NURS 6501 WU Wk 2 Advanced Pathophysiology Rheumatoid Arthritis Discussion
Follow the instructions from attach. This assignment is of Pathophysiology I did answered myself to most of the questions. I need help with formatting the paper nicely, presentable, and professional. It is ok that tutor make correction and add any more important information to this topic. Make sure to include the scenario case provided by professor. Tutor must be an expert in Acute-APRN(RN) Master program, apply APA style in citation, references follow the rubric table for details about grading. I highly appreciate it.
Week 2 Assignment NURS 6501 Advanced Pathophysiology Week 2: 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. 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. CASE STUDY WEEK #2 THIS IS FOR WEEK #2 — PLEASE NOTE: A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever. Patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every Friday morning and prednisone 5 mg po qam. He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats. He says he has had more fatigue than usual and reports some chest pain associated with coughing. He admits to having occasional episodes of hemoptysis. He works as a grain inspector at a large farm cooperative. After extensive work-up, the patient was diagnosed with Invasive aspergillosis. Scenario 1: To prepare: WEEK #2 This week look at the objectives, resources, and assignment. This week you examine compensatory mechanisms and physiological responses to disorders. You also explore the impact of patient factors on the pathophysiology of disorders and resulting compensatory mechanisms. Objectives are: By the end of the week, you will be able to: • • • • • • Compare maladaptive and physiological responses of immune disorders Evaluate the impact of patient factors on the pathophysiology of immune disorders Analyze the pathophysiology of disorders Assess adaptive responses to alterations Evaluate clinical considerations of disorders Understand and apply key terms, concepts, and principles related to adaptive and compensatory mechanisms Assignment this week: 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 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. My Answer : First of all, the patient ‘s immune system is weak due to immunosuppression therapy. Patient got infected with opportunistic fungal infection aspergillosis acquired by inhaling mold from the grains, presenting with pulmonary invasive aspergillosis with symptoms of fever 101degree F, fatigue, chest pain, coughing, and occasional episodes of hemoptysis. 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 MY ASWER continue …RA results from dysregulation of the humoral and cellmediated components of the immune system. Most patients • • produce antibodies called rheumatoid factors; these seropositive patients tend to have a more aggressive course than patients who are seronegative. ➢ Immunoglobulins (Igs) can activate the complement system, which amplifies the immunoresponse by enhancing chemothaxis, phagocytosis, and release of lymphokines by mononuclear cells that are then presented to T lymphocytes. The processed antigen is recognized by the major histompatibility complex proteins on the lymphocyte surface, resulting in activation of T and B cells. ➢ Tumor necrosis factor (TNF), interleukin-1 (IL-1), and IL-6 are proinflammatory cytokines important in the initiation and continuance of inflammation. ➢ Activated T cells produce cytotoxins, which are directly toxic to tissues, and cytokines, which stimulate further activation of inflammatory processes and attract cells to areas of inflammation. Macrophages are stimulated to release prostaglandins and cytoxins. ➢ Activated B cells produce plasma cells, which form antibodies that, in combination with complement, result in the accumulation of polymorphonuclear leukocytes. These leukocytes release cytotoxins, oxygen free radicals, and hydroxyl radicals that promote cellular damage to synovium and bone. ➢ Vasoactive substances (histamines, kinins, and prostaglandins) are released at sites of inflammation, increasing blood flow and vascular permeability. This causes edema, warmth , erythema, and pain and makes it easier for granulocytes to pass from blood vessels to sites of inflammation. ➢ Chronic inflammation of the synovial tissue lining the joint capsule results in tissue proliferation (pannus formation). Pannus invades cartilage and eventually the bone surface, producing erosions of bone and cartilage and leading to joint destruction. The end result may be loss of joint space, loss of joint motion, bony fusion (ankylosis), joint subluxation, tendon contractures, and chronic deformity. Identify the genes that may be associated with the development of the disease. MY Answer: Associated gene HLA-DR4 The response includes an accurate, complete, detailed, and specific analysis of 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. MY Answer: This patient is on Nonbiologic (disease-modifying antirheumatic drug (DMARD) such as methothrexate, and prednisone for immunosuppression therapy (tutor explain briefly about how these two drugs work in the immune system, and a more in detail about the process of immunosuppression focus in rheumatoid arthritis. The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems. “ My answer” MTX inhibits cytokine production and purine biosynthesis, which may be responsible for its antiinflammatory properties. Its onsent is relatively rapid (as early as 2-3 weeks), and 45% to 67% of patient s remained on it in studies ranging from 5 to 7years. Corticosteroids have antiinflammatory and immunosuppressive properties.They interfere with antigen presentation to T lymphocytes, inhibit prostaglandin and leukotrene synthesis, and inhibit neutrophil and monocyte supeoxide radical generation (tutor include the process of therapy the dosing and time for both MTX and corticoids (prednisone, and methylprednisolone). Submit your Case Study Analysis Assignment by Day 7 of Week 2. See Rubric Detail for grading NURS_6501_Module1_Case Study_Assignment_Rubric Exit • Excellent 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. 28 (28%) – 30 (30%) 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 Excellent appropriate, to support the explanation. Identify the genes that may be associated with the development of the disease. 23 (23%) – 25 (25%) Explain the process of immunosuppression and the effect it has on body systems. 28 (28%) – 30 (30%) 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 (5%) – 5 (5%) Written Expression and Formatting English Writing Standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page 5 (5%) – 5 (5%) The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease. The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems. 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. Uses correct grammar, spelling, and punctuation with no errors. Uses correct APA format with no errors. Excellent numbers, running heads, parenthetical/in-text citations, and reference list. Total Points: 100 Name: NURS_6501_Module1_Case Study_Assignment_Rubric 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. 4661; 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. 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. …
