Assignment: Case Study Analysis NURS 6501

Assignment: Case Study Analysis NURS 6501

Assignment: Case Study Analysis NURS 6501

One of the most useful components of patient care is a correct diagnosis which leads to offering a patient the correct treatment. Central to correct diagnosis and treatment is an understanding of the cell, and cell behavior as come conditions may have various circumstances and factors affecting their onset, hence making them more complex (Karaca & Aslan, 2018). Therefore, understanding the cells and cell behavior needs to be integrated with ethnic and racial variables, patient characteristics, environment, and genes. This week’s assignment deals with a patient cases study where the symptoms presented by the patient will be analyzed using various discussion questions.

Why the Patient Presented With the Symptoms

The patient has presented with various symptoms such as fevers, constipation, and crampy left lower quadrant pain. After refusing colonoscopy for some time, the patient eventually went for one, which revealed a positive test for adenocarcinoma of the colon. Even though the patient went for colonoscopy after resolution of the acute diverticulitis, the symptoms presented at the clinic point to a recurring case of acute diverticulitis. The patient has the three most common symptoms of diverticulitis (fever, constipation, and pain in the lower left quadrant). The condition is more an individual’s lifetime and therefore could be troubling the patient. The patient also eats a diet lacking in fiber and is obese, which are all factors leading to the development of the condition.

Genes That May Be Associated With the Development of the Condition

            According to Strate & Morris (2019), diverticulitis may result from a complex interaction of gut microbiome, genetics, medications, lifestyle factors, and diet. Even though it has been agreed that genetics play a substantial role in the development of the condition, only a few genes have been implicated. However, a recent study reported that one of the genes that can be implicated in the development of diverticulitis is the laminin β 4 gene (LAMB4) (Coble et al.,2017). Prior to the findings regarding LAMB4, the Tumor necrosis factor superfamily member 15 (TNFSF15) gene was also found to be associated with the development of diverticulitis.

The Process of Immunosuppression and the Effect It Has On Body Systems

            Immunosuppression refers to reduced immune system activation. While some parts of the immune system may possess immunosuppressive effects, immunosuppression can be also be induced (Xe, 2020). The process can be induced by the administration of medications belonging to the class of antidepressants, in some cases to allow organ transplant or bone marrow transplant to prevent a possible rejection. The process of immunosuppression may come from the blockage of intracellular pathways necessary for recognizing antigen or other immune response systems or when the immune effector cells are killed (Xe, 2020). Immunosuppression, especially when persistent, exposes an individual to the risk of cancer, especially virus-connected cancers. The effects of immunosuppression induced by ultraviolet ratio or ionizing or pharmaceutical drugs depend on the dosage or the intensity used as higher dosage or intensity lead to enhanced effects on the body systems (Xe, 2020). Even though not common, immunosuppression induced for an organ transplant can lead to metastatic tumor cells or occult tumors within the organs or tissues. The occult metastatic melanoma is dangerous for the individual receiving the transplanted organ and tissue.

Conclusion

In conclusion, as an APRN, it is important to understand effective patient diagnosis for effective treatment. It allows careful analysis of symptoms to come up with the best management strategy. This write-up has explored a case study of a patient presenting with various symptoms. After an analysis, it was noted that the symptoms could be coming from recurring diverticulitis.

References

Coble, J. L., Sheldon, K. E., Yue, F., Salameh, T. J., Harris, III, L. R., Deiling, S., … & Broach, J. R. (2017). Identification of a rare LAMB4 variant associated with familial diverticulitis through exome sequencing. Human molecular genetics, 26(16), 3212-3220. https://doi.org/10.1093/hmg/ddx204.

Karaca, T., & Aslan, S. (2018). Effect of ‘nursing terminologies and classifications’ course on nursing students’ perception of nursing diagnosis. Nurse education today, 67, 114-117. https://doi.org/10.1016/j.nedt.2018.05.011

Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298. https://doi.org/10.1053/j.gastro.2018.12.033.

