walden nurs6501 full course
walden nurs6501 full course
walden nurs6501 full course
Week 1 discussion
Factors That Influence Disease
In clinical settings, some of the most common questions that
patients ask are Why do I have this? What caused this disorder? Will it ever go
away? These emotional questions can be difficult to ask and to answer. However,
for patients to come to terms with their diagnoses and adhere to treatment
plans, they must have an understanding of factors that might have caused, or
continue to impact, their disorders. As an advanced practice nurse, it is
important that you are able to explain disorders, associated alterations and
symptoms, and changes that might occur within your patients’ bodies.
To prepare:
Review this week’s media presentation with Dr. Terry
Buttaro. Reflect on the importance of developing an in-depth understanding of
pathophysiology.
Select a disorder from the following list:
Adrenal insufficiency (Addison’s disease)
Atherosclerosis
Cholelithiasis (gallstones)
Colon cancer
Cystic fibrosis
Hemophilia
Nephrolithiasis (kidney stones)
Osteoporosis
Parkinson’s disease
Tuberculosis
Select one of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how that factor might impact
your selected disorder, as well as potential associated alterations and
symptoms.
Identify the pathophysiology of the associated alterations,
including the normal and altered cellular function. Consider both intra- and
extra-cellular changes that occur.
By Day 3
Post a brief description of a patient scenario involving the
disorder and the factor you selected. Explain how the factor might impact your
selected disorder, as well as potential associated alterations and symptoms.
Finally, explain the pathophysiology of the associated alterations, including
changes in cellular function.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different disorders and factors than you, in the following
ways:
Share insights on how the factor you selected impacts the
pathophysiology of the disorder your colleague selected.
Expand on your colleague’s posting by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 2 discussion
DQ1
Maladaptive Responses to Immune Disorders
Maladaptive responses to disorders are compensatory
mechanisms that ultimately have adverse health effects for patients. For
instance, a patient’s allergic reaction to peanuts might lead to anaphylactic
shock, or a patient struggling with depression might develop a substance abuse
problem. To properly diagnose and treat patients, advanced practice nurses must
understand both the pathophysiology of disorders and potential maladaptive
responses that some disorders cause.
Consider immune disorders such as HIV, psoriasis,
inflammatory bowel disease, and systemic lupus E. What are resulting
maladaptive responses for patients with these disorders?
To prepare:
Review Chapter 5 and Chapter 7 in the Huether and McCance
text. Reflect on the concept of maladaptive responses to disorders.
Select two of the following immune disorders: HIV,
psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).
Identify the pathophysiology of each disorder you selected.
Consider the compensatory mechanisms that the disorders trigger. Then compare
the resulting maladaptive and physiological responses of the two disorders.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how the factor might impact your
selected immune disorders.
By Day 3
Post a brief description of the pathophysiology of your
selected immune disorders. Explain how the maladaptive and physiological
responses of the two disorders differ. Finally, explain how the factor you
selected might impact the pathophysiology of each disorder.
Read a selection of your colleagues’ responses.
By Day 5
Respond to at least two of your colleagues on two different
days who selected different immune disorders and/or factors than you, in the
following ways:
Share insights on how the factor you selected impacts the
pathophysiology of the immune disorder your colleague selected.
Expand on your colleague’s posting by providing additional
insights or contrasting perspectives based on readings and evidence.
DQ2
Arthritis
While arthritis impacts nearly 50 million adults in the
United States, it is not a disease that is limited to adulthood. Consider the
case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with
juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was
always swollen and that she often wanted to be carried instead of walking on
her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder
was discovered. Arthritis in children is not uncommon. According to the CDC
(2011), an estimated 294,000 children under age 18 have some form of arthritis
or rheumatic condition. Due to the prevalence of the disorder in both children
and adults, you must understand the pathophysiology and symptoms of arthritis
in order to properly diagnose and prescribe treatment.
