the blood vessels to create room for the high blood pressure resulting from liver cirrhosis (Arab, Barrera & Arrese, 2017). The high pressure in the portal veins causes leakage of protein fluid to the surface of various organs such as the liver, intestine, and this protein-containing fluid tends to accumulate within the patient’s abdomen. This creates the problem of Ascites, which is presented by the described symptoms.

Scenario 6: Hepatic Encephalopathy (HE)

Hepatic encephalopathy can be referred to as reduced brain function, which the main cause is liver disease. In this case of a patient having liver cirrhosis, it will reduce or stop the liver’s functioning, leading to a build-up of toxins in the patient’s bloodstream (Ferenci, 2017). In this condition, the liver is not able to filter toxins from the body so that it can be removed. When the liver is damaged, it cannot perform its function properly, making the toxin to be circulated throughout the body. Continuous build-up of these toxins in the patient’s disease tends to damage the brain, and this is reflected by the patient been confused due to brain disorientation and flapping his hand. 

Scenario 7: Sudden onset of Abdominal Pain

The most likely problem associated with these symptoms may be gastrointestinal or stomach ulcers. This may lead to the abdominal sudden onset of pain. If this problem is not treated earlier, it can bring other problems such as heart attacks, patient vomiting bloody due to internal bleed from the stomach sores. It can disrupt heart operation as blood pressure is affected. The continuous manifestation of these symptoms may lead to deadly stages, such as when a patient starts experiencing a heart attack or abnormal heartbeat.

Scenario 8: Acute Cholecystitis

Question 1

Gallstones are a hard deposit of bile, which are formed in the gallbladder. They can be referred to as parts of a solid component forming in the gallbladder. Gallstones are formed if the bile contains too much bilirubin, excessive cholesterol, or inadequate bile salt (Ibrahim et al.,2018). It develops when there is too much cholesterol or bilirubin, which tends to crystalize and finally form gallstones. The result can also be seen when the gallbladder cannot perform its function properly, making it unable to empty well. Bile can solidify and form a solid substance that can block the bile passage from the liver.

Because of these gallstones’ formation, the patient gall bladder enlarged to create room for the new substances formed; stones are seen in the patient bile duct was resulted from solidified excessive cholesterol or hardened bile forming stones which disruption the bile transportation (Ibrahim et al., 2018). Theses gallstone’s presence was the main reason for dilated common duct as it tries to be more elastic to house the bile produced and the blocking stones formed.

Question 2

The patient becomes jaundiced when there was excess production of bilirubin in his body. The bilirubin is located in the red blood cells, and when its cells die, they are filtered from the body by the liver. Because the patient developed jaundice, this means her life stop carrying its function well, leading to the accumulation of bilirubin in the patient’s body, which made her skin look yellow—therefore making the patient jaundiced.

Scenario 9: Pancreatitis

Pancreatitis is a condition that develops when the patient’s digestive enzymes become functional or activated before leaving the pancreas. This will, in turn, result in irritating the pancreas cells and finally make it enlarge because of inflammation (Kleeff et al., 2017). Therefore, the activated digestive enzyme creates an unconducive environment for the pancreas cell to function, making them swell, leading to this condition of pancreatitis. When this process continues, it can go further and lead to chronic pancreatitis. In this scenario, because the patient has a history of alcoholism for a long time, it could have played a big role in her problem. This is because the pancreas’ acinar cell metabolizes ethanol into harmful byproducts, which damages bile ducts. After this, the bile can no longer transport enzymes anymore, and they tend to build up in the digestive tract, and if this continues, it starts digesting the pancreas. The damaged tissue led to inflammation of the entire pancreas, resulting in further damage leading to pancreatitis. Therefore, Ruth’s drinking behavior leads to her development of this pancreas problem.

Scenario 10: Hepatitis B

The symptoms given by the patient are a clear indicator of hepatitis B.  These symptoms include; nausea and vomiting, abdominal pain, loss of appetite, fatigue, and dark urine. Following the patient history and combining with the symptoms he is reporting automatically show he has hepatitis B. This is because of his history behavior, such as engaging in sexual activities and sharing needles, are the main cause of this disease (Terrault et al., 2018).

Scenario 11: Ulcerative Colitis (UC)

The problem of ulcerative colitis is commonly associated with the malfunction of the immune system. This happens when the body’s immune system tries to defend the body from a certain virus or disease (Xu et al., 2019). The body responds by producing an abnormal response that attacks the digestive tract cells instead of fighting the virus or other problem. This, in turn, results in inflammation and ulcers in the patient digestive tract, which affects the inner part of the colon and rectum.

Scenario 12: Acute Kidney Injury

The patient is suffering from a postrenal type of acute kidney injury. This type involves nephropathy obstruction, which is causing the patient urine flow restriction (Mehran, Dangas & Weisbrod, 2019). It is diagnosed following the symptoms and cause given by the patient and the lab result. For example, it is associated with other diseases such as congenital defects and other swelling symptoms in the lower extremities. These symptoms were the main factor that leads the CXR to diagnose the patient for this kind of kidney injury.

Scenario 13: Glomerular filtration rate (GFR)

The most important concept which the APRN should address when dealing with the student about the glomerular filtration rate is the function of each part of the component involved. This is because it will help stress how this rate is checked and how any disruption from normal can be detected (Bersie et al., 2020). The APRN should also stress on how the students can estimate the amount of blood passing at glomeruli at a given time. The normal GFR should be communication and all the problem or disorder which may be associated with GFR. By doing so, the students will understand how this rate is achieved and know the factor that can affect the normalcy.

Scenario 14: Autoregulation

APRN should start by giving the student the overall meaning concept of autoregulation. Another concept would involve how the body can regulate local blood. The factors and hormones involved. The relationship between blood flow and blood flow regulation and how blood pressure can cater to body function (Wang, Ortega-Gutierrez & Peterson, 2018). The concept of how various blood pressures may make the blood run fast and how one can deal with to ensure blood flow in the body is stable and effective.

Scenario 15: Hormonal Regulation

The APRN should address how hormones regulations take place in the body. He should bring out the concept of how this process occurs and all the components required (Bersie et al., 2020). This will involve addressing both the negative and positive feedback mechanisms used by the body to achieve this regulation. In this concept, he will also mention how the thyroid system contributes to promoting hormone regulations. Organs that are responsible for producing these hormones should be covered in this concept.

Scenario 16: Pyelonephritis

Pyelonephritis can be referred to as the inflammation of the kidney because of infection from bacteria. Urinal calculi calculus may lead to urine obstruction, and this can result in acute pyelonephritis (Johnson & Russo, 2018). When urinal calculi occur, the urine accumulates, leading to the multiplication of bacteria as the body cannot flash all the urine out. These bacteria may attack the kidney, and the damaged part may lead to inflammation of the whole kidney. Whenever the kidney stone is formed in the urinary tract, the outflow of urine is not possible, and the bacteria collected in other body parts may be accumulated here, and upon their accumulation, they lead to pyelonephritis.

Scenario 17: Chronic Renal Failure

Diabetes and hypertension are among the primary cause of chronic renal failure. When a person is suffering from hypertension or diabetes, high blood sugar, or high pressure resulting from hypertension, they can damage the kidney’s blood vessels, hence interfering with its function (Mehran, Dangas & Weisbrod, 2019. When this damage occurs, the kidney may fail to perform its function leading to kidney failure. If such damage kidney continues for a long time, it tends to impair it, leading to the development of chronic renal failure.

 

References

Arab, J. P., Barrera, F., & Arrese, M. (2017). Bile acids and portal hypertension. Annals of hepatology, 16, Ferenci, P. (2017). Hepatic encephalopathy. Gastroenterology report, 5(2), 138-147.S83-S86

Bersie‑Larson, L. M., Gyoneva, L., Goodman, D. J., Dorfman, K. D., Segal, Y., & Barocas, V. H. (2020). Glomerular filtration and podocyte tensional homeostasis: importance of the minor type IV collagen network. Biomechanics and Modeling in Mechanobiology.

Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal Reflux Disease (GERD). Missouri medicine, 115(3), 214.

Ibrahim, M., Sarvepalli, S., Morris-Stiff, G., Rizk, M., Bhatt, A., Walsh, R. M., … & Burke, C. A. (2018). Gallstones: Watch and wait or intervene. Cleve Clin J Med, 85(4), 323-331.

Johnson, J. R., & Russo, T. A. (2018). Acute pyelonephritis in adults. New England Journal of Medicine, 378(1), 48-59.

Kleeff, J., Whitcomb, D. C., Shimosegawa, T., Esposito, I., Lerch, M. M., Gress, T., … & Muñoz, J. E. D. (2017). Chronic pancreatitis. Nature reviews Disease primers, 3(1), 1-18.

Lanas, A., & Chan, F. K. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613-624.

Mehran, R., Dangas, G. D., & Weisbord, S. D. (2019). Contrast-associated acute kidney injury. New England Journal of Medicine, 380(22), 2146-2155.

Steele, C. (2020). Upper GI Bleed. In Resources for Optimal Care of Emergency Surgery (pp. 137-137). Springer, Cham.

Terrault, N. A., Lok, A. S., McMahon, B. J., Chang, K. M., Hwang, J. P., Jonas, M. M., … & Wong, J. B. (2018). Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology, 67(4), 1560-1599.

Wang, A., Ortega-Gutierrez, S., & Petersen, N. H. (2018). Autoregulation in the Neuro ICU. Current treatment options in neurology, 20(6), 20.

Xu, X., Yang, W., Liang, Q., Shi, Y., Zhang, W., Wang, X., … & Yin, L. (2019). Efficient and targeted drug/siRNA co-delivery mediated by reversibly crosslinked polymersomes toward the anti-inflammatory treatment of ulcerative colitis (UC). Nano Research, 12(3), 659-667.

Young-Fadok, T. M. (2018). Diverticulitis. New England Journal of Medicine, 379(17), 1635-1642.

 

 

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What’s Coming Up in Module 4?

In Module 4, you will analyze processes related to endocrine disorders. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact physiological functioning and altered physiology.

Week 6 Knowledge Check: Endocrine Disorders

In the Week 6 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 4. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Also, during this week you will take your Midterm Exam. Please make sure to finalize and complete your Knowledge Check prior to completing your exam.

