NURS 6053 Week 10 Module 7 Assignment: Case Study Analysis Sample Essay

NURS 6053 Week 10 Module 7 Assignment: Case Study Analysis

NURS 6053 Week 10 Module 7 Assignment Case Study Analysis Sample Essay

Women and men’s health problems have considerable impact on their health, wellbeing, and quality of life (Chhetri et al., 2018; Khalafalla et al., 2019). Nurses and other healthcare providers assess patients to determine the most effective treatments to address their needs. Therefore, this paper examines health needs of a female patient that came to the emergency department with complaints related to sexually transmitted infection.

Factors that Affect Fertility (STDs)

Female fertility depends largely on several factors. One of them as seen in this case study is sexually transmitted infections. Untreated STDs often lead to the development of other complications such as pelvic inflammatory disease, which cause infertility. STDs such as chlamydia and gonorrhea contribute to the highest cases of infertility in the population. Pelvic inflammatory disease can cause scarring of the reproductive tissues, leading to infertility and complications such as ectopic pregnancies (Chhetri et al., 2018; Khalafalla et al., 2019). The additional factors that may affect fertility include weight, alcoholism, vitamin deficiencies, and thyroid disease.

Patient Symptoms

The patient’s complaints during the visit to the hospital include vaginal discharge, vomiting, chills, nausea, and fever. She notes that the symptom onset was three days ago. They started as LLW pain as well as bilateral lower back pain. The patient is married, and notes that she engages in sexual intercourse with her husband. Physical assessment findings showed elevated white blood cells, normal hemoglobin, hematocrit, and platelet levels. She has fever with normal cardio-respiratory exam and tachycardia. There is foul smelling green drainage and reddened cervices with bilateral adnexal tenderness. As a result, she is likely to be suffering from a sexually transmitted infection.

Why Inflammatory Markers Rise in STD/PID

Inflammatory markets rise significantly in STD and pelvic inflammatory disease. The rise is largely due to the presence of a bacterial infection in one’s system. The bacterial infection stimulates respiratory response, which includes an elevated release of white blood cells and neutrophils to fight the infection. This phenomenon can be seen in the patient’s lab values such as white blood cells and C-reactive proteins that are elevated. Inflammation also occurs due to the massive release of neutrophils and cytokines in response to the infections (Ravel et al., 2021). The presence of adnexal tenderness shows an elevated inflammatory response to the bacterial infection. CRP levels in the body rise whenever there is an inflammation in the body.

Conclusion

Female problems such as STDs and PID affects fertility status. Lifestyle factors such as obesity also play a role. Inflammatory biomarkers rise significantly with STDs and PIID. Patients are increasingly at risk of prostatitis and need for spleen removal due to these infections. Therefore, interventions to prevent and timely treatment of STDs are important.

References

Chhetri, A., Biswas, S. C., & Gupta, K. (2018). Infection and infertility. Practical Guide in Infertility; Jaypee Brothers Medical Publishers: Delhi, India, 107.

Khalafalla, K., Elbardisi, H., & Arafa, M. (2019). Sexually transmitted infection and male infertility. In Male Infertility in Reproductive Medicine (pp. 69–77). CRC Press.

Ravel, J., Moreno, I., & Simón, C. (2021). Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. American Journal of Obstetrics and Gynecology, 224(3), 251–257.

Module 7 Assignment Case Study Analysis

Nursing care has evolved over the years to be more comprehensive, implying that for holistic care,

the nurse must understand biological and physical abnormalities that occur within individuals’ bodies due to various illnesses. Pathophysiology forms a nursing practice basis as it relates to a strong foundation for various nursing roles and responsibilities like ordering relevant diagnostic tests (Cook et al., 2019; NURS 6053 Week 10 Module 7 Assignment Case Study Analysis Sample Essay).

When a nurse appropriately recognizes pathophysiological symptoms and signs of the patient’s illness, then the chances are high that a higher quality of advanced care will follow. The purpose of the assignment is to explore various pathophysiological signs and symptoms of a  forty-two year  old patient who comes to the emergency department with perineal pain accompanies by chills and fever, inability to appropriately empty the bladder, low back pain, and dysuria history. Using a set of guiding questions, the patient’s case will be discussed.