To prepare:
Review Chapter 37 in the Huether and McCance text and
Chapter 24 in the McPhee and Hammer text. Identify the pathophysiology of
osteoarthritis and rheumatoid arthritis. Consider the similarities and
differences of the disorders.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology of the disorders, as well as the diagnosis of
and treatment for the disorders.
By Day 4
Post a description of the pathophysiology of osteoarthritis
and rheumatoid arthritis, including the similarities and differences between
the disorders. Then explain how the factors you selected might impact the
pathophysiology of the disorders, as well as the diagnosis of treatment for the
disorders.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in one or more of the following
ways:
Offer alternative diagnoses and prescription of treatment
options for osteoarthritis and rheumatoid arthritis.
Share an insight from having read your colleague’s posting,
synthesizing the information to provide new perspectives.
Week 3 discussion
Pain
The neurological system affects all parts and functions of
the body through nerve stimulation. Nerves also control the sensation and
perception of pain. While pain can be described in a variety of ways, it is
essentially labeled according to its duration and source. As an advanced
practice nurse evaluating a patient, you need to consider the following
questions: Does the pain quickly come and go, or is it persistent and ongoing?
Does the pain arise at the source of injury or in another location? In this
Discussion, you compare three common types of pain—acute, chronic, and
referred.
To prepare:
Review this week’s media presentation on the neurological
system, as well as Chapter 13 in the Huether and McCance text.
Identify the pathophysiology of acute, chronic, and referred
pain. Consider the similarities and differences between these three types of
pain.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology, diagnosis, and prescription of treatment for
acute, chronic, and referred pain.
By Day 3
Post a description of the pathophysiology of acute, chronic,
and referred pain, including similarities and differences between them. Then,
explain how the factors you selected might impact the pathophysiology, diagnosis,
and prescription of treatment for acute, chronic, and referred pain.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in the following ways:
Share insights on how your colleague’s factors impact the
pathophysiology of pain.
Suggest alternative diagnoses and treatment options for
acute, chronic, and referred pain.
Week 4 discussion
Cardiovascular
Disorders
Veins and arteries are vital elements of the cardiovascular
system. They carry the blood supply through the body and are essential for
proper function. Sometimes veins and arteries malfunction, resulting in
cardiovascular disorders. Malfunctions of arteries and veins are similar to
malfunctions of a water hose. Consider the structure and function of a hose. A
tap releases water, which then travels through the hose and comes out the other
end. If the hose has been dormant for several months, dirt and rusty particles
might build up inside, resulting in a restricted flow of water. Similarly,
buildup of plaque inside the coronary arteries restricts blood flow and leads
to disorders such as coronary heart disease. This disease is one of the most
common cardiovascular disorders, and according to the National Heart, Lung and
Blood Institute (2011), is the leading cause of death for men and women in the
United States. In this Discussion, you examine the pathophysiology of
cardiovascular disorders such as coronary heart disease.
To prepare:
Review this week’s media presentation on alterations of
cardiovascular functions, as well as Chapter 23 in the Huether and McCance
text. Identify the pathophysiology of cardiovascular disorders.
Select one patient factor: genetics, gender, ethnicity, age,
or behavior. Consider how the factor you selected might impact the
pathophysiology of cardiovascular disorders.
Select one of the following alterations of cardiovascular
disorders: peripheral arterial disease, myocardial infarction, coronary artery
disease, congestive heart failure, or dysrhythmia. Think about how hypertension
or dyslipidemia can lead to the alteration you selected.
By Day 3
Post a description of the pathophysiology of cardiovascular
disorders, including how the factor you selected might impact the
pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the
alteration you selected for patients with the factor you identified
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different alterations and factors than you, in one or more of
the following ways:
Share insights on how the factor you selected impacts the
cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 5 discussion
DQ1
Cardiovascular
Disorders
At least once a year, the media report on a seemingly
healthy teenage athlete collapsing during a sports game and dying of heart
complications. These incidents continue to outline the importance of physical
exams and health screenings for teenagers, especially those who play sports.