Next Module

To go to the next Module:

Module 4

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Module 2: Cardiovascular and Respiratory Disorders

What’s Happening This Module?

Module 2: Cardiovascular and Respiratory Disorders is a 2-week module, Weeks 3 and 4 of the course. In this module, you will examine fundamental concepts of cellular processes and the alterations that lead to various cardiovascular and respiratory diseases and disorders. You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 3 and 4
Knowledge Check: Cardiovascular and Respiratory Disorders	Complete by Day 7 of Week 3
Module 2 Case Study Analysis	You are encouraged to work on your Module 2 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 4.

Go to the Week’s Content

 

Week 3

Week 4

 

Week 3: Concepts of Cardiovascular and Respiratory Disorders

The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.

Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.

This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
• Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
• Chapter 35: Structure and Function of the Pulmonary System; Summary Review
• Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery  hypertension); Summary Review

 

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Required Media

 

Module 2 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 2 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 Knowledge Check and Assignment. (4m)

Pneumonia

MedCram. (2015, September 14). Pneumonia explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo

Note: The approximate length of the media program is 13 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Cardiovascular and Respiratory Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • myocardial infarction
  • endocarditis
  • myocarditis
  • valvular disorders
  • lipid panels
  • coagulation
  • clotting cascade
  • deep vein thrombosis
  • hypertension
  • heart failure
  • COPD
  • asthma
  • pneumonias

Complete the Knowledge Check by Day 7 of Week 3

To complete this Knowledge Check:

Module 2 Knowledge Check

 

What’s Coming Up in Week 4?

Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology.

Next Week

To go to the next week:

Week 4

 

 

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Analyze processes related to cardiovascular and respiratory disorders
• Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
• Analyze racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
• Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
• Chapter 35: Structure and Function of the Pulmonary System; Summary Review
• Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.

 

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Note: The above article was first presented in the Week 3 resources. If you read it previously you are encouraged to review it this week.

Required Media

Pneumonia

MedCram. (2015, September 14). Pneumonia explained clearly by MedCram [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo

Note: The approximate length of the media program is 13 minutes.
(Previously reviewed in Week 3)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

 

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

Scenario 4 (week 4):

45-year-old woman presents with the chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. The patient has a history of COPD with a chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals a flattened diaphragm and an increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

 

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.

Any racial/ethnic variables that may impact physiological functioning.

How these processes interact to affect the patient.

By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

In your Case Study Analysis related to the scenario provided, explain the following

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M2Assgn+last name+first initial.(extension)” as the name.
• Click the Module 2 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M2Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Module 2 Assignment

 

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Week 4 Case Study Sample Paper

NURS 6501 Week 2 Assignment: Case Study Analysis

Case Study Analysis

Student’s Name:

Department, University:

Number and Name of Course:

Instructors Name, Title:

Date:

 

Case Study Analysis

Congestive heart failure (CHF), often termed simply as heart failure, refers to a progressive and chronic condition affecting the heart muscles pumping power. It specifically involves the stage in which there is buildup of fluids in the heart, which results in inefficient pumping (Hajar, 2019). This paper will analyze a CHF patient and present the cardiovascular and cardiopulmonary pathophysiologic processes causing her symptoms, the effect of ethnicity and racial variables and the interaction of processes affecting the patient.

Cardiovascular and Cardiopulmonary Pathophysiologic Processes

CHF often manifests in patients as fatigue, swollen legs, ankles or abdomen, gaining weight, and breath shortness when exercising or lying flat. Diuretics are the mainstay pharmacological therapy which reduces preload in patient with CHF. However, the patient in the case admits to not taking her diuretics. The diuretic medications inhibit water reabsorption from the tubules which consequently increases the volume and loss of water in the urine (McCance, & Huether, 2019). The patient admits that she stopped taking her diuretics as they made her get up every few hours to go to the bathroom. The main cause of the symptoms presented by the patient involves reduction in the hearts muscular efficiency which has occurred due to damage. Systole dysfunction results in stroke volume decreases where reductions in the heart muscles contractility enhances end systolic volume. The hearts contractility is lost due to reduced abilities of the fibers myosin and actin cross-linking during the hearts relaxation and contractions.

Ethnic or Racial Variables

Compared to other races or ethnic groups, African Americans have higher chances of heart failure incidences together with increased risks of mortalities caused by CHF compared to white populations (Tillman et al., 2019). Nearly 50% of all African American adults bear some kind of CVD with hypertension being the main etiological factor that contributes to such trends. The pathophysiology of hypertension in this population group is associated with relatively low renin activities, sodium sensitivities and possibly reduced production of nitric oxide. Other risk factors are higher burdens of diabetes and kidney diseases, genetics, socioeconomic health determinants, limited care access, together with lack of compliance to medications (CDC, 2016).

Interaction of processes

Various structural and functional changes occur in the heart of patients with CHF which interact to give rise to the disease condition. Compensatory increases in blood volume occur with the aim of increasing ventricular preloads and therefore enhancing stroke volumes.  Reductions in renal perfusions also occur and lead to reduced urine retention and output. Aorta baroreceptors and stretch receptors are also stimulated by decreases in blood pressure which the results in stimulation of the sympathetic nervous system. Decreases in flow of blood to the kidney leads to release of angiotensin and renin with retention of fluids and sodium by the kidneys occurring when the condition persists and this consequently increases volumes in circulation.

Conclusion

CHF affects the pumping power of heart muscles and manifests in various symptoms presented by the patient in the case. Diuretics are used in treating the condition and lack of adherence can lead to increased heart damage. African Americans are disproportionately affected by heart failure with hypertension or high blood pressure being the major etiological contributing factor. The disease condition arises due to interaction of changes in the functioning and structure of the heart.

References

Centers for Disease Control and Prevention (2016). Public health action plan to prevent heart disease and stroke. http://www.cdc.gov/dhdsp/action_plan

Hajar, R. (2019). Congestive Heart Failure: A History. Heart Views, 20(3), 129–132.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Tillman, F., Kim, J., Makhlouf, T., & Osae, L. (2019). A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans. Therapeutic advances in cardiovascular disease, 13, 1753944719840192.

 

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What’s Coming Up in Module 3?

In Module 3, you will analyze processes related to gastrointestinal and hepatobiliary disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In Week 5 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 3. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 3

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Week 2: Altered Physiology

With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.

This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Analyze alterations in the immune system that result in disease processes
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.

 

Justiz-Vaillant, A. A., & Zito, P. M. (2019). 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.
Note: This article was presented in the Week 1 resources. If you read it previously you are encouraged to review it this week.

 

 

Required Media

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology  | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

 

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly [LK1] (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.
• Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

To participate in this Assignment:

Module 1 Assignment

 

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Sample Paper – Week 2 Assignment

NURS 6501 Week 2 Assignment – Altered Physiology

Altered Physiology

Student’s Name:

Institutional Affiliation:

 

Altered Physiology

One of the symptoms that the patient presented with is crampy left lower quadrant pain. The reason as to why the patient is presenting with this symptom is because of his history of diverticulitis. This is the main cause of persistent pain on the lower left side of the abdomen. Diverticulitis can also cause constipation and high fever (Feuerstein, & Falchuk, 2016). The symptom of constipation, in this case, is also being caused by his diet that lacks fiber. Foods with a low level of fiber take more time to digest, lose stools, irregular bowel movements, and cause a person to experience stomach pain. Eating food rich in fiber also prevents a person from being obese (Lockyer, Spiro, & Stanner, 2016).

The Genes that may be Associated with the Development of the Disease

Considering that the patient’s grandfather died of colon cancer back in the 1950s, it is evident that the disease is being genetically transferred since the patient tested positive for adenocarcinoma of the colon. Inherited mutations can be passed on in families and are found in a person’s cells. Colon cancer is one of the most common inherited cancer syndromes. Changes in the DNA inside our cells cause the development of cancer. DNA refers to the chemical in our cells that make up our genes and usually control our cells’ functioning. The genes that are involved in the development of this disease include MSH6 and MSH2 both on chromosome 2 and MLH1 on chromosome 3 (“Causes of Colorectal Cancer | Is Colon Cancer Hereditary?,” n.d.)   .Mistakes made in DNA replication are repaired by the protein products of these genes.  The mutation of these genes causes the proteins not to work as required, and hence the mistakes made in DNA replication end up not being repaired. As a result, the DNA gets damaged, which leads to the development of colon cancer.

Process of Immunosuppression and the Effect it has on Body Systems

This refers to the suppression of the body’s immune system and its ability to fight diseases and infections. The suppression may result from diseases that affect the immune system or the impact of pharmaceutical agents that fight certain conditions such as cancer (Axelrad, Lichtiger, & Yajnik, 2016).  To prevent rejection of the donor tissue, the process of immunosuppression can involve a deliberate induction with drugs to help in preparation for bone marrow or other organ transplantation. Some of the drugs administered during immunosuppression include corticosteroids, cyclosporine, FK506, azathioprine, and rapamycin. It also involves the use of irradiation to assist in depressing immune reactivity in recipients of bone marrow allotransplants or organ and the profound depression of immune’s response that affects individuals with certain diseases such as HIV. Immunosuppressant’s assists the new organ and the body to easily coexist.

After the process of immunosuppression, the immune system gets fooled into overlooking the organ that has been transplanted. In addition to that, potential harms to the body may also be overlooked by the immune system. This increases the risk of a person to infections and other diseases. The body becomes less resistant to infections when an immunosuppressant drug weakens the immune system (Rosenthal, & Moore, 2015).  Most drugs used during the process tend to decrease muscle function. Immunosuppression also increases the risk of malignancy and cardiovascular disease. The medications used during the process of immunosuppression can also increase the risk for fractures as they tend to decrease the bones’ density. The way the body manages the blood sugar is also altered. This increases the risk of high blood sugar and secondary diabetes.

Conclusion

Diverticulitis. This is the main cause of persistent pain on the lower left side of the abdomen. Inherited mutations can be passed on in families and are found in a person’s cells. Colon cancer is one of the most common inherited cancer syndromes. The genes that are involved in the development of this disease include MSH6, MSH2 and MLH1. Immunosuppression refers to the suppression of the body’s immune system and its ability to fight diseases and infections.