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Factors Influencing Fertility

Among the factors that can affect fertility, especially in males, is sexually transmitted diseases. This patient presents with a history of dysuria. The condition may signal urogenital infection such as urinary tract infection, epididymitis, prostatitis, or urethritis. Chlamydia as a condition may affect testicles when not treated in time. Such an occurrence may lead to permanent disability and sterility (Goulart et al., 2020). The other kind of condition that may affect fertility is a pelvic inflammatory disease. Pelvic inflammatory disease is caused by various conditions, some classified under sexually transmitted diseases such as gonorrhea and chlamydia, while others are not.

PID/STD and Enhanced Inflammatory Markers

Upon performing a physical examination on the patient, the results showed that the patient’s prostate was warm to touch, swollen, extremely tender, and enlarged. All these are signs of inflammation according to NURS 6053 Week 10 Module 7 Assignment Case Study Analysis Sample Essay. The inflammatory markers rise in STD/PID can be caused by various immune system’s molecular pathways dysregulation as a result of various factors such as autoimmune response, hormones, dietary factors, aging, urinary reflux, sexually transmitted microorganisms, viruses, and infectious bacterial agents (Darwish et al., 2020).

NURS 6053 Week 10 Module 7 Assignment Case Study Analysis Sample Essay Prostatitis

One of the causes of prostatitis is bacteria entry from the urethra, bladder, or kidney into the prostate gland. Prostatitis may also come from a range of sexually transmitted organisms like HIV, chlamydia, or Neisseria gonorrhoeae (Papeš et al., 2017). The condition can commence upon urine leakage into the prostate. The forty-two-year-old patient also presented with some prostatitis symptoms such as severe pain low back pain; therefore, he could have prostatitis.

ITP Diagnosis and Splenectomy

In NURS 6053 Week 10 Module 7 Assignment Case Study Analysis Sample Essay, a patient may have to undergo splenectomy upon diagnosis of ITP since, in such individuals, the body regards platelets as not part of it and therefore always eliminating them. Spleen usually removes the destroyed and damaged platelets. As such, when the spleen is removed, then more platelets can keep on to be part of the body hence better health (Rodeghiero, 2018). Therefore splenectomy is a standard treatment strategy whenever a patient is diagnosed with ITP.

Anemia and Anemia Types

Anemia is one of the blood disorders that come when an individual’s body only manages to produce few red blood cells or loses or destroys too many red blood cells. There are various kinds of anemia, for example, microcytic and macrocytic anemia. Microcytic anemia occurs when an individual’s red blood cells are fewer than normal; in addition, the present red blood cells are too small (Lanier et al.,2018). This type of anemia results from insufficient production of hemoglobin. On the other hand, macrocytic anemia results when an individual’s body has overly large red blood cells and, at the same time, fewer normal red blood cells.

Conclusion

In conclusion, pathophysiology is important since it helps nurse practitioners to lay a strong foundation for providing effective and high-quality patient care. It is important that a nurse carefully examine a patient’s symptoms to come up with the right care. This write-up has explored a case study of a forty-two-year-old presenting with various symptoms.

References

Cook, N., Shepherd, A., Boore, J., & Dunleavy, S. (2019). Essentials of Pathophysiology for Nursing Practice. Sage.

Darwish, A. (2020). Pelvic Inflammatory Disease: An Underestimated Serious Health Problem. In Clinical Diagnosis and Management of Gynecologic Emergencies (pp. 81-92). CRC Press.

Goulart, A. C. X., Farnezi, H. C. M., França, J. P. B. M., Dos Santos, A., Ramos, M. G., & Penna, M. L. F. (2020). HIV, HPV and Chlamydia trachomatis: impacts on male fertility. JBRA Assisted Reproduction, 24(4), 492. https://dx.doi.org/10.5935%2F1518-0557.20200020.

Lanier, J. B., Park, J. J., & Callahan, R. C. (2018). Anemia in older adults. American family physician, 98(7), 437-442. https://www.aafp.org/afp/2018/1001/p437.html

Papeš, D., Pasini, M., Jerončić, A., Vargović, M., Kotarski, V., Markotić, A., & Škerk, V. (2017). Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study. International journal of STD & AIDS, 28(6), 613-615. https://doi.org/10.1177%2F0956462417691440.

