NURS 6501 Week 10 Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

Sexually Transmitted Infection Case Study

The inability to get pregnant despite having frequent, unprotected sexual contact for at least a year is known as infertility. Globally, infertility is a significant public health issue. Women shoulder the majority of the responsibility for infertility. Endocrine factors, vaginal factors, cervical factors, uterine factors, tubal factors, and pelvic-peritoneal abnormalities are just a few of the causes of female infertility (Tsevat et al., 2018 NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders). The most frequent reason for infertility is tubal factor insufficiency.

NURS 6501 Week 10

STDs and Infertility

Tubal factor infertility is mostly attributed to untreated infections of the female reproductive tract. Sexually transmitted infections can ascend along the reproductive tract and cause inflammation of the fallopian tubes as well as scarring and damage. Scarring of the fallopian tubes interferes with the motility of ova to the uterus. This also predisposes the woman to an ectopic pregnancy in the event that fertilization occurs. Pelvic-peritoneal adhesions may result from persistent infections. Chlamydia trachomatis and Neisseria gonorrhoeae are the most common causes of STIs associated with tubal factor infertility and pelvic inflammatory disease (Low & Broutet, 2017).

From the case study provided, it is highly likely that the woman has an STI that may have progressed to a PID. This is evidenced by the manifestation of symptoms. She has fever, nausea, vomiting, abdominal pain, and vaginal discharge. Her fertility can be affected because her STI has resulted in the development of PID. The signs of PID are adnexal tenderness, lower abdominal pain, fever, chills and the chandelier sign which is usually an indication of inflammation in the pelvis. Pelvic inflammation causes scarring and adhesions that contribute to tubal factor infertility. The scarring interferes with motility of both the sperms and ova.

Inflammatory Markers and STDs

An STD is an infection. An infection is an inflammatory process. Inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and plasma viscosity (PV) are commonly used in primary care for diagnosis of inflammatory conditions such as infections. ESR is defined as the distance that erythrocytes settle in anticoagulated blood in one hour. CRP is usually better for checking infections (Watson et al., 2019). Other inflammatory markers such as white blood cells are also useful for checking for infections caused by bacteria. Therefore, WBC and CRP will rise in STD or PID. The lab results for this patient indicate a high CRP and WBC levels.

During an infection, pathogen-associated molecular patterns activate pattern recognition receptors of the innate immune system. Proinflammatory and anti-inflammatory mediators are produced as a result with the main aim being to contain the infection. Inflammation is critical in the resolution of infection. Neutrophils are mobilized to the site of infection to try and fight the infection.

Neutrophils are the most common type of white blood cells and increase during bacterial infections (McCance & Huether, 2019). This increase in neutrophils can be elicited by lab testing which is seen as high WBCs. As in the case provided, the patient has both high WBCs and CRPs. The congregation of neutrophils to the site of infection leads to the secretion of inflammatory markers to recruits more defense cells against the infection. This explains the rise in WBCs and other inflammatory markers in STD/PID.

Conclusion

STIs such as chlamydia and gonorrhoea generally affect female fertility due the sequelae of such infections. One such sequelae of such infections is pelvic inflammatory disease which lead to scarring and adhesions in the fallopian tube. Also, STDs are infections that cause an inflammatory process that leads to a rise in inflammatory markers. White blood cells are also recruited to fight infections.

References for NURS 6501 Week 10 Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

Low, N., & Broutet, N. J. (2017). Sexually transmitted infections-Research priorities for new challenges. PLoS Medicine, 14(12), e1002481. https://doi.org/10.1371/journal.pmed.1002481

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

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. https://doi.org/10.1016/j.ajog.2016.08.008

Watson, J., Jones, H. E., Banks, J., Whiting, P., Salisbury, C., & Hamilton, W. (2019). Use of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracy. The British Journal Of General Practice: The Journal Of The Royal College Of General Practitioners, 69(684), e462–e469. https://doi.org/10.3399/bjgp19X704309

NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders Instructions

NURS 6501 Week 10 Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

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

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (omit those that don’t apply to the scenario):

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.

Scenario: 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. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

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.

Resources

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
• Chapter 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. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

• 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.

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. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

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.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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 “Announcements” section of the classroom for your assignment from your Instructor.

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

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).

BY 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/templatesLinks to an external site.). All papers submitted must use this formatting.

NURS 6501 Module7 Case Study Assignment Rubric

This criterion is linked to a Learning Outcome Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following as it relates to the case you were assigned (omit section that does not pertain to your case, faculty will give full points for that section):Explain the factors that affect fertility (STDs) NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders
25 to >22.0 ptsExcellent

The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.

22 to >19.0 ptsGood

The response describes the patient symptoms. … The response includes accurate, explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.

19 to >17.0 ptsFair

The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes explanations of the processes related to women’s and men’s health, infections, and hematologic disorders, with explanations that are vague or based on inappropriate evidence/research.

17 to >0 ptsPoor

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. … The response does not include explanations of the processes related to women’s and men’s health, infections, and hematologic disorders, or the explanations are vague or based on inappropriate evidence/research.

25 pts
This criterion is linked to a Learning Outcome Explain why inflammatory markers rise in STD/PID
20 to >17.0 ptsExcellent

The response includes an accurate, complete, detailed, and specific analysis of the concepts and principles of pathophysiology across the life span and is supported by evidence and/or research, as appropriate, to support the explanation.

17 to >15.0 ptsGood

The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

15 to >13.0 ptsFair

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/ research.

13 to >0 ptsPoor

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/ research. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

20 pts
This criterion is linked to a Learning Outcome Explain why prostatitis and infection happen. Also explain the causes of systemic reaction. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders
20 to >17.0 ptsExcellent

The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

17 to >15.0 ptsGood

The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

15 to >13.0 ptsFair

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/ research. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

13 to >0 ptsPoor

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/ research.

20 pts
This criterion is linked to a Learning Outcome Explain why a patient would need a splenectomy after a diagnosis of ITP. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders
10 to >4.0 ptsExcellent

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

4 to >3.0 ptsGood

The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

3 to >2.0 ptsFair

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations are based on inappropriate evidence/ research.

2 to >0 ptsPoor

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/ research.

10 pts
This criterion is linked to a Learning Outcome Explain anemia and the different kinds of anemia (i.e., micro and macrocytic).
10 to >4.0 ptsExcellent

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

4 to >3.0 ptsGood

The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

3 to >2.0 ptsFair

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations are based on inappropriate evidence/ research. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

2 to >0 ptsPoor

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/ research.

10 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders
5 to >4.0 ptsExcellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 to >3.0 ptsGood

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. … The purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 to >2.0 ptsFair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%-79% of the time….The purpose, introduction, and conclusion of the assignment are vague or off topic.

2 to >0 ptsPoor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. … No purpose statement, introduction, or conclusion were provided.

5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation
5 to >4.0 ptsExcellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 ptsGood

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 ptsFair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 ptsPoor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders

5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. NURS 6501 Week 10 Concepts of Women’s and Men’s Health , Infections, and Hematologic Disorders
5 to >4.0 ptsExcellent

Uses correct APA format with no errors.

4 to >3.0 ptsGood

Contains a few (1 or 2) APA format errors.

3 to >2.0 ptsFair

Contains several (3 or 4) APA format errors.

2 to >0 ptsPoor

Contains many (≥ 5) APA format errors.

5 pts
Total Points: 100

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