 

References

Axelrad, J. E., Lichtiger, S., & Yajnik, V. (2016). Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment. World journal of gastroenterology, 22(20), 4794.

Causes of Colorectal Cancer | Is Colon Cancer Hereditary? (n.d.). Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/what-causes.html

Feuerstein, J. D., & Falchuk, K. R. (2016, August). Diverticulosis and diverticulitis. In Mayo Clinic Proceedings (Vol. 91, No. 8, pp. 1094-1104). Elsevier.

Lockyer, S., Spiro, A., & Stanner, S. (2016). Dietary fibre and the prevention of chronic disease–should health professionals be doing more to raise awareness?. Nutrition Bulletin, 41(3), 214-231.

Rosenthal, M. D., & Moore, F. A. (2015). Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure. Journal of advanced nutritional and human metabolism, 1(1).

 

What’s Coming Up in Module 2?

In Module 2, you will analyze processes related to cardiovascular and respiratory disorders. To do this, you will analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 3 Knowledge Check: Cardiovascular and Respiratory Disorders

In the Week 3 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 2. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 2

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Module 1: Foundational Concepts of Cellular Pathophysiology

What’s Happening This Module?

This course is composed of eight (8) separate modules. Each module consists of an overarching topic and each week within the module includes specific subtopics for learning. As you work through each module, you will draw upon the knowledge you gain by completing various Knowledge Checks and Case Study Assignments.

Module 1: Foundational Concepts of Cellular Pathophysiology is a 2-week module, Weeks 1 and 2 of the course. In this module, you will examine fundamental concepts of cellular processes and the alterations that lead to various diseases. You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 1 and 2
Discussion: Alterations in Cellular Processes	Post by Day 3 of Week 1 and respond to your colleagues by Day 6 of Week 1.
Module 1 Assignment: Case Study Analysis	You are encouraged to work on your Module 1 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 2.

Go to the Week’s Content

 

Week 1

Week 2

 

Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Evaluate the impact of the genetic environment on disease

Learning Resources

Required Readings

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
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

 

Justiz-Vaillant, A. A., & Zito, P. M. (2019). 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

 

Required Media

 

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)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

 

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

 

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Discussion: Alterations in Cellular Processes

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.

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 colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. 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!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

 

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Sample Paper – Week 1 Discussion

NURS 6501 Week 1 Discussion – Alterations in Cellular Processes

Alterations in Cellular Processes

Student’s Name:

Institutional Affiliation:

Alterations in Cellular Processes

Considering that the patient was given naloxone in the field and became responsive and has a history of substance abuse, it can be concluded that he has been abusing opioids in large quantities. The patient could also be suffering from rhabdomyolysis. This is a syndrome that is caused by indirect or direct muscle injury. The condition develops when muscle fibers die, and their content gets released into the bloodstream. Traumatic and non-traumatic causes can cause the condition. In this case, the non-traumatic causes that could have led to rhabdomyolysis are substance abuse, which includes the use of illegal drugs and alcohol. The condition can also be caused by antipsychotics, especially when taken in large quantities (Nance & Mammen, 2015). For people who have been diagnosed with this condition, the serum and urine myoglobin levels usually are high. Genetics play a role in the development of this disease. The genetic conditions that normally predispose to this disease include channelopathies, muscular dystrophies, and metabolic myopathies (Nance, & Mammen, 2015).

The reason why the patient is experiencing the symptom of burning pain over his left hip and forearm is because of muscle injury that could have occurred in the substance abuse process leading to necrosis, as seen in the ED during the evaluation process (D’Arcy, 2019). The excessive abuse of opioids had caused the symptom of unresponsiveness.

The physiologic response in the scenario is that the patient becomes responsive after receiving naloxone. I think this response occurred because naloxone is a medication that helps in the reversal of opioid overdose. It helps bind opioid receptors, block, and reverse other opioid effects (Rzasa Lynn, & Galinkin, 2018). The medication can help restore respiration to a person whose breathing has been stopped or slowed due to overconsumption of heroin or prescription opioids. The cells that are involved in this process are the μ-opioid receptors. Another characteristic that would change the response is genetics. Some people have an opioid receptor gene with a single building block change that normally protects them against substance dependence. In contrast, the variations in genes for three dopamine receptors are associated with increased risk for opioid addiction (Chiasson-Downs, 2018).

 

References

Chiasson-Downs, K. (2018, April 24). Why genetics makes some people more vulnerable to opioid addiction – and protects others. Retrieved from https://theconversation.com/why-genetics-makes-some-people-more-vulnerable-to-opioid-addiction-and-protects-others-92000

D’Arcy, M. S. (2019). Cell death: a review of the major forms of apoptosis, necrosis and autophagy. Cell biology international, 43(6), 582-592.

Nance, J. R., & Mammen, A. L. (2015). Diagnostic evaluation of rhabdomyolysis. Muscle & nerve, 51(6), 793-810.

Rzasa Lynn, R., & Galinkin, J. L. (2018). Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic advances in drug safety, 9(1), 63-88.

 

 

What’s Coming Up in Week 2?

Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology.

Next Week

To go to the next week:

Week 2

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Advanced practice nurses must be equipped with an in-depth understanding of pathophysiological disease processes across the lifespan. In this course, students focus on understanding the bio-physiological processes, the deviations from these processes, and an in-depth examination of the scientific concepts related to the biology of disease processes. Advanced practice nursing students learn how normal organ systems function and how organ systems are interrelated to help the body maintain homeostasis.

Through knowledge of pathophysiological disease processes, students gain the information needed to develop appropriate treatment plans for patients across the life span. Students explore a variety of topics, such as immunity, inflammation, cancer genetics, and cardiovascular disease. They also examine a range of disease processes, including hematologic, renal, neurologic, gastrointestinal, and reproductive disorders.

Module 1: Foundational Concepts of Cellular Pathophysiology

What’s Happening This Module?

This course is composed of eight (8) separate modules. Each module consists of an overarching topic and each week within the module includes specific subtopics for learning. As you work through each module, you will draw upon the knowledge you gain by completing various Knowledge Checks and Case Study Assignments.

Module 1: Foundational Concepts of Cellular Pathophysiology is a 2-week module, Weeks 1 and 2 of the course. In this module, you will examine fundamental concepts of cellular processes and the alterations that lead to various diseases. You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 1 and 2
Discussion: Alterations in Cellular Processes	Post by Day 3 of Week 1 and respond to your colleagues by Day 6 of Week 1.
Module 1 Assignment: Case Study Analysis	You are encouraged to work on your Module 1 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 2.

Go to the Week’s Content

 

Week 1

Week 2

 

Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Evaluate the impact of the genetic environment on disease

Learning Resources

Required Readings

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
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

 

Justiz-Vaillant, A. A., & Zito, P. M. (2019). 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

 

Required Media

 

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)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

 

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

 

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Discussion: Alterations in Cellular Processes

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.

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 colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. 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!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

 

Sample Paper – Week 1 Discussion

NURS 6501 – Alterations in Cellular Processes

Alterations in Cellular Processes

Student’s Name:

Institutional Affiliation:

Alterations in Cellular Processes

Considering that the patient was given naloxone in the field and became responsive and has a history of substance abuse, it can be concluded that he has been abusing opioids in large quantities. The patient could also be suffering from rhabdomyolysis. This is a syndrome that is caused by indirect or direct muscle injury. The condition develops when muscle fibers die, and their content gets released into the bloodstream. Traumatic and non-traumatic causes can cause the condition. In this case, the non-traumatic causes that could have led to rhabdomyolysis are substance abuse, which includes the use of illegal drugs and alcohol. The condition can also be caused by antipsychotics, especially when taken in large quantities (Nance & Mammen, 2015). For people who have been diagnosed with this condition, the serum and urine myoglobin levels usually are high. Genetics play a role in the development of this disease. The genetic conditions that normally predispose to this disease include channelopathies, muscular dystrophies, and metabolic myopathies (Nance, & Mammen, 2015).

The reason why the patient is experiencing the symptom of burning pain over his left hip and forearm is because of muscle injury that could have occurred in the substance abuse process leading to necrosis, as seen in the ED during the evaluation process (D’Arcy, 2019). The excessive abuse of opioids had caused the symptom of unresponsiveness.

The physiologic response in the scenario is that the patient becomes responsive after receiving naloxone. I think this response occurred because naloxone is a medication that helps in the reversal of opioid overdose. It helps bind opioid receptors, block, and reverse other opioid effects (Rzasa Lynn, & Galinkin, 2018). The medication can help restore respiration to a person whose breathing has been stopped or slowed due to overconsumption of heroin or prescription opioids. The cells that are involved in this process are the μ-opioid receptors. Another characteristic that would change the response is genetics. Some people have an opioid receptor gene with a single building block change that normally protects them against substance dependence. In contrast, the variations in genes for three dopamine receptors are associated with increased risk for opioid addiction (Chiasson-Downs, 2018).

 

References

Chiasson-Downs, K. (2018, April 24). Why genetics makes some people more vulnerable to opioid addiction – and protects others. Retrieved from https://theconversation.com/why-genetics-makes-some-people-more-vulnerable-to-opioid-addiction-and-protects-others-92000

D’Arcy, M. S. (2019). Cell death: a review of the major forms of apoptosis, necrosis and autophagy. Cell biology international, 43(6), 582-592.

Nance, J. R., & Mammen, A. L. (2015). Diagnostic evaluation of rhabdomyolysis. Muscle & nerve, 51(6), 793-810.

Rzasa Lynn, R., & Galinkin, J. L. (2018). Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic advances in drug safety, 9(1), 63-88.

 

 

What’s Coming Up in Week 2?

Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology.

Next Week

To go to the next week:

Week 2

Week 2: Altered Physiology

With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.

This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Analyze alterations in the immune system that result in disease processes
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.

 

Justiz-Vaillant, A. A., & Zito, P. M. (2019). 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.
Note: This article was presented in the Week 1 resources. If you read it previously you are encouraged to review it this week.

