NURS 6501 Alterations in Cellular Processes

NURS 6501 Alterations in Cellular Processes

NURS 6501 Alterations in Cellular Processes

Protein Malnutrition Sample Paper

This week’s case study is about a client who is 83 years of age and is a skilled nursing amenity resident. The patient presented to the facility with generalized lower limb and abdominal edema. The interaction with the patient revealed a history of malabsorption syndrome and poor feeding from a lack of dentures. Thus, a diagnosis of protein malnutrition was arrived at.

NURS 6501 Alterations in Cellular Processes

Malnutrition is a serious health crisis resulting in increased morbidity and mortality risk. Broadly, malnutrition can be classified into marasmus, an inadequate supply of energy to meet the body’s requirement, or kwashiorkor, which is the supply of adequate energy with insufficient protein intake (McCance et al., 2019). Classification can also be based on the severity, with malnutrition being classified as mild, moderate, or severe.

Role of Genetics In Protein Malnutrition

Protein malnutrition is etiologically multi-factorial. Its causes include inadequate/improper food intake, impaired absorption, increased gastrointestinal loss of nutrients, increased nutritional needs from various stressors, increased protein loss, and inadequate protein synthesis (Dipasquale et al., 2020). This particular patient’s protein malnutrition is likely due to impaired absorption from the history of the maladaptive syndrome and inadequate food intake based on the difficulty feeding attributed to lack of dentures.

Genetics plays a role in the causation of protein malnutrition. Human genetic variations can alter host genes that impact food absorption and metabolism, including proteins, through many mechanisms. Some studies have identified nutrition-associated genes that influence macronutrient intake, such as FTO and single-nucleotide polymorphism genes, which cause reduced protein intake (Duggal et al., 2018 NURS 6501 Alterations in Cellular Processes). The genetic variation of individuals also determines the gut microbe composition, which may, in turn, contribute to malnutrition.

Reason For Patient’s Presenting Symptoms

The patient came to the emergency department presenting with generalized lower limb edema and abdominal edema. Protein malnutrition is typically characterized by low serum albumin levels due to the decreased synthesis and storage of serum proteins. Low albumin levels lead to an imbalance between oncotic pressure and hydrostatic pressure across vascular walls. Albumin contributes to oncotic pressure, which maintains the intravascular fluid within the blood vessels. Its deficiency thus leads to loss of fluid to the extra-vascular spaces and tissues, which presents clinically as edema.

Physiologic Response To The Stimulus

Reduced oncotic pressure due to low serum albumin level leads to edema from extra-vascular movement of intravascular fluid. In serious cases, this results in intravascular volume depletion, leading to hypovolemia and even shock. The body responds to this by increasing the antidiuretic hormone levels to replace the depleted intravascular fluid.  This is achieved by water retention by the renal system through the action of this hormone.

Cells Involved In The Process

Antidiuretic hormone is secreted by the posterior pituitary gland. This hormone acts in the distal renal and collecting tubules and leads to water reabsorption by causing the expression of water transport channels. This leads to intravascular fluid repletion. In addition to decreasing urine output, this hormone also acts on the endothelial cells of blood vessels to cause vasoconstriction in cases of hypotension.

Influence of Other Characteristics

In addition to genetics, several other factors contribute to the development of malnutrition. Aging, for example, has been shown to increase the risk of malnutrition, as is the case with the patient in this study. This is attributed to factors such as lack of dentures, loss of taste, and reduced movement (Besora-Moreno et al., 2020 NURS 6501 Alterations in Cellular Processes). This leads to reduced food intake with resultant malnutrition. This may necessitate measures such as nutritional support and screening of the elderly population for early diagnosis and interventions.

References

Besora-Moreno, M., Llauradó, E., Tarro, L., & Solà, R. (2020). Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients, 12(3), 737. https://doi.org/10.3390/nu12030737

Dipasquale, V., Cucinotta, U., & Romano, C. (2020). Acute Malnutrition in Children: Pathophysiology, Clinical Effects, and Treatment. Nutrients, 12(8), 2413. https://doi.org/10.3390/nu12082413

Duggal, P., & Petri, W. (2018). Does Malnutrition Have a Genetic Component? Annual Review Of Genomics And Human Genetics, 19(1), 247–262. https://doi.org/10.1146/annurev-genom-083117-021340

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier. NURS 6501 Alterations in Cellular Processes

Week 1: Discussion – ALTERATIONS IN CELLULAR PROCESSES INSTRUCTIONS

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. NURS 6501 Alterations in Cellular Processes

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. NURS 6501 Alterations in Cellular Processes

WEEKLY RESOURCES

To prepare for NURS 6501 Alterations in Cellular Processes :

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

BY DAY 3 OF WEEK 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your peers’ posting. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

LEARNING RESOURCES

Required Readings for NURS 6501 Alterations in Cellular Processes

  • McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children(8th ed.). St. Louis, MO: Mosby/Elsevier.
    • Chapter 1: Cellular Biology; Summary Review
    • Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
    • Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
    • Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
    • Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
  • Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactionsDownload 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)

  • Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)

Week 1: Assignment

PART 1

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Field Experience: MSN Nurse Practitioner Practicum ManualLinks to an external site.

PART 2

This mandatory assignment is an acknowledgement that you fully understand the course guidelines.