He, X. (Ed.). (2020). Immunosuppression. BoD–Books on Demand.

Adenocarcinoma of the colon or rectum is a type of cancer that is initiated inside the cells that are responsible for forming glands that produce mucus. This mucus is produced to aid in the lubrication of the rectum and colon. Patients who are positive for Adenocarcinoma of the colon exhibit signs and symptoms such as a change in bowel movements, loss of weight, presence of blood in the stool and a feeling of being tired all the time. The major cause of this disease is old age, genetic disorders, and lifestyle factors. People who engage in activities such as smoking, alcohol abuse, poor diet, obesity and lack of physical activity are at a higher risk of contracting the disease (Kulke et al.,2015).  Moreover, old age and being male has also been proven to be probable risk factors. The 65-year old African American patient may have presented the symptoms provided due to his old age and being male.

Mutations in the pair of genes (POLE and POLD1) have all been associated with the development of Adenocarcinoma of the colon. Most deaths relating to colon cancer have also been linked to the metastatic disease. A metastasis-associated in colon cancer 1(MACC1) gene has been isolated as the one responsible for contributing to the metastatic disease. It has a transcriptional factor that influences how the hepatocyte growth factor is expressed. These two genes are responsible for the proliferation, scattering, and invasion of cancer cells. Moreover, they are responsible for the growth of tumors (Maliha, Krittiya, Aneeqa, Wai & Scott,2017)

Colorectal cancer originates from epithelial cells lining of the rectum present in the gastrointestinal tract. This occurs as a result of mutations that occur in the Wnt signaling pathway hence increasing the signaling activity (Lin, Chang, Liou, Su, Tsao, & Huang,2018). These mutations can both be acquired or inherited. Its immunosuppression procedure involves mutation of the APC gene. This gene prevents the accumulation of β-catenin protein. In the absence of the APC, β-catenin can accumulate and move to the nucleus then activate the arrangement of proto-oncogenes. Even though these genes are crucial for stem cell renewal, they can also lead to cancer when expresses inappropriately at high levels.

References

Kulke MH, Shah MH, Benson AB rd., Bergsland E, Berlin JD, Blaszkowsky LS, et al (2015). Neuroendocrine tumors, version 1. J Natl Compr Canc Netw .2015;13:78-108.

Lin KH, Chang NJ, Liou LR, Su MS, Tsao MJ. &Huang ML. (2018). Metachronous adenocarcinoma and large cell neuroendocrine carcinoma of the colon. Formos J Surg [serial online]; 51:76-80. Available from: http://www.e-fjs.org/text.asp?2018/51/2/76/231140

Maliha K, Krittiya, Aneeqa S, Wai C, & Scott K, (2017).  Early-Onset Signet-Ring Cell Adenocarcinoma of the Colon: A Case Report and Review of the Literature. Case Reports in Oncological Medicine. Volume 2017 |Article ID 2832180 | 7 pages | https://doi.org/10.1155/2017/2832180

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

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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.
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Submit Your Assignment by Day 7 of Week 2

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Module 1 Assignment

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

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

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Module 2

A 32-year-old woman arrives at the ED with, vomiting, nausea, fever, chills, and vaginal discharge. Symptoms lasted three days. Her LLQ and lower back hurt. She denies urinary incontinence, peculiar urine, and increased urination. She claims monogamy. Her WBC, sedimentation, and CRP were elevated. Abdominal exam indicates LLQ pain. A pelvic exam indicates putrid green discharge, a reddish cervix, adnexal pain, and the chandelier sign. Gram-negative diplococci in ER wet preps. The purpose of this paper is to analyze the case of the patient above and mention a diagnosis of PID and how it is associated with infertility.

Factors that Affect Fertility (STDs).