 

 

Required Media

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology  | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

 

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly [LK1] (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.
• Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

To participate in this Assignment:

Module 1 Assignment

 

 

Sample Paper – Week 2 Assignment

NURS 6501 Week 2 Assignment – Altered Physiology

Altered Physiology

Student’s Name:

Institutional Affiliation:

Altered Physiology

One of the symptoms that the patient presented with is crampy left lower quadrant pain. The reason as to why the patient is presenting with this symptom is because of his history of diverticulitis. This is the main cause of persistent pain on the lower left side of the abdomen. Diverticulitis can also cause constipation and high fever (Feuerstein, & Falchuk, 2016). The symptom of constipation, in this case, is also being caused by his diet that lacks fiber. Foods with a low level of fiber take more time to digest, lose stools, irregular bowel movements, and cause a person to experience stomach pain. Eating food rich in fiber also prevents a person from being obese (Lockyer, Spiro, & Stanner, 2016).

The Genes that may be Associated with the Development of the Disease

Considering that the patient’s grandfather died of colon cancer back in the 1950s, it is evident that the disease is being genetically transferred since the patient tested positive for adenocarcinoma of the colon. Inherited mutations can be passed on in families and are found in a person’s cells. Colon cancer is one of the most common inherited cancer syndromes. Changes in the DNA inside our cells cause the development of cancer. DNA refers to the chemical in our cells that make up our genes and usually control our cells’ functioning. The genes that are involved in the development of this disease include MSH6 and MSH2 both on chromosome 2 and MLH1 on chromosome 3 (“Causes of Colorectal Cancer | Is Colon Cancer Hereditary?,” n.d.)   .Mistakes made in DNA replication are repaired by the protein products of these genes.  The mutation of these genes causes the proteins not to work as required, and hence the mistakes made in DNA replication end up not being repaired. As a result, the DNA gets damaged, which leads to the development of colon cancer.

Process of Immunosuppression and the Effect it has on Body Systems

This refers to the suppression of the body’s immune system and its ability to fight diseases and infections. The suppression may result from diseases that affect the immune system or the impact of pharmaceutical agents that fight certain conditions such as cancer (Axelrad, Lichtiger, & Yajnik, 2016).  To prevent rejection of the donor tissue, the process of immunosuppression can involve a deliberate induction with drugs to help in preparation for bone marrow or other organ transplantation. Some of the drugs administered during immunosuppression include corticosteroids, cyclosporine, FK506, azathioprine, and rapamycin. It also involves the use of irradiation to assist in depressing immune reactivity in recipients of bone marrow allotransplants or organ and the profound depression of immune’s response that affects individuals with certain diseases such as HIV. Immunosuppressant’s assists the new organ and the body to easily coexist.

After the process of immunosuppression, the immune system gets fooled into overlooking the organ that has been transplanted. In addition to that, potential harms to the body may also be overlooked by the immune system. This increases the risk of a person to infections and other diseases. The body becomes less resistant to infections when an immunosuppressant drug weakens the immune system (Rosenthal, & Moore, 2015).  Most drugs used during the process tend to decrease muscle function. Immunosuppression also increases the risk of malignancy and cardiovascular disease. The medications used during the process of immunosuppression can also increase the risk for fractures as they tend to decrease the bones’ density. The way the body manages the blood sugar is also altered. This increases the risk of high blood sugar and secondary diabetes.

Conclusion

Diverticulitis. This is the main cause of persistent pain on the lower left side of the abdomen. Inherited mutations can be passed on in families and are found in a person’s cells. Colon cancer is one of the most common inherited cancer syndromes. The genes that are involved in the development of this disease include MSH6, MSH2 and MLH1. Immunosuppression refers to the suppression of the body’s immune system and its ability to fight diseases and infections.

 

References

Axelrad, J. E., Lichtiger, S., & Yajnik, V. (2016). Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment. World journal of gastroenterology, 22(20), 4794.

Causes of Colorectal Cancer | Is Colon Cancer Hereditary? (n.d.). Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/what-causes.html

Feuerstein, J. D., & Falchuk, K. R. (2016, August). Diverticulosis and diverticulitis. In Mayo Clinic Proceedings (Vol. 91, No. 8, pp. 1094-1104). Elsevier.

Lockyer, S., Spiro, A., & Stanner, S. (2016). Dietary fibre and the prevention of chronic disease–should health professionals be doing more to raise awareness?. Nutrition Bulletin, 41(3), 214-231.

Rosenthal, M. D., & Moore, F. A. (2015). Persistent inflammatory, immunosuppressed, catabolic syndrome (PICS): A new phenotype of multiple organ failure. Journal of advanced nutritional and human metabolism, 1(1).

 

What’s Coming Up in Module 2?

In Module 2, you will analyze processes related to cardiovascular and respiratory disorders. To do this, you will analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 3 Knowledge Check: Cardiovascular and Respiratory Disorders

In the Week 3 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 2. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 2

 

 

 

Module 2: Cardiovascular and Respiratory Disorders

What’s Happening This Module?

Module 2: Cardiovascular and Respiratory Disorders is a 2-week module, Weeks 3 and 4 of the course. In this module, you will examine fundamental concepts of cellular processes and the alterations that lead to various cardiovascular and respiratory diseases and disorders. You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 3 and 4
Knowledge Check: Cardiovascular and Respiratory Disorders	Complete by Day 7 of Week 3
Module 2 Case Study Analysis	You are encouraged to work on your Module 2 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 4.

Go to the Week’s Content

 

Week 3

Week 4

 

Week 3: Concepts of Cardiovascular and Respiratory Disorders

The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.

Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.

This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
• Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
• Chapter 35: Structure and Function of the Pulmonary System; Summary Review
• Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery  hypertension); Summary Review

 

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Required Media

 

Module 2 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 2 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 Knowledge Check and Assignment. (4m)

Pneumonia

MedCram. (2015, September 14). Pneumonia explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo

Note: The approximate length of the media program is 13 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Cardiovascular and Respiratory Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • myocardial infarction
  • endocarditis
  • myocarditis
  • valvular disorders
  • lipid panels
  • coagulation
  • clotting cascade
  • deep vein thrombosis
  • hypertension
  • heart failure
  • COPD
  • asthma
  • pneumonias

Complete the Knowledge Check by Day 7 of Week 3

To complete this Knowledge Check:

Module 2 Knowledge Check

 

What’s Coming Up in Week 4?

Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology.

Next Week

To go to the next week:

Week 4

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Analyze processes related to cardiovascular and respiratory disorders
• Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
• Analyze racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
• Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
• Chapter 35: Structure and Function of the Pulmonary System; Summary Review
• Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.

 

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Note: The above article was first presented in the Week 3 resources. If you read it previously you are encouraged to review it this week.

Required Media

Pneumonia

MedCram. (2015, September 14). Pneumonia explained clearly by MedCram [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo

Note: The approximate length of the media program is 13 minutes.
(Previously reviewed in Week 3)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

Scenario 4 (week 4):

45-year-old woman presents with the chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. The patient has a history of COPD with a chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals a flattened diaphragm and an increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

 

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.

Any racial/ethnic variables that may impact physiological functioning.

How these processes interact to affect the patient.

By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

In your Case Study Analysis related to the scenario provided, explain the following

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M2Assgn+last name+first initial.(extension)” as the name.
• Click the Module 2 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M2Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Module 2 Assignment

 

 

 

 

Week 4 Case Study Sample Paper

NURS 6501 Week 4 Case Study

Case Study Analysis

Student’s Name:

Department, University:

Number and Name of Course:

Instructors Name, Title:

Date:

Case Study Analysis

Congestive heart failure (CHF), often termed simply as heart failure, refers to a progressive and chronic condition affecting the heart muscles pumping power. It specifically involves the stage in which there is buildup of fluids in the heart, which results in inefficient pumping (Hajar, 2019). This paper will analyze a CHF patient and present the cardiovascular and cardiopulmonary pathophysiologic processes causing her symptoms, the effect of ethnicity and racial variables and the interaction of processes affecting the patient.

Cardiovascular and Cardiopulmonary Pathophysiologic Processes

CHF often manifests in patients as fatigue, swollen legs, ankles or abdomen, gaining weight, and breath shortness when exercising or lying flat. Diuretics are the mainstay pharmacological therapy which reduces preload in patient with CHF. However, the patient in the case admits to not taking her diuretics. The diuretic medications inhibit water reabsorption from the tubules which consequently increases the volume and loss of water in the urine (McCance, & Huether, 2019). The patient admits that she stopped taking her diuretics as they made her get up every few hours to go to the bathroom. The main cause of the symptoms presented by the patient involves reduction in the hearts muscular efficiency which has occurred due to damage. Systole dysfunction results in stroke volume decreases where reductions in the heart muscles contractility enhances end systolic volume. The hearts contractility is lost due to reduced abilities of the fibers myosin and actin cross-linking during the hearts relaxation and contractions.

Ethnic or Racial Variables

Compared to other races or ethnic groups, African Americans have higher chances of heart failure incidences together with increased risks of mortalities caused by CHF compared to white populations (Tillman et al., 2019). Nearly 50% of all African American adults bear some kind of CVD with hypertension being the main etiological factor that contributes to such trends. The pathophysiology of hypertension in this population group is associated with relatively low renin activities, sodium sensitivities and possibly reduced production of nitric oxide. Other risk factors are higher burdens of diabetes and kidney diseases, genetics, socioeconomic health determinants, limited care access, together with lack of compliance to medications (CDC, 2016).

Interaction of processes

Various structural and functional changes occur in the heart of patients with CHF which interact to give rise to the disease condition. Compensatory increases in blood volume occur with the aim of increasing ventricular preloads and therefore enhancing stroke volumes.  Reductions in renal perfusions also occur and lead to reduced urine retention and output. Aorta baroreceptors and stretch receptors are also stimulated by decreases in blood pressure which the results in stimulation of the sympathetic nervous system. Decreases in flow of blood to the kidney leads to release of angiotensin and renin with retention of fluids and sodium by the kidneys occurring when the condition persists and this consequently increases volumes in circulation.

Conclusion

CHF affects the pumping power of heart muscles and manifests in various symptoms presented by the patient in the case. Diuretics are used in treating the condition and lack of adherence can lead to increased heart damage. African Americans are disproportionately affected by heart failure with hypertension or high blood pressure being the major etiological contributing factor. The disease condition arises due to interaction of changes in the functioning and structure of the heart.