During these health screenings, examiners check for cardiovascular alterations
such as heart murmurs because they can be a sign of an underlying heart
disorder. Since many heart alterations rarely have symptoms, they are easy to
miss if health professionals are not specifically looking for them. Once
cardiovascular alterations are identified in patients, it is important to refer
them to specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation
examination. He has no significant medical history and no family history suggestive
of risk for premature cardiac death. The patient is examined while sitting
slightly recumbent on the exam table and the advanced practice nurse
appreciates a grade II/VI systolic murmur heard loudest at the apex of the
heart. Other physical findings are within normal limits, the patient denies any
cardiovascular symptoms, and a neuromuscular examination is within normal
limits. He is cleared with no activity restriction. Later in the season he
collapses on the field and dies.
To prepare:
Review the scenario provided, as well as Chapter 24 in the
Huether and McCance text. Consider how you would diagnose and prescribe
treatment for the patient.
Select one of the following patient factors: genetics,
ethnicity, or behavior. Reflect on how the factor you selected might impact
diagnosis and prescription of treatment for the patient in the scenario.
By Day 3
Post a description of how you would diagnose and prescribe
treatment for the patient in the scenario. Then explain how the factor you
selected might impact the diagnosis and prescription of treatment for that
patient.
Read a selection of your colleagues’ responses.
By Day 5
Respond to at least two of your colleagues who selected a
different factor than you, in one of the following ways:
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Share insights based on your own experience and additional
research.
DQ2
Anaphylactic Shock
The treatment of anaphylactic shock varies depending on a
patient’s physiological response to the alteration. Immediate medical
intervention and emergency room visits are vital for some patients, while
others can be treated through basic outpatient care.
Consider the January 2012 report of a 6-year-old girl who
went to her school nurse complaining of hives and shortness of breath. Since
the school did not have any medication under her name to use for treatment and
was not equipped to handle her condition, she was sent to an emergency room
where she was pronounced dead. This situation has raised numerous questions
about the progression of allergic reactions, how to treat students with severe
allergies, how to treat students who develop allergic reactions for the first
time, and the availability of epinephrine in schools. If you were the nurse at
the girl’s school, how would you have handled the situation? How do you know
when it is appropriate to treat patients yourself and when to refer them to
emergency care?
To prepare:
Review “Anaphylactic Shock” in Chapter 23 of the Huether and
McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text,
and the Jacobsen and Gratton article in the Learning Resources.
Identify the multisystem physiologic progression that occurs
in anaphylactic shock. Think about how these multisystem events can occur in a
very short period of time.
Consider when you should refer patients to emergency care
versus treating as an outpatient.
Select two patient factors different from the one you
selected in this week’s first Discussion: genetics, gender, ethnicity, age, or
behavior. Reflect on how the factors you selected might impact the process of anaphylactic
shock.
By Day 4
Post an explanation of the physiological progression that
occurs in anaphylactic shock. Then, describe the circumstances under which you
would refer patients for emergency care versus treating as an outpatient.
Finally, explain how the patient factors you selected might impact the process
of anaphylactic shock.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues who selected at
least one different factor than you in one of the following ways:
Share insights on how the factor your colleague selected
impacts the pathophysiology of anaphylactic shock.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 6 discussion
Respiratory
Alterations
In clinical settings, patients often present with various
respiratory symptoms such as congestion, coughing, and wheezing. While
identifying a symptom’s underlying illness can be challenging, it is essential
because even basic symptoms such as persistent coughing can be a sign of a more
severe disorder. Advanced practice nurses must be able to differentiate between
moderate and severe respiratory disorders, as well as properly diagnose and
prescribe treatment for their patients. For this reason, you must have an
understanding of the pathophysiology of respiratory disorders.
Consider the following three scenarios:
Scenario 1:
Ms. Teel brings in her 7-month-old infant for evaluation.
She is afraid that the baby might have respiratory syncytial virus (RSV) because
she seems to be coughing a lot, and Ms. Teel heard that RSV is a common
condition for infants. A detailed patient history reveals that the infant has
been coughing consistently for several months. It’s never seemed all that bad.