Rodeghiero, F. (2018). A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP. British journal of haematology, 181(2), 183-195. https://doi.org/10.1111/bjh.15090

SAMPLE 2

Case Study Analysis

Various factors affect fertility. The presence of the STDs such as Chlamydia and gonorrhea are examples of some of the common forms of STDs that lead to infertility in a person. The reason inflammatory markers tend to rise in STD/PID is the high level of white cell count. The high level of white cells count indicates that the pelvic inflammatory disease is excessively severe (Low, N. & Broutet N. J. 2017). Hence, the inflammatory response is an indication of the presence of an infection and is a response as the first line of defense (Chaparro & Suchdev, 2019).

Acute bacterial prostatitis is caused by the presence of common strains of bacteria. The infections begin when the bacteria that are present in the urine find their way onto the prostate area. Most of the time, the common forms of treatment entail antibiotics to ensure that the infection is effectively treated. Notably, prostate massage should not be performed for patients that have acute prostatitis condition, given that it will end up causing sepsis (Le, 2016). It is rare to witness sepsis that arises from prostatitis but can occur among patients whose immunity has been compromised.

A patient that has been diagnosed with ITP needs splenectomy given that the immune system of the patient treats the platelets as foreign material to the body and hence will destroy them. The spleen is the part that is responsible for the removal of the damaged platelets from the body. For this reason, removing the spleen of the patient is a strategy that will ensure that there are more platelets in the body (Chaparro & Suchdev, 2019).

The presence of macrocytic anemia is an indication that the red blood cells have low levels of hemoglobin in the body. Hemoglobin is a form of protein that contains high levels of iron that is responsible for the transportation of oxygen around the body. The underlying causes of macrocytic anemia include deficiency in B-12 or folate in the body (Le, 2016). For this reason, the condition is sometimes called vitamin deficiency anemia.

Microcytic anemia is defined as a state in which there is the presence of small and hypochromic red blood cells in the peripheral of the blood smear that is characterized by a low level of the MCV. A low level of MVC means less than 83 microns 3. Hence, the most common cause of microcytic anemia is iron deficiency.

The different kinds of anemia include:

• Hypochromic microcytic anemias include iron-deficient anemia, thalassemia, and sideroblastic anemia.
• Normochromic microcytic anemia
• Anemia of inflammation of chronic diseases including infectious diseases such as tuberculosis, HIV/AIDS, and inflammatory diseases such as rheumatoid arthritis.
• Hypochromic microcytic anemias are caused by a genetic condition that is regarded as congenital spherocytic anemia.

Other causes of microcytic anemia include:

• Lead toxicity
• Copper deficiency
• Excess zinc leading to deficiency in copper
• Excessive alcohol consumption
• Drug abuse

References

Chaparro, C. M., & Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology, and etiology in low‐ and middle‐income countries. Annals of the New York Academy of Sciences. https://doi.org/10.1111/nyas.14092

Le, C. H. (2016). The prevalence of anemia and moderate-severe anemia in the US population (NHANES 2003-2012). PLOS ONE, 11(11), e0166635. https://doi.org/10.1371/journal.pone.0166635

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

The case study addresses HH, who is 68 years old male. The patient has been diagnosed with community-acquired pneumonia. His PMH is significant to diabetes, COPD, hyperlipidemia, and HTN. The patient is on ceftriaxone 1 g IV qday and azithromycin 500 mg IV qday. Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting and has lost some weight. The patient is also presenting with an allergic reaction to penicillin. This paper examines a patient who is present with COPD, diabetes, and hyperlipidemia and is receiving antibiotics although he is allergic to them.

The patient in the scenario has community-acquired pneumonia, improving oxygen demands on day three of ceftriaxone 1 gram daily and azithromycin 500gm intravenous daily. It is important to obtain sputum cultures when treating pneumonia before starting antibiotic therapy (Quinton et al., 2018). The scenario does not list any lab results, and therefore, the infective agent is unknown. Common bacteria that cause CAP are Streptococcus pneumoniae, mycoplasma ssp., Hemophilus influenzae, and staphylococcus aureus (Ding et al., 2018). This patient has an allergic reaction to the penicillin family, evidenced by his skin rash. Patients with a history of penicillin allergy should never receive them again (Rosenthal & Burchum, 2021).