References

Centers for Disease Control and Prevention (2016). Public health action plan to prevent heart disease and stroke. http://www.cdc.gov/dhdsp/action_plan

Hajar, R. (2019). Congestive Heart Failure: A History. Heart Views, 20(3), 129–132.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Tillman, F., Kim, J., Makhlouf, T., & Osae, L. (2019). A comprehensive review of chronic heart failure pharmacotherapy treatment approaches in African Americans. Therapeutic advances in cardiovascular disease, 13, 1753944719840192.

 

What’s Coming Up in Module 3?

In Module 3, you will analyze processes related to gastrointestinal and hepatobiliary disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In Week 5 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 3. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 3

 

 

Module 3: Gastrointestinal and Hepatobiliary Disorders

What’s Happening This Module?

Module 3: Gastrointestinal and Hepatobiliary Disorders is a 1-week module, Week 5 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact gastrointestinal and hepatobiliary systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 5
Knowledge Check: Gastrointestinal and Hepatobiliary Disorders	Complete by Day 7 of Week 5

Go to the Week’s Content

 

Week 5

Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders

Patients of gastrointestinal and hepatobiliary disorders often face life-altering changes, including changes to diet, new treatment regimens, and more. For some disorders, treatments can include surgery.

Gastrointestinal conditions, such as ulcers, diverticulitis, and pancreatitis, often cause varying levels of pain and discomfort. Hepatobiliary conditions can also bring significant changes to patient routines and well-being.

This week, you examine fundamental concepts of gastrointestinal and hepatobiliary disorders. You explore common disorders in these categories, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the life span

Learning Resources

Required Readings

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 38: Structure and Function of the Renal and Urological Systems including Summary Review
• Chapter 39: Alteration of Renal and Urinary Function (stop at Fluids and electrolytes); Summary Review
• Chapter 41: Structure and Function of the Digestive System (stop at Tests of digestive function); Summary Review
• Chapter 42: Alterations of Digestive Function (stop at Cancer of the digestive track); Summary Review

 

Osna, N. A., Donohue, T. M., Jr., & Kharbanda, K. K. (2017). Alcoholic liver disease: Pathogenesis and current management. Alcohol Research: Current Reviews, 38(2), 7–21

 

 

Document: NURS 6501 Midterm Exam Review (PDF document)

Note: Use this document to help you as you review for your Midterm Exam in Week 6.

 

Required Media

 

Module 3 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 3 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 Knowledge Check. (2m)

Liver Function Tests

MedCram. (2013, April 14). Liver function tests LFTs explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=bFdTgty0T0I

Note: The approximate length of the media program is 11 minutes.

Liver Diseases

MedCram. (2019, May 15). Diagnosis of key liver diseases: Hepatitis A, B C vs. alcoholic vs. ischemic (AST vs ALT labs) [Video file]. Retrieved from https://www.youtube.com/watch?v=ZZRHA2JvCGA

Note: The approximate length of the media program is 13 minutes.

Liver Pathophysiology

MedCram. (2013, April 9). Liver explained clearly: Pathophysiology, LFTs, hepatic diseases  [Video file]. Retrieved from https://www.youtube.com/watch?v=BTGkB8nOu7g

Note: The approximate length of the media program is 14 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 41 and 42 that relate to the hepatobiliary system. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Ulcers
  • Hepatitis markers
  • After HP shots
  • Gastroesophageal Reflux Disease
  • Pancreatitis
  • Liver failure—acute and chronic
  • Gall bladder disease
  • Inflammatory bowel disease
  • Diverticulitis
  • Jaundice
  • Bilirubin
  • Gastrointestinal bleed – upper and lower
  • Hepatic encephalopathy
  • Intra-abdominal infections (e.g., appendicitis)
  • Renal blood flow
  • Glomerular filtration rate
  • Kidney stones
  • Infections – urinary tract infections, pyelonephritis
  • Acute kidney injury
  • Renal failure – acute and chronic

Complete the Knowledge Check By Day 7 of Week 5

To complete this Knowledge Check:

Module 3 Knowledge Check

 

 

 

 

 

Sample Paper – Week 5 Knowledge Check

NURS 6501 Module 3 Knowledge Check

 

 

 

Check Knowledge Scenarios

Student Name:

Institutional Affiliation:

Check Knowledge Scenarios

Scenario 1 Peptic Ulcer Disease

Question 1

The patients have been using ibuprofen, which is categorized as inflammatory drugs. This drug is the most cause of peptic ulcers. The patient was also reported to have been smoking tobacco, excessive caffeine, drinking alcohol, and psychological stress on managing his families. All these factors may have led to the development of peptic ulcer disease.

Question 2

Ibuprofen drugs contribute to peptic ulcer development by interfering with the patient’s stomach ability to protect itself from gastric acid corrosion. Tobacco smoking destroys gastroduodenal mucosa risking the stomach to PUD, while ethanol in alcohol led to gastric irritation, which may risk the patient to get ulcers (Lanas & Chan, 2019). Caffeine also causes the production of acid in the body, which is a direct cause of PUD.

Scenario 2 Gastroesophageal Reflux Disease (GERD)

GERD is mainly caused by frequent acid reflux. This involves the backwash of stomach acids to the esophageal, causing burning pain (Clarret & Hachem, 2018). His action, such as smoking, can aggravate this problem of frequent acid reflux acid. It can also be facilitated by excessive drinking of certain beverages such as alcohol and coffee. Other factors that risk the people getting GERD is obesity, problem or disorder of connective tissues, etc.

 

Scenario 3 Upper GI Bleed

GI is a problem that occurs in the digestive tract. Upper GI happens in the esophagus, stomach, or beginning of small interest (Steele, 2020). This problem can range from excessive bleeding, which is life-threatening, to a minor, which can only be identified through conducting the patient stool test. The main cause associated with this disease is peptic ulcers; these are open sores in the intestine lining. It can also be caused by the tearing of veins located in the esophagus, which can result in bleeding. Another factor that can contribute to this problem is the enlargement of veins in the esophagus abnormally, but this is common for liver disease people. Esophagitis is another factor that involves inflammation of the esophagus, and it is the most contributors to this problem.

Scenario 4 Diverticulitis

This problem results from pressure build-up due to a lack of enough fiber diet, which finally leads to constipation. The process repeats continuously while the patient develops pressure and staining, which finally causes diverticulosis (Young-Fadok, 2018). Due to this pressure, the colon gives up the weak pint and gives way causing a protruding marble size pouches in the colon, resulting in diverticula. Finally, this diverticula tend to break, leading to inflammation (diverticulitis) or in some worse case to other infections.

Scenario 5 Portal Hypertension

Cirrhosis is a liver disease that results from excessive drinking of alcohol. The patient has developed portal hypertension, which is associated with cirrhosis. This occurs because, in the body, there is a large vessel that transports blood to the liver, knows as portal vein (Arab, Barrera & Arrese, 2017). When a person develops cirrhosis, it slows the blood flow and subjects the portal vein to stress. Because the heart continues pumping blood, this slow movement of blood in the liver causes high blood pressure, resulting in portal hypertension.

Scenario 5 part 2: Ascites

Ascites is the abnormal accumulation of fluid within the peritoneal cavity. This is caused by conditions such as portal hypotension. This problem involves enlarging the blood vessels to create room for the high blood pressure resulting from liver cirrhosis (Arab, Barrera & Arrese, 2017). The high pressure in the portal veins causes leakage of protein fluid to the surface of various organs such as the liver, intestine, and this protein-containing fluid tends to accumulate within the patient’s abdomen. This creates the problem of Ascites, which is presented by the described symptoms.

Scenario 6: Hepatic Encephalopathy (HE)

Hepatic encephalopathy can be referred to as reduced brain function, which the main cause is liver disease. In this case of a patient having liver cirrhosis, it will reduce or stop the liver’s functioning, leading to a build-up of toxins in the patient’s bloodstream (Ferenci, 2017). In this condition, the liver is not able to filter toxins from the body so that it can be removed. When the liver is damaged, it cannot perform its function properly, making the toxin to be circulated throughout the body. Continuous build-up of these toxins in the patient’s disease tends to damage the brain, and this is reflected by the patient been confused due to brain disorientation and flapping his hand.

 

 

Scenario 7: Sudden onset of Abdominal Pain

The most likely problem associated with these symptoms may be gastrointestinal or stomach ulcers. This may lead to the abdominal sudden onset of pain. If this problem is not treated earlier, it can bring other problems such as heart attacks, patient vomiting bloody due to internal bleed from the stomach sores. It can disrupt heart operation as blood pressure is affected. The continuous manifestation of these symptoms may lead to deadly stages, such as when a patient starts experiencing a heart attack or abnormal heartbeat.

Scenario 8: Acute Cholecystitis

Question 1

Gallstones are a hard deposit of bile, which are formed in the gallbladder. They can be referred to as parts of a solid component forming in the gallbladder. Gallstones are formed if the bile contains too much bilirubin, excessive cholesterol, or inadequate bile salt (Ibrahim et al.,2018). It develops when there is too much cholesterol or bilirubin, which tends to crystalize and finally form gallstones. The result can also be seen when the gallbladder cannot perform its function properly, making it unable to empty well. Bile can solidify and form a solid substance that can block the bile passage from the liver.

Because of these gallstones’ formation, the patient gall bladder enlarged to create room for the new substances formed; stones are seen in the patient bile duct was resulted from solidified excessive cholesterol or hardened bile forming stones which disruption the bile transportation (Ibrahim et al., 2018). Theses gallstone’s presence was the main reason for dilated common duct as it tries to be more elastic to house the bile produced and the blocking stones formed.

Question 2

The patient becomes jaundiced when there was excess production of bilirubin in his body. The bilirubin is located in the red blood cells, and when its cells die, they are filtered from the body by the liver. Because the patient developed jaundice, this means her life stop carrying its function well, leading to the accumulation of bilirubin in the patient’s body, which made her skin look yellow—therefore making the patient jaundiced.