Ms. Teel thought it was just a normal thing, but then she read about RSV.
Closer evaluation indicates that the infant coughs mostly at night; and, in
fact, most nights the baby coughs to some extent. Additionally, Ms. Teel
confirms that the infant seems to cough more when she cries. Physical
examination reveals an apparently healthy age- and weight-appropriate,
7-month-old infant with breath sounds that are clear to auscultation. The
infant’s medical history is significant only for eczema that was actually quite
bad a few months back. Otherwise, the only remarkable history is an allergic
reaction to amoxicillin that she experienced 3 months ago when she had an ear
infection.
Scenario 2:
Kevin is a 6-year-old boy who is brought in for evaluation
by his parents. The parents are concerned that he has a really deep cough that
he just can’t seem to get over. The history reveals that he was in his usual
state of good health until approximately 1 week ago when he developed a
profound cough. His parents say that it is deep and sounds like he is barking.
He coughs so hard that sometimes he actually vomits. The cough is productive
for mucus, but there is no blood in it. Kevin has had a low-grade temperature
but nothing really high. His parents do not have a thermometer and don’t know
for sure how high it got. His past medical history is negative. He has never
had childhood asthma or RSV. His mother says that they moved around a lot in
his first 2 years and she is not sure that his immunizations are up to date.
She does not have a current vaccination record.
Scenario 3:
Maria is a 36-year-old who presents for evaluation of a
cough. She is normally a healthy young lady with no significant medical
history. She takes no medications and does not smoke. She reports that she was
in her usual state of good health until approximately 3 weeks ago when she
developed a “really bad cold.” The cold is characterized by a profound, deep,
mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary
problem is the cough. She develops these coughing fits that are prolonged, very
deep, and productive of a lot of green sputum. She hasn’t had any fever but
does have a scratchy throat. Maria has tried over-the-counter cough medicines
but has not had much relief. The cough keeps her awake at night and sometimes
gets so bad that she gags and dry heaves.
To prepare:
Review the three scenarios, as well as Chapter 26 and
Chapter 27 in the Huether and McCance text.
Select one of the scenarios and consider the respiratory
disorder and underlying alteration associated with the type of cough described.
Identify the pathophysiology of the alteration that you
associated with the cough.
Select two of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how the factors you selected might
impact the disorder.
By Day 3
Post a description of the disorder and underlying
respiratory alteration associated with the type of cough in your selected
scenario. Then, explain the pathophysiology of the respiratory alteration.
Finally, explain how the factors you selected might impact the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected a different scenario than you, in one or more of the
following ways:
Share insights on how the factor you selected impacts the
disorder your colleague identified.
Ask a probing question regarding the disorder that your
colleague identified.
Suggest an alternative disorder for the scenario your
colleague selected.
Week 7 discussion
Anemia
In clinical settings, advanced practice nurses often
encounter patients with blood disorders such as anemia. Consider the case of a
17-year-old girl who is rushed to the emergency room after suddenly fainting.
The girl’s mother reports that her daughter has had difficulty concentrating
for the past week, frequently becomes dizzy, and has not been eating normally
due to digestion problems. The mother also informs the nurse that their family
has a history of anemia. With the family history of anemia, it appears that
this is the likely diagnosis. However, in order to properly diagnose and treat
the patient, not only must her symptoms and family history be considered, but
also factors such as gender, ethnicity, age, and behavior. This poses the
question: How do patient factors impact the incidence and prevalence of
different types of anemia?
To prepare:
Review Chapter 20 in the Huether and McCance text. Reflect
on the pathophysiological mechanisms of iron deficiency anemia.
Select one of the following types of anemia: pernicious
anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation
anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms
of the anemia you selected.
Consider the similarities and differences between iron
deficiency anemia and the type of anemia you selected.
Reflect on how patient factors such as genetics, gender,
ethnicity, age, and behavior might impact these anemic disorders.