Similar medications with no incidences of allergic reactions are sulfonamides, trimethoprim, and erythromycin. Patients with allergic reactions to penicillin can receive third or fourth-generation cephalosporin or carbapenems such as Tetracyclines (doxycycline), quinolones (ciprofloxacin), macrolides (gentamycin), and glycopeptides (vancomycin) (Rosenthal & Burchum, 2021). These are all unrelated to penicillins and are safe to use in patients with penicillin allergies.

The patient has a chronic obstructive pulmonary disease (COPD). COPD can be exacerbated by respiratory tract infections and may require antibiotic therapy, bronchodilators, glucocorticoids, and supplemental oxygen (Amin et al., 2021). The scenario did not indicate any bronchodilators nor glucocorticoids being administered. Depending on the patient’s dynamics, some of these medications need to be considered.

The patient is currently showing signs of improvement. However, the patient is also experiencing stomach discomfort, nausea, and vomiting, likely due to antibiotic therapy. I will keep the patient on antibiotics since they are necessary for his treatment. However, I will add an antiemetic such as ondansetron (Zofran) intravenous 4 mg for every six hours to control the symptoms.

I will also change the type of antibiotic he is currently on since the patient’s status is improving. I should consider changing the current therapy to include trimethoprim (sulfamethoxazole), the drug of choice for Hemophilus influenzae, gram-negative bacilli, in upper respiratory infections (Rosenthal & Burchum, 2021). Staphylococcus aureus is gram-positive cocci that can be penicillinase-producing or methicillin-resistant; in this case, the first drug of choice is vancomycin (daptomycin) (Ding et al., 2018).

Alternative drugs for treating Streptococcus pneumoniae are azithromycin, levofloxacin, meropenem, imipenem, and trimethoprim/sulfamethoxazole. Mycoplasma pneumoniae is a mycoplasma bacteria that one of the first choice antibiotics is azithromycin (Rosenthal & Burchum, 2021). The fourth-generation cephalosporin has a narrow pseudomonas aeruginosa (Rosenthal & Burchum, 2021). Cefepime is a fourth-generation cephalosporin with the highest activity against gram-negative bacteria (Rosenthal & Burchum, 2021). According to Metlay et al. (2019), appropriate antibiotic combination therapy for community-acquired pneumonia might include ceftriaxone, cefotaxime, ceftaroline, ertapenem, or ampicillin-sulbactam with azithromycin, clarithromycin, clarithromycin XL or Doxycycline.

Based on this scenario, my treatment plan would be to stop the ceftriaxone first and then start cefepime. I will keep the route of administration unchanged since IV antibiotics are preferred because of the high mortality associated with community-acquired pneumonia and the unmeasurable absorption of antibiotics in the GI tract (Metlay et al., 2019). Adding to the fact that the patient is not currently showing hemodynamic stability or functional normal gastrointestinal tract that would tolerate PO medications.

As the patient proceeds with therapy, it is essential to ensure the administration of a bronchodilator and antibiotic together. Fluoroquinolones help inhibit the two enzymes involved in the synthesis of DNA (Pham et al., 2019). The bronchodilator makes breathing easier by relaxing the muscles in the lungs and widening the airways (Pham et al., 2019).

The patient needs to know his symptoms, what to expect during admission, stay period, and discharge. Most patients admitted with CAP have at least one lingering symptom of pneumonia for 6 weeks post-discharge, such as cough, fatigue, or difficulty breathing (Metlay et al., 2019). I would also educate the patient on preventive measures such as pneumococcal influenza vaccines, especially recommended for adults older than 65 years old (Rosenthal & Burchum, 2021). My education plan will also include taking daily Zinc and Vitamin C and smoke cessation, if applicable; it is also important that a patient diet is considered, which helps manage the patient’s diabetic condition. Therefore, a balanced diet and regular exercise help in managing the condition. These measures will help improve patient outcomes, reduce reinfection, and prevent future hospitalization.