Scenario 9: Pancreatitis

Pancreatitis is a condition that develops when the patient’s digestive enzymes become functional or activated before leaving the pancreas. This will, in turn, result in irritating the pancreas cells and finally make it enlarge because of inflammation (Kleeff et al., 2017). Therefore, the activated digestive enzyme creates an unconducive environment for the pancreas cell to function, making them swell, leading to this condition of pancreatitis. When this process continues, it can go further and lead to chronic pancreatitis. In this scenario, because the patient has a history of alcoholism for a long time, it could have played a big role in her problem. This is because the pancreas’ acinar cell metabolizes ethanol into harmful byproducts, which damages bile ducts. After this, the bile can no longer transport enzymes anymore, and they tend to build up in the digestive tract, and if this continues, it starts digesting the pancreas. The damaged tissue led to inflammation of the entire pancreas, resulting in further damage leading to pancreatitis. Therefore, Ruth’s drinking behavior leads to her development of this pancreas problem.

Scenario 10: Hepatitis B

The symptoms given by the patient are a clear indicator of hepatitis B.  These symptoms include; nausea and vomiting, abdominal pain, loss of appetite, fatigue, and dark urine. Following the patient history and combining with the symptoms he is reporting automatically show he has hepatitis B. This is because of his history behavior, such as engaging in sexual activities and sharing needles, are the main cause of this disease (Terrault et al., 2018).

Scenario 11: Ulcerative Colitis (UC)

The problem of ulcerative colitis is commonly associated with the malfunction of the immune system. This happens when the body’s immune system tries to defend the body from a certain virus or disease (Xu et al., 2019). The body responds by producing an abnormal response that attacks the digestive tract cells instead of fighting the virus or other problem. This, in turn, results in inflammation and ulcers in the patient digestive tract, which affects the inner part of the colon and rectum.

Scenario 12: Acute Kidney Injury

The patient is suffering from a postrenal type of acute kidney injury. This type involves nephropathy obstruction, which is causing the patient urine flow restriction (Mehran, Dangas & Weisbrod, 2019). It is diagnosed following the symptoms and cause given by the patient and the lab result. For example, it is associated with other diseases such as congenital defects and other swelling symptoms in the lower extremities. These symptoms were the main factor that leads the CXR to diagnose the patient for this kind of kidney injury.

Scenario 13: Glomerular filtration rate (GFR)

The most important concept which the APRN should address when dealing with the student about the glomerular filtration rate is the function of each part of the component involved. This is because it will help stress how this rate is checked and how any disruption from normal can be detected (Bersie et al., 2020). The APRN should also stress on how the students can estimate the amount of blood passing at glomeruli at a given time. The normal GFR should be communication and all the problem or disorder which may be associated with GFR. By doing so, the students will understand how this rate is achieved and know the factor that can affect the normalcy.

Scenario 14: Autoregulation

APRN should start by giving the student the overall meaning concept of autoregulation. Another concept would involve how the body can regulate local blood. The factors and hormones involved. The relationship between blood flow and blood flow regulation and how blood pressure can cater to body function (Wang, Ortega-Gutierrez & Peterson, 2018). The concept of how various blood pressures may make the blood run fast and how one can deal with to ensure blood flow in the body is stable and effective.

Scenario 15: Hormonal Regulation

The APRN should address how hormones regulations take place in the body. He should bring out the concept of how this process occurs and all the components required (Bersie et al., 2020). This will involve addressing both the negative and positive feedback mechanisms used by the body to achieve this regulation. In this concept, he will also mention how the thyroid system contributes to promoting hormone regulations. Organs that are responsible for producing these hormones should be covered in this concept.

Scenario 16: Pyelonephritis

Pyelonephritis can be referred to as the inflammation of the kidney because of infection from bacteria. Urinal calculi calculus may lead to urine obstruction, and this can result in acute pyelonephritis (Johnson & Russo, 2018). When urinal calculi occur, the urine accumulates, leading to the multiplication of bacteria as the body cannot flash all the urine out. These bacteria may attack the kidney, and the damaged part may lead to inflammation of the whole kidney. Whenever the kidney stone is formed in the urinary tract, the outflow of urine is not possible, and the bacteria collected in other body parts may be accumulated here, and upon their accumulation, they lead to pyelonephritis.

Scenario 17: Chronic Renal Failure

Diabetes and hypertension are among the primary cause of chronic renal failure. When a person is suffering from hypertension or diabetes, high blood sugar, or high pressure resulting from hypertension, they can damage the kidney’s blood vessels, hence interfering with its function (Mehran, Dangas & Weisbrod, 2019. When this damage occurs, the kidney may fail to perform its function leading to kidney failure. If such damage kidney continues for a long time, it tends to impair it, leading to the development of chronic renal failure.

 

References

Arab, J. P., Barrera, F., & Arrese, M. (2017). Bile acids and portal hypertension. Annals of hepatology, 16, Ferenci, P. (2017). Hepatic encephalopathy. Gastroenterology report, 5(2), 138-147.S83-S86

Bersie‑Larson, L. M., Gyoneva, L., Goodman, D. J., Dorfman, K. D., Segal, Y., & Barocas, V. H. (2020). Glomerular filtration and podocyte tensional homeostasis: importance of the minor type IV collagen network. Biomechanics and Modeling in Mechanobiology.

Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal Reflux Disease (GERD). Missouri medicine, 115(3), 214.

Ibrahim, M., Sarvepalli, S., Morris-Stiff, G., Rizk, M., Bhatt, A., Walsh, R. M., … & Burke, C. A. (2018). Gallstones: Watch and wait or intervene. Cleve Clin J Med, 85(4), 323-331.

Johnson, J. R., & Russo, T. A. (2018). Acute pyelonephritis in adults. New England Journal of Medicine, 378(1), 48-59.

Kleeff, J., Whitcomb, D. C., Shimosegawa, T., Esposito, I., Lerch, M. M., Gress, T., … & Muñoz, J. E. D. (2017). Chronic pancreatitis. Nature reviews Disease primers, 3(1), 1-18.

Lanas, A., & Chan, F. K. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613-624.

Mehran, R., Dangas, G. D., & Weisbord, S. D. (2019). Contrast-associated acute kidney injury. New England Journal of Medicine, 380(22), 2146-2155.

Steele, C. (2020). Upper GI Bleed. In Resources for Optimal Care of Emergency Surgery (pp. 137-137). Springer, Cham.

Terrault, N. A., Lok, A. S., McMahon, B. J., Chang, K. M., Hwang, J. P., Jonas, M. M., … & Wong, J. B. (2018). Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology, 67(4), 1560-1599.

Wang, A., Ortega-Gutierrez, S., & Petersen, N. H. (2018). Autoregulation in the Neuro ICU. Current treatment options in neurology, 20(6), 20.

Xu, X., Yang, W., Liang, Q., Shi, Y., Zhang, W., Wang, X., … & Yin, L. (2019). Efficient and targeted drug/siRNA co-delivery mediated by reversibly crosslinked polymersomes toward the anti-inflammatory treatment of ulcerative colitis (UC). Nano Research, 12(3), 659-667.

Young-Fadok, T. M. (2018). Diverticulitis. New England Journal of Medicine, 379(17), 1635-1642.

 

 

What’s Coming Up in Module 4?

In Module 4, you will analyze processes related to endocrine disorders. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact physiological functioning and altered physiology.

Week 6 Knowledge Check: Endocrine Disorders

In the Week 6 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 4. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Also, during this week you will take your Midterm Exam. Please make sure to finalize and complete your Knowledge Check prior to completing your exam.

Next Module

To go to the next Module:

Module 4

 

 

Module 4: Endocrine Disorders

What’s Happening This Module?

Module 4: Endocrine Disorders is a 1-week module, Week 6 of the course. In this module you will examine fundamental concepts of diseases and disorders that impact endocrine systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 6
Knowledge Check: Endocrine Disorders	Complete by Day 5 of Week 6
Midterm Exam	Complete by Day 7 of Week 6

 

Go to the Week’s Content

 

Week 6

Week 6: Concepts of Endocrine Disorders

Endocrine disorders are complex matters, and there is not always a one-size-fits-all treatment. Particularly in matters requiring the adjustment of hormone levels, treatment may require a custom approach tailored to individual patients. An understanding of these complications is essential to supporting these individual treatment plans.

This week, you examine alterations in the endocrine system and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 21: Mechanisms of Hormonal Regulation, including Summary Review
• Chapter 22: Alterations of Hormonal Regulation, including Summary Review
• Chapter 23: Obesity and Disorders of Nutrition, including Summary Review

American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33

Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393-overview

Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349

Document: NURS 6501 Midterm Exam Review (PDF document)

Note: Use this document to help you as you review for your Midterm Exam in Week 6.

 

Required Media

Module 4 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 4 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 Knowledge Check and your Midterm. (3m)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 21 through 23 related to the endocrine system and disorders. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Optional Resources

The following source provides various tutorials related to maximizing your time management and managing stress. Feel free to access this resource to support you as you move through this course.

Walden University. (2019). ASC success strategies interactive tutorials. Retrieved from https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies

Knowledge Check: Endocrine Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Diabetes
  • Hyper- and hypothyroidism
  • Adrenal disorders
  • Parathyroidism (hyper and hypo)
  • Checks & balances / negative feedback
  • Syndrome of Inappropriate Antidiuretic Hormone
  • Pheochromocytosis
  • Diabetes insipidus
  • Diabetic ketoacidosis

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm Exam.)

Complete the Knowledge Check By Day 5 of Week 6

 

To complete this Knowledge Check:

Module 4 Knowledge Check

 

Midterm Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm exam.)

To prepare:

To help you review for your midterm exam, access the Midterm Exam Review document found in this week’s Learning Resources as well as any Knowledge Check feedback you might have received. (Note: You will also need to review all of your materials from each of these weeks to also help you better prepare for your midterm.)

By Day 7 of Week 6

Submit your Midterm Exam.

To complete your exam:

Midterm Exam

 

What’s Coming Up in Module 5?

In Module 5, you will analyze processes related to neurological and musculoskeletal disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

In the Week 7 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 5. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

 

To go to the next Module:

Module 5

Module 5: Neurological and Musculoskeletal Disorders

What’s Happening This Module?

Module 5: Neurological and Musculoskeletal Disorders is a 2-week module, Weeks 7 and 8 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact neurological and musculoskeletal systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Weeks 7 and 8
Knowledge Check: Neurological and Musculoskeletal Disorders	Submit your Assignment by Day 7
Module 5 Assignment: Case Study Analysis	You are encouraged to work on your Module 5 Assignment throughout the module. However, this Assignment is not due until Day 7 of Week 8.