After checking her vitals and determining that this patient’s body temperature and pulse rate were increased, PID was identified as the cause. Both chlamydia and gonorrhea, if not treated, have the potential to spread to the uterus and fallopian tubes. This may result in pelvic inflammatory disease, often known as PID, which can cause inflammation, scarring, and obstruction in the patient’s reproductive organs, like fallopian tubes (Chitneni et al., 2020). Tubal scarring may cause the fallopian tubes to become blocked, preventing eggs from being transported to the uterus. Those who have had trauma to their fallopian tubes are often at an increased risk of developing an ectopic pregnancy.

Inflammatory Markers Rise in STD/PID.

STIs damage the vaginal mucosa, which protects against invasive bacteria and viruses. Receptors on the cell surface or within the cell identify STI infections, causing mucosal inflammation (Rizk et al., 2020). In the example, inflammatory biomarkers like CRP and ESR are elevated. STIs may cause mucosal reactions that can cause discharge, blistering, and warts among others. This response seeks to eliminate infections, but it often fails or causes pathology that weakens the barrier and allows HIV to enter submucosal target cells.

Prostatitis and Systemic reaction

Inflammation is often seen in prostatitis, a disorder that affects the prostate gland. Prostatitis often causes discomfort in the groin, pelvis, or genitalia as well as unpleasant or difficult urinating. Although not all cases of prostatitis are caused by bacterial infections, some cases of the condition are (Li et al., 2021). Acute bacterial prostatitis is often caused by common bacterial strains. The spread of the virus may have originated in the urinary or reproductive systems.

Splenectomy and ITP

ITP patients’ immune systems kill platelets as alien items. The spleen removes damaged platelets, therefore eliminating it may enable more platelets to circulate (Tahir et al., 2020). Patients with persistent, severe ITP have a splenectomy. After failing various treatments, leading US ITP experts undertake splenectomy. A nuclear medicine department does an indium-labeled platelet spleen scan to see whether the spleen is degrading platelets. If this test shows that the immune system is largely killing platelets elsewhere, a splenectomy won’t help.

Anemia

When blood produces fewer normal, healthy RBCs than usual, anemia results. With hemoglobin and hematocrit, MCV can be used to categorize anemia as microcytic (MCV below normal range), normocytic, or macrocytic (MCV above normal range) (Tvedten, 2022). Based on the underlying cause, additional forms of anemia include aplastic, hemolytic,  and sickle cell anemia.

Conclusion

PID is a common infection that affects sexually active women. Most of the time, STIs like gonorrhea and chlamydia are to blame. If PID is not treated, it can make a person unable to have children. So, if the problem is severe and keeps coming back, the patient might have to have surgery.

References

Chitneni, P., Bwana, M. B., Owembabazi, M., O’Neil, K., Kalyebara, P. K., Muyindike, W., Musinguzi, N., Bangsberg, D. R., Marrazzo, J. M., Haberer, J. E., Kaida, A., & Matthews, L. T. (2020). Sexually Transmitted Infection Prevalence Among Women at Risk for HIV Exposure Initiating Safer Conception Care in Rural, Southwestern Uganda. Sexually Transmitted Diseases, 47(8), e24–e28. https://doi.org/10.1097/olq.0000000000001197

Li, C., Xu, L., Lin, X., Li, Q., Ye, P., Wu, L., Wang, M., Li, L., Li, L., Zhang, Y., Li, H., & Qin, G. (2021). Effectiveness and safety of acupuncture combined with traditional Chinese medicine in the treatment of chronic prostatitis. Medicine, 100(49), e28163. https://doi.org/10.1097/md.0000000000028163

Rizk, B., Borahay, M. A., & Abdel Maguid Ramzy. (2020). Clinical Diagnosis and Management of Gynecologic Emergencies. CRC Press.

Tahir, F., Ahmed, J., & Malik, F. (2020). Post-splenectomy Sepsis: A Review of the Literature. Cureus, 12(2). https://doi.org/10.7759/cureus.6898

‌Tvedten, H. (2022). Classification and Laboratory Evaluation of Anemia. Schalm’s Veterinary Hematology, 198–208. https://doi.org/10.1002/9781119500537.ch25