By Day 3
Post an explanation of the pathophysiological mechanisms of
iron deficiency anemia and the anemia you selected. Compare these two types of
anemia, as well as their potential causes. Finally, explain how genetics,
gender, ethnicity, age, and behavior might impact the anemic disorders you
selected.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different types of anemia than you, in the following ways:
Share insights on how the anemia you selected is similar to
or different from the one your colleague selected.
Discuss how genetic, gender, ethnic, age, and behavioral
factors impact the diagnosis and prescription of treatment for anemic patients.
Week 8 discussion
Digestive Disorders
Many patient symptoms can be tied to multiple disorders,
which may lead to misdiagnoses. For instance, consider two digestive disorders
of the gastrointestinal tract—inflammatory bowel disease and irritable bowel
syndrome. These two disorders are commonly confused because they present similar
symptoms. As an advanced practice nurse, you must know the differences to
properly diagnose and treat the disorders. How does the pathophysiology of
inflammatory bowel disease compare to the pathophysiology of irritable bowel
syndrome? How do treatments for the two disorders compare?
To prepare:
Review Chapter 34 in the Huether and McCance text and
Chapter 13 in the McPhee and Hammer text.
Identify the pathophysiological mechanisms of inflammatory
bowel disease and irritable bowel syndrome. Think about similarities and
differences between the disorders.
Consider common treatments for inflammatory bowel disease
and irritable bowel syndrome. Reflect on whether treatments for one disorder
would work for the other disorder.
Select one of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factor you selected
might impact the pathophysiology of and treatments for each disorder.
By Day 3
Post an explanation of the pathophysiological mechanisms of
inflammatory bowel disorder and irritable bowel syndrome, including
similarities and differences. Then describe common treatments, addressing
whether treatments for one disorder would work for the other disorder. Finally,
explain how the patient factor you selected might impact the pathophysiology of
and treatments for each disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different treatments and factors than you, in the following
ways:
Offer alternative common treatments for the disorders.
Share insight on how the factor you selected impacts the
treatment of alterations of digestive function.
Week 9 discussion
Diabetes
According to the American Diabetes Association (2011), 25.8
million children and adults have been diagnosed with diabetes in the United
States. Approximately 2 million more are diagnosed every year, with another 79
million people considered to be in a pre-diabetes state. These millions of
people are at risk of several alterations, including heart disease, stroke,
kidney failure, neuropathy, and blindness. Since diabetes has a major impact on
the health of millions of people around the world, it is essential for nurses
to understand the pathophysiology and associated alterations of this disorder.
In this Discussion, you compare two types of diabetes—diabetes mellitus and
diabetes insipidus.
To prepare for this Discussion:
Review Chapter 18 in the Huether and McCance text and
Chapter 18 in the McPhee and Hammer text. Identify the pathophysiology of
diabetes mellitus and diabetes insipidus. Consider the similarities and
differences between resulting alterations of hormonal regulation.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Think about how the factors you selected
might impact the diagnosis and prescription of treatment for these two types of
diabetes.
By Day 3
Post an explanation of the pathophysiology of diabetes
mellitus and diabetes insipidus. Describe the differences and similarities
between resulting alterations of hormonal regulation. Then explain how the
factors you selected might impact the diagnosis and prescription of treatment
for these two types of diabetes.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in one or more of the following
ways:
Share insights on how the factor you selected impacts the
pathophysiology of diabetes mellitus and diabetes insipidus.
Offer alternative diagnoses and prescription of treatment
options for diabetes mellitus and diabetes insipidus.
Validate an idea with your own experience and additional
research.
Reference:
American Diabetes Association. (2011). Diabetes
statistics. Retrieved from
http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Week 10 discussion
Urinary Tract
Infections
Urinary tract infections (UTIs) are caused by bacteria—most
often Escherichia coli. However, certain viruses, fungi, and parasites can also
lead to infection. The infection can affect the lower and upper urinary tract,
including the urethra, prostate (in males), bladder, ureter, and kidney. Due to
the progression of the disease and human anatomy, symptoms present differently
among the sexes as well as among age groups. It is important to understand how
these factors, as well as others, impact the pathophysiology of UTIs. Advanced
practice nurses must have this foundation in order to properly diagnose
patients.