Go to the Week’s Content

Week 7

Week 8

Week 7: Concepts of Neurological and Musculoskeletal Disorders – Part 1

Anatomists often use the analogy of a house to explain the human body, with skeletal systems, respiratory systems, and circulatory systems represented as a home’s framing structure, ventilation, and piping, respectively. Such analogies further emphasize the point that relationships between systems can result in complications when issues arise in one system.

With hundreds of diseases that can impact the brain, spine, and nerves, neurological disorders represent a complicated array of issues that present significant health concerns. Disorders such as strokes and Parkinson’s disease not only affect the nervous system, however; they can have secondary impacts in other areas, especially the musculoskeletal system.

This week, you examine fundamental concepts of neurological disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 15: Structure and Function of the Neurologic System
• Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
• Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
• Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
• Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
• Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
• Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

 

Required Media

Module 5 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 5 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 Knowledge Check and your Assignment. (3m)

 

Khan Academy. (2019b). Ischemic stroke . Retrieved from https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

 

Osmosis.org. (2019, June 12). Osteoporosis  – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Neurological and Musculoskeletal Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Stroke
  • Multiple sclerosis
  • Transient Ischemic Attack
  • Myasthenia gravis
  • Headache
  • Seizure disorders
  • Head injury
  • Spinal cord injury
  • Inflammatory diseases of the musculoskeletal system
  • Osteoporosis
  • Osteopenia
  • Bursitis
  • Tendinitis
  • Gout
  • Lyme Disease
  • Spondylosis
  • Fractures
  • Parkinson’s
  • Alzheimer’s

Three basic bone-formations:

• • Osteoblasts
  • Osteocytes
  • Osteoclasts

Complete the Knowledge Check By Day 7 of Week 7

 

To complete this Knowledge Check:

Module 5 Knowledge Check

 

Next Week

 

To go to the next week:

Week 8

 

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.

This week, you continue to examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

 

Learning Objectives

Students will:

• Analyze processes related to neurological and musculoskeletal disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here.

 

Required Readings

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 15: Structure and Function of the Cardiovascular and Lymphatic Systems (stop at Aging and the nervous system)
• Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
• o   Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function; pp. 504–511, pp. 516–530 (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
• Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
• Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
• Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

 

 

Required Media

Khan Academy. (2019b). Ischemic stroke. Retrieved from ttps://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

 

Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and the sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

 

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored in the diagnosis, and you explain the implications to patient health.

 

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

 

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

 

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

Any racial/ethnic variables that may impact physiological functioning.

How these processes interact to affect the patient.

 

Week 8 Case Study:

A 67-year-old man presents to the HCP with a chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair. Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill-rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement. The patient states that he has episodes of extreme sweating and flushing not associated with the activity. Laboratory data unremarkable and the HCP has diagnosed the patient with Parkinson’s Disease.

In your Case Study Analysis related to the scenario provided, explain the following:

• Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.

Day 7 of Week 8

Submit your Case Study Analysis Assignment by Day 7 of Week 8.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

 

 

Sample Paper – Week 8 Case Study Analysis

NURS 6501 Week 8 Assignment – Case Study Analysis

Module 5 Assignment: Case Study Analysis NURS 6501 Week 8

Student’s Name:

Institutional Affiliation:

 

Module 5 Assignment

Individuals with Parkinson’s disease exhibit musculoskeletal conditions that occur because of the discrepancy between the exterior load and the human body’s ability to fight biomechanical and physiological strain. When the body experiences an excessive force, this can generate diverse pathophysiological developments which depend on the affected tissues. The role of this paper will be to highlight a case study and indicate the neurological and musculoskeletal conditions that can make the patient exhibit such symptoms. Further, the paper will highlight the racial variables that can hinder the physiological functioning of the individual. Lastly, the paper will indicate how all these factors interact to affect the patient. When individuals present musculoskeletal conditions, they exhibit different symptoms depending on how far the physiological developments have progressed.

Case Study

A 67-year-old man goes to his HCP after experiencing symptoms that point to Parkinson’s disease. The symptoms include tremors in the arms and legs. After analysis, the patient also exhibits a “pill-rolling” movement, and he also exhibits jerky or cog wheeling movement. The patient also exhibits an uneven gait, and he shuffles when he walks with his head or neck hips and knees flexed forward.

Neurological and Musculoskeletal Pathophysiological Processes

Parkinson’s disease, also known as “atypical Parkinson’s” or “Parkinson’s syndrome,” is a disorder where the patient displays some of the signs related with Parkinson’s disease include tremor, rigidity, bradykinesia, and postural instability. According to DeMaagd and Philip (2015), the disease arises because of the damage of numerous transmitters, which in most cases, is dopamine. The signs of the disease deteriorate with time because more cells become affected by the disease become lost. The disease always affects the nerve cells in the brain that are responsible for movement. The primary function of dopamine is to convey chemical messages from one nerve cell to a different one through a synapse, which is the space between the presynaptic cell and the postsynaptic receptor. When the dopamine-producing cells die, symptoms such as tremors, stiffness, and balancing problems are exhibited in the patient.

Racial and Ethnic Variables Impacting Physiological Functioning

Parkinson’s disease (PD) affects individuals of all races and ethnicity across the globe. Parkinson’s disease’s origin is thought to be multifactorial as such caused by a continuum of factors such as genetics and environmental factors. As such, Sauerbier et al. (2018) believe that sociocultural and geographical differences can impact nutrition and environmental issues between diverse societies. Therefore, it is not uncommon to have a varying prevalence of Parkinson’s disease between the different ethnicities worldwide. However, the relationship between Parkinson’s disease and race remain controversial, with studies suggesting that African-Americans are less likely to have Parkinson’s disease than their white counterparts (Dahodwala et al., 2009). A study conducted to investigate the prevalence of PD indicated that it was lower in Asian countries than in North America (Sauerbier et al., 2018). However, most studies agree that the prevalence of PD increases with age, irrespective of ethnic and geographical background.

Interaction of Processes to Affect Patient

Certainly, the Parkinson’s disease arises because of a confluence of myriad factors that can range from racial and ethnic variables to the individual’s neurological and musculoskeletal processes. In this case, all these processes such as environmental issues arising from the ethnicity of the individual and the neurological and musculoskeletal process, like damage of neural transmitters, might have interacted to make the 67-year-old-man depict symptoms of Parkinson’s disease such as slowed movement, stiffness, and pill-rolling movement.

Conclusion

The above analysis has highlighted the processes that characterize Parkinson’s disease. Further, the paper has indicated that race does not significantly influence the probability of an individual contracting the disease. However, race can affect an individual’s knowledge of the disease to diagnosis and, finally, treatment of the affected individuals.

 

References

Dahodwala, N., Siderowf, A., Xie, M., Noll, E., Stern, M., & Mandell, D. (2009). Racial differences in the diagnosis of Parkinson’s disease. Movement Disorders, 24(8), 1200-1205. https://doi.org/10.1002/mds.22557

DeMaagd, G., & Philip, A. (2015). Parkinson’s disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. PubMed Central (PMC). Retrieved 16 October 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517533/.

Sauerbier, A., Aris, A., Lim, E., Bhattacharya, K., & Chaudhuri, K. (2018). Impact of ethnicity on the natural history of Parkinson disease. Mja.com.au. Retrieved 16 October 2020, from https://www.mja.com.au/system/files/issues/208_09/10.5694mja17.01074.pdf.

 

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Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M5Assgn+last name+first initial.(extension)” as the name.
• Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M5Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 8

To participate in this Assignment:

Module 5 Assignment

 

What’s Coming Up in Module 6?

In Module 6, you will identify processes related to psychological disorders. You will also examine the neurobiology of various psychological issues and consider variables that may impact physiological functioning and altered physiology.

Week 9 Knowledge Check: Psychological Disorders

In the Week 9 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 6. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

 

Next Module

 

Module 6: Psychological Disorders

What’s Happening This Module?

Module 6: Psychological Disorders is a 1-week module, Week 9 of the course. In this module, you will examine fundamental concepts of disorders that impact patterns of behavior or psychology that can affect multiple areas of life.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 9
Knowledge Check: Psychological Disorders	Complete by Day 7 of Week 9

 

Go to the Week’s Content

 

Week 9

 Week 9: Concepts of Psychological Disorders

Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.

Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.

This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

•  Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 19: Neurobiology of Schizophrenia, Mood Disorders, Anxiety Disorders, and Obsessive-Compulsive Disorder, including Summary Review

 

Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624. Retrieved from https://www.aafp.org/afp/2015/0501/p617.html

Credit Line: Diagnosis and management of generalized anxiety disorder and panic disorder in adults by Locke, A. B., Kirst, N., & Shultz, C., in American Family Physician, Vol. 91/Issue 9. Copyright 2015 by American Academy of Family Physicians. Reprinted by permission of American Academy of Family Physicians via the Copyright Clearance Center.

 

McIntyre, R. S. & Calabrese, J. R. (2019). Bipolar depression: The clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion, 1–14. doi:10.1080/03007995.2019.1636017. Retrieved from https://www.tandfonline.com/doi/full/10.1080/03007995.2019.1636017

Credit Line: Bipolar depression: The clinical characteristics and unmet needs of a complex disorder by McIntyre, R. S. & Calabrese, J. R., in Current Medical Research and Opinion. Copyright 2019 by Librapharm Ltd. Reprinted by permission of Librapharm Ltd via the Copyright Clearance Center.

 

Required Media

 

Module 6 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 6 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 Knowledge Check. (1m)

Generalized Anxiety Syndrome

Osmosis.org. (2016, February 29). Generalized anxiety disorder (GAD) – causes, symptoms, & treatment [Video file]. Retrieved from https://www.youtube.com/watch?v=9mPwQTiMSj8

Note: The approximate length of the media program is 5 minutes.

 

Knowledge Check: Psychological Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Generalized anxiety disorder
  • Depression
  • Bipolar disorders
  • Schizophrenia
  • Delirium and dementia
  • Obsessive compulsive disease

Complete the Knowledge Check By Day 7 of Week 9

To complete this Knowledge Check:

Module 6 Knowledge Check

 

What’s Coming Up in Module 7?

