NURS 6501 Week 2 Altered Physiology

NURS 6501 Week 2 Altered Physiology

NURS 6501 Week 2 Altered Physiology

Altered Physiology Sample Paper

The patient, a 49-year-old male with rheumatoid arthritis, presents with a fever of 1010F, his chief complaint. Other clinical manifestations include unfamiliar fatigue, occasional episodes of hemoptysis, and chest pain accompanied by coughing. He is diagnosed with invasive aspergillosis (IA), which is among the leading causes of death in severely immunocompromised patients.

NURS 6501 Week 2 Altered Physiology

Schauwvlieghe et al. (2018) assert that IA, an infection caused by Aspergillus, is the most common mold infection among immunocompromised individuals that usually affect the respiratory system. Aspergillus is everywhere, outdoors and indoors. Based on the type of Aspergillosis, treatment may involve antifungal medications, observations, or, in certain cases, surgery. For the 49-year-old patient, there is a need to develop a care plan based on the presenting symptoms.

Why the Patient is Presenting the Symptoms Described

In most cases, IA occurs in patients with immunosuppression or neutropenia. It often presents with such signs/symptoms as pleuric chest pain, cough, hemoptysis, dyspnea, and fever (Schauwvlieghe et al., 2018). Some risk factors for this condition include bimodal distribution and bone marrow transfer; other symptoms can develop when the infection spreads to other body parts from the lungs.

When the infection spreads quickly from the lungs to other body parts, such as the skin, kidneys, heart, or brain, it is known as sepsis. Going through the patient’s working environment, it is evident that he is one person alleged with long-term working dusty environment. IA primarily affects agricultural workers, patients with structural lung disease, and immunocompromised patients.

Gene Associated with the Development of IA

People’s immune systems differ by ethnicity/race and from one country to another. White, Parr & Barnes (2018) assert that it has long been known that individuals from different part of the world have varying susceptibilities to chronic inflammation, autoimmunological illnesses, and infections, especially in the case of genes involved in antiviral and inflammatory responses. Genetic variations that are distributed differently across people of different ethnicity/race or countries are primarily responsible for these variations.

Particularly, most of the susceptibility markers for invasive aspergillosis are located in genes indirectly/directly involved in the activation of the nuclear factor-kappa B that signals the pathway. Findings of different research studies have indicated that host genetic polymorphisms near/within immune-associated genes significantly contribute to the infection’s development (Lupiañez et al., 2016).

In particular, tumor necrosis, C-type lectins, and single nucleotide polymorphism factors can increase a patient’s risk of developing this infection. The common genetic polymorphisms found in IRF4, Rel, RelB, RelA, NFkB2, and NFkB1 significantly influence the risk of developing IA.

The Process of Immunosuppression and its Effects on Body Systems

Immunosuppression is as a result of reduced T-lymphocytes and B-lymphocytes that cause compromised cell-mediated and humoral immunity. For patients undergoing bone or marrow transplant, the process is deliberately undertaken by administering such drugs as cyclosporine, FK506, corticosteroids, or azathioprine to weaken immune reactivity.

Poor differentiation of T-lymphocytes from lymphoid cells leads to decreased cell-mediated immunity, while reduced B-lymphocytes results in lower circulating antibody levels, leading to Agammaglobulinemia or Hypogammaglobinemia.

Because immunosuppression reduces the efficiency or activation of the immune system to fight infections or disease-causing pathogens, it significantly affects the immune system. As a result of this process, the immune system of the body weakens and the body remains vulnerable to infectious diseases. 

NURS 6501 Week 2 Altered Physiology References

Lupiañez, C. B., Villaescusa, M. T., Carvalho, A., Springer, J., Lackner, M., Sánchez-Maldonado, M., … & PCRAGA Study Group. (2016). Common genetic polymorphisms within NFκB-related genes and the risk of developing invasive aspergillosis. Frontiers in Microbiology, 7, 1243. https://doi.org/10.3389/fmicb.2016.01243

Schauwvlieghe, A. F., Rijnders, B. J., Philips, N., Verwijs, R., Vanderbeke, L., Van Tienen, C., … & Dutch-Belgian Mycosis study group. (2018). Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study. The Lancet Respiratory Medicine, 6(10), 782-792. https://doi.org/10.1016/S2213-2600(18)30274-1

White, P. L., Parr, C., & Barnes, R. A. (2018). Predicting invasive aspergillosis in hematology patients by combining clinical and genetic risk factors with early diagnostic biomarkers. Journal of Clinical Microbiology, 56(1), e01122-17. https://doi.org/10.1128/JCM.01122-17

WEEK 2: ALTERED PHYSIOLOGY

INTRODUCTION

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. NURS 6501 Week 2 Altered Physiology

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

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. NURS 6501 Week 2 Altered Physiology

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.

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 for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

The Assignment

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.

Week 2 Case Study Assignment

Class,

Below is our week two case study scenario:

A 34-year-old Hispanic-American male with end-stage renal disease received a kidney transplant from a cadaver donor, as no one in his family was a good match. His postoperative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued and began to run temperatures up to 101˚F. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection. 

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

NURS 6501 Module 1 Case Study Assignment Rubric

NURS_6501_Module1_Case Study_Assignment_Rubric
Criteria Ratings Pts
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: Explain why you think the patient presented the symptoms described.
30 to >27.0 pts

Excellent

The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

27 to >24.0 pts

Good

The response describes the patient symptoms. … The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

24 to >22.0 pts

Fair

The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/ research.

22 to >0 pts

Poor

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. … The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/ research.

30 pts
This criterion is linked to a Learning Outcome Identify the genes that may be associated with the development of the disease.
25 to >22.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.

22 to >19.0 pts

Good

The response includes an accurate analysis of the genes that may be associated with the development of the disease.

19 to >17.0 pts

Fair

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

17 to >0 pts

Poor

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

25 pts
This criterion is linked to a Learning Outcome Explain the process of immunosuppression and the effect it has on body systems.
30 to >27.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

27 to >24.0 pts

Good

The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

24 to >17.0 pts

Fair

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

17 to >0 pts

Poor

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

30 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.
5 to >4.0 pts

Excellent

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 pts

Good

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

3 to >2.0 pts

Fair

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

2 to >0 pts

Poor

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 pts

Excellent

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

4 to >3.0 pts

Good

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

3 to >2.0 pts

Fair

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

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

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.
5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

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

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts
Total Points: 100

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