To prepare:
Review Chapter 29 in the Huether and McCance text. Identify
the pathophysiology of lower and upper urinary tract infections. Consider the
similarities and differences between the two types of infections.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology of the infections, as well as the diagnosis of
and treatment for the infections.
By Day 3
Post a description of the pathophysiology of lower and upper
urinary tract infections, including their similarities and differences. Then
explain how the factors you selected might impact the pathophysiology of the
infections, as well as the diagnosis of and treatment for the infections.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected at least one different factor than you, in one or more of the
following ways:
Offer alternative diagnoses and prescription of treatment
options for urinary tract infections.
Share an insight from having read your colleague’s posting,
synthesizing the information to provide new perspectives.
Week 11 discussion
Disorders of the
Reproductive Systems
While the male and female reproductive systems are unique to
each sex, they share a common function—reproduction. Disorders of this system
range from delayed development to structural and functional abnormalities.
Since many reproductive disorders not only result in physiological consequences
but also psychological consequences such as embarrassment, guilt, or profound
disappointment, patients are often hesitant to seek treatment. Advanced
practice nurses need to educate patients on disorders and help relieve
associated stigmas. During patient evaluations, patients must feel comfortable
answering questions so that you, as a key health care provider, will be able to
diagnose and recommend treatment options. As you begin this Discussion,
consider reproductive disorders that you would commonly see in the clinical
setting.
To prepare for this Discussion:
Review Chapter 22 and Chapter 23 in the McPhee and Hammer text,
as well as Chapter 32 in the Huether and McCance text.
Select two disorders of the male and/or female reproductive
systems that interest you. Consider the similarities and differences between
the disorders.
Select one of the following factors: genetics, ethnicity,
age, or behavior. Think about how the factor you selected might impact the
diagnosis of and treatment for the reproductive disorders.
By Day 3
Post a description of the two reproductive disorders you
selected, including their similarities and differences. Then explain how the
factor you selected might impact the diagnosis of treatment for the
reproductive disorders.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different disorders or factors than you, in one or more of
the following ways:
Share insights on how the factor you selected impacts the
pathophysiology of the disorder your colleague selected.
Offer alternative diagnoses and prescription of treatment
options for the disorder your colleague selected.
Validate an idea with your own experience and additional
research.
Week 2 assignment
Assignment: Adaptive
Response
As an advanced practice nurse, you will examine patients
presenting with a variety of disorders. You must, therefore, understand how the
body normally functions so that you can identify when it is reacting to
changes. Often, when changes occur in body systems, the body reacts with
compensatory mechanisms. These compensatory mechanisms, such as adaptive
responses, might be signs and symptoms of alterations or underlying disorders.
In the clinical setting, you use these responses, along with other patient
factors, to lead you to a diagnosis.
Consider the following scenarios:
Scenario 1:
Jennifer is a 2-year-old female who presents with her
mother. Mom is concerned because Jennifer has been “running a temperature” for
the last 3 days. Mom says that Jennifer is usually healthy and has no
significant medical history. She was in her usual state of good health until 3
days ago when she started to get fussy, would not eat her breakfast, and would
not sit still for her favorite television cartoon. Since then she has had a
fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has
been giving her ibuprofen, but when the fever went up to 103.2oF today, she
felt that she should come in for evaluation. A physical examination reveals a
height and weight appropriate 2-year-old female who appears acutely
unwell. Her skin is hot and dry. The
tympanic membranes are slightly reddened on the periphery, but otherwise normal
in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates.
Anterior cervical nodes are readily palpable and clearly tender to touch on the
left side. The child indicates that her throat hurts “a lot” and it is painful
to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats
per minute, and a respiratory rate of 24 beats per minute.
Scenario 2:
Jack is a 27-year-old male who presents with redness and
irritation of his hands. He reports that he has never had a problem like this
before, but about 2 weeks ago he noticed that both his hands seemed to be
really red and flaky. He denies any discomfort, stating that sometimes they
feel “a little bit hot,” but otherwise they feel fine. He does not understand
why they are so red. His wife told him that he might have an allergy and he
should get some steroid cream. Jack has no known allergies and no significant
medical history except for recurrent ear infections as a child. He denies any
traumatic injury or known exposure to irritants. He is a maintenance engineer
in a newspaper building and admits that he often works with abrasive solvents
and chemicals. Normally he wears protective gloves, but lately they seem to be
in short supply so sometimes he does not use them. He has exposed his hands to
some of these cleaning fluids, but says that it never hurt and he always washed
his hands when he was finished.
Scenario 3:
Martha is a 65-year-old woman who recently retired from her
job as an administrative assistant at a local hospital. Her medical history is
significant for hypertension, which has been controlled for years with
hydrochlorothiazide. She reports that lately she is having a lot of trouble
sleeping, she occasionally feels like she has a “racing heartbeat,” and she is
losing her appetite. She emphasizes that she is not hungry like she used to be.
The only significant change that has occurred lately in her life is that her
87-year-old mother moved into her home a few years ago. Mom had always been
healthy, but she fell down a flight of stairs and broke her hip. Her recovery
was a difficult one, as she has lost a lot of mobility and independence and
needs to rely on her daughter for assistance with activities of daily living.
Martha says it is not the retirement she dreamed about, but she is an only
child and is happy to care for her mother. Mom wakes up early in the morning,
likes to bathe every day, and has always eaten 5 small meals daily. Martha has
to put a lot of time into caring for her mother, so it is almost a “blessing”
that Martha is sleeping and eating less. She is worried about her own health
though and wants to know why, at her age, she suddenly needs less sleep.
To Prepare
Review the three scenarios, as well as Chapter 6 in the
Huether and McCance text.
Identify the pathophysiology of the disorders presented in
each of the three scenarios, including their associated alterations. Consider
the adaptive responses to the alterations.
Review the examples of “Mind Maps—Dementia, Endocarditis,
and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning
Resources. Then select one of the disorders you identified from the scenarios.
Use the examples in the media as a guide to construct a mind map for the
disorder you selected. Consider the epidemiology, pathophysiology, risk
factors, clinical presentation, and diagnosis of the disorder, as well as any
adaptive responses to alterations.
Review the Application Assignment Rubric found under Course
Information
To Complete
Write a 2- to 3-page paper excluding the title page,
reference page and Mind Map that addresses the following:
For each of the three scenarios explain the pathophysiology,
associated alterations and the patients’ adaptive responses to the alterations
caused by the disease processes. You are
required to discuss all three scenarios within the paper component of this
assignment.
Construct one mind map on a selected disorder presented in
one of the scenarios. Your Mind Map must include the epidemiology,
pathophysiology, risk factors, clinical presentation, and diagnosis of the
disorder, as well as any adaptive responses to alterations.
Week 4 assignment
Assignment: Disorders
of the Veins and Arteries
Advanced practice nurses often treat patients with vein and
artery disorders such as chronic venous insufficiency (CVI) and deep venous
thrombosis (DVT). While the symptoms of both disorders are noticeable, these
symptoms are sometimes mistaken for signs of other conditions, making the
disorders difficult to diagnose. Nurses must examine all symptoms and rule out
other potential disorders before diagnosing and prescribing treatment for
patients. In this Assignment, you explore the epidemiology, pathophysiology,
and clinical presentation of CVI and DVT.
To Prepare
Review the section “Diseases of the Veins” (pp. 598-599) in
Chapter 23 of the Huether and McCance text. Identify the pathophysiology of
chronic venous insufficiency and deep venous thrombosis. Consider the
similarities and differences between these disorders.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think
about how the factor you selected might impact the pathophysiology of CVI and
DVT. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on the factor you selected.
Review the “Mind Maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct two mind
maps—one for chronic venous insufficiency and one for venous thrombosis.
Consider the epidemiology and clinical presentation of both chronic venous
insufficiency and deep venous thrombosis.
To