In Module 7, you will analyze processes related to women’s and men’s health, infections, and hematologic disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

 

Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In the Week 10 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 7. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next module:

Module 7

Module 7: Women’s and Men’s Health, Infections, and Hematologic Disorders

What’s Happening This Module?

Module 7: Women’s and Men’s Health, Infections, and Hematologic Disorders is a 1-week module, Week 10 of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact women’s and men’s health, including infections and hematologic disorders. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these populations.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 10
Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders	Complete by Day 7 of Week 10
Module 7 Assignment: Case Study Analysis	Submit by Day 7 of Week 10

 

Go to the Week’s Content

Week 10

Week 10: Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.

Understanding these differences in traits and their impact on pathophysiology can better equip acute care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.

This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the life span
• Analyze processes related to women’s and men’s health, infections, and hematologic disorders
• Identify racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings

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 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
• Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
• Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
• Chapter 27: Sexually Transmitted Infections, including Summary Review
• Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review
• Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
• Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review

 

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true

Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.

Document: NURS 6501 Final Exam Review (PDF document)

Note: Use this document to help you as you review for your Final Exam in Week 11.

Required Media

 

Module 7 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 7 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 Knowledge Check and your Assignment. (3m)

Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia

Note: The approximate length of the media program is 5 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 24, 26, 28, and 30 that relate to the reproductive and hematological systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Sexually transmitted diseases
  • Prostate
  • Epididymitis
  • Factors that affect fertility
  • Reproductive health
  • Alterations and fertility
  • Anemia
  • ITP and TTP
  • DIC
  • Thrombocytopeni

Complete the Knowledge Check By Day 7 of Week 10

 

To complete this Knowledge Check:

Module 7 Knowledge Check

 

Module 7 Assignment: Case Study Analysis

An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.

Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.  Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ­ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl  Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2  99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.

In your Case Study Analysis related to the scenario provided, explain the following:

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

 

 

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Sample Paper – Week 10 Case Study Analysis

NURS 6501 Week 10 Assignment – Case study, STDs and Infertility

 

Case study, STDs and Infertility

Student’s Name

Institution of Affiliation

Course Name

Date

Introduction

Infertility is a global concern that accounts for over 9% of women in their reproductive age. In the United States, over 1.5 million are infertile. Infertility is defined as the inability to conceive within a period of 12 months or longer or regular unprotected sex. Infertility is associated with several factors that include tubal, endocrine, cervical, vaginal, pelvic, and peritoneal defects, however approximately 15-30 cases of infertility have not been explained (Tsevat et al, 2017).

STD and Infertility

Chlamydia and gonorrhea have been identified as STDs that can progress to cause infertility around the world. A CDC report indicates that there were over 2million cases of chlamydia and gonorrhea in the United States. They have been the most infectious sexually transmitted infections according to the report. These infections are easily treatable, however, they have few noticeable symptoms, making it harder for people to seek the appropriate care. Approximately 25% of women who present with symptoms show abdominal/pelvic pain, spotting, and unusual discharge. These infections progress to the uterus and the fallopian tubes to cause pelvic inflammatory disease (Tsevat et al, 2017). This leads to inflammation and scarring causing blockage on the fallopian tubes. Tubal scarring causes blockage of the tubes, preventing the eggs from reaching the uterus.

Inflammatory Markers in PID

When conducting laboratory tests for PID, results will indicate elevation on nonspecific markers i.e. white blood cells WBC, endoplasmic sedimentation rate ESR, and C- reactive protein CRP. These markers are usually diagnostic for several conditions that present with cell or tissue inflammation. CA-125 is another inflammatory marker identified in patients with PID. Several studies argue that elevation of CA-125 is an indication of peritoneal involvement and salpingitis (Ahmed et al, 2017). There is a significant correlation between salpingitis and tubal inflammation and levels of CA-125.

Systemic Reaction

In patients with STDs infection is the most common systemic reaction due to the pathogenesis of the disease. The bacteria often spread to the surrounding tissues such as the prostate, cervix, and vaginal walls due to interaction with urine or during sexual intercourse (Krivan et al, 2017). As such these bacteria proliferate and cause infection of the organs, increasing the severity of the condition.

Splenectomy in ITP

Patients diagnosed with ITP have idiopathic destruction of platelets in the body. This destruction is done at the targets located at the spleen. The use of steroids, immunoglobulin, and those drugs that boost platelet production have been identified as the alternative treatments of this disorder. However, splenectomy remains to be the most effective treatment method that removes the targets in the body that destroy these platelets (Chaturvedi et al, 2018). As compared to long-term use of medication, splenectomy treats the condition once through the removal of the targets that destroy platelets.

Anemia

Anemia is a hematologic condition characterized by a decrease in hemoglobin levels. Patients with anemia will present with paleness, confusion, exhaustion, and low appetite. It can be divided into macrocytic, normocytic, and microcytic anemia. Macrocytic anemia occurs when the red blood cells are larger than normal. These large cells will be fewer and carry less hemoglobin hence causing macrocytic anemia. Patients with normocytic anemia have normal size red blood cells that are fewer in the body. They may present tiredness, irritability, and shortness of breath. On the other hand, microcytic anemia presents with small and hypochromic red blood cells in the blood that do not carry adequate hemoglobin necessary to transport oxygen in the body (Weiss et al, 2019). Patients may present with paleness, weakness, irritability, shortness of breath, tachycardia, and pica.

 

 

References

Ahmed, S., Parvin, S., Shaha, D. R., Begum, P., Sanjowal, L., Hassan, M. K., & Arif, K. M. (2017). Clinical Profile of Pelvic Inflammatory Disease (PID). Faridpur Medical College Journal, 12(1), 25-30.

Chaturvedi, S., Arnold, D. M., & McCrae, K. R. (2018). Splenectomy for immune thrombocytopenia: down but not out. Blood, The Journal of the American Society of Hematology, 131(11), 1172-1182.

Krivan, G., Jolles, S., Granados, E. L., Paolantonacci, P., Ouaja, R., Cissé, O. A., & Bernatowska, E. (2017). New insights in the use of immunoglobulins for the management of immune deficiency (PID) patients. American journal of clinical and experimental immunology, 6(5), 76.

Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American journal of obstetrics and gynecology, 216(1), 1-9.

Weiss, G., Ganz, T., & Goodnough, L. T. (2019). Anemia of inflammation. Blood, The Journal of the American Society of Hematology, 133(1), 40-50.

 

 

Day 7 of Week 10

Submit your Case Study Analysis Assignment by Day 7 of Week 10

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “M7Assgn+last name+first initial.(extension)” as the name.
• Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Module 7  Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M7Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Module 7 Assignment

 

What’s Coming Up in Module 8?

In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.

Week 11 Knowledge Check: Pediatrics

In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 11 Final Exam: Pediatrics

In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Final Exam, since the resources cover the topics addressed. Plan

 

Next Module

 

To go to the next module:

Module 8

 

Module 8: Pediatrics

What’s Happening This Module?

Module 8: Pediatrics is a 1-week module, Week 11, the final week of the course. In this module, you will examine fundamental concepts of diseases and disorders that impact the health of infants, children, and adolescents. You will also examine concepts and principles of pathophysiology across the life span. Lastly, you will take the Final Exam for the course.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 11
Knowledge Check: Pediatrics	Complete by Day 5 of Week 11
Final Exam	Submit by Day 7 of Week 11

 

Go to the Week’s Content

 

Week 11

 

Week 11: Concepts of Pediatrics

Pediatric disorders can present unique challenges to patients, families, and healthcare providers. Disorders in these areas are complicated by the fact that young patients can have difficulties communicating symptoms. Furthermore, the manner in which disease and disorders manifest in children may be unique.

APRNs working to support these patients and their loved ones must demonstrate not only support and compassion, but expertise to communicate and guide understanding of diagnoses and treatment plans. This includes an understanding of disease and disorders at the pediatric level.

This week, you examine pathophysiology in pediatrics. You apply key terms, concepts, and principles in this area to demonstrate an understanding of the impact they have on altered physiology in children.

Learning Objectives

Students will:

• Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings

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 14: Cancer in Children, including Summary Review
• Chapter 20: Alterations of Neurologic Function in Children (stop at Childhood tumors); Summary Review
• Chapter 34: Alterations of Cardiovascular Function in Children (stop at Defects decreasing pulmonary blood flow); Summary Review
• Chapter 37: Alterations of Pulmonary Function in Children (stop at Congenital malformations); Summary Review
• Chapter 40: Alterations of Renal and Urinary Tract Function in Children, including Summary Review
• Chapter 43: Alterations of Digestive Function in Children, including Summary Review
• Chapter 46: Alterations of Musculoskeletal Function in Children (stop at Avascular diseases); (start at Cerebral palsy) (musculoskeletal tumors in children); Summary Review
• Chapter 48: Alterations of the Integument in Children, including Summary Review
• Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children, including Summary Review

 

U.S. National Library of Medicine. (2019). Normal growth and development. Retrieved from https://medlineplus.gov/ency/article/002456.htm

 

Document: NURS 6501 Final Exam Review (PDF document)

 

Note: Use this document to help you as you review for your Final Exam in Week 11.

 

 

Required Media

 

Module 8 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 8 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 Knowledge Check and your Final Exam. (3m)

 

Wyatt, K. (2018, February 4). Pediatrics – Growth and development milestones review  [Video file]. Retrieved from https://www.youtube.com/watch?v=ZG60nC3RJwc

Note: The approximate length of the media program is 34 minutes.

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapter 20, 34, 37, 40, 43, and 46 that relate to alterations in hematological function in children. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Pediatrics

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

• • Growth and development
  • Normal growth patterns
  • Scoliosis (ortho)
  • Kawasaki
  • Alterations in children
  • Congenital (heart syndrome)
  • PDAs
  • Sudden Infant Death Syndrome (SIDS)
  • Asthma
  • Lead poisoning and effects on neurological functioning
  • Sickle cell
  • Hemophilia

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Final Exam.)

Complete the Knowledge Check By Day 5 of Week 11

 

To complete this Knowledge Check:

Module 8 Knowledge Check

 

Final Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 7, 8, 9, 10, and 11. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Final Exam.)

By Day 7 of Week 11

Complete and submit your Final Exam.

To complete your exam:

Final Exam

 

What’s Coming Up?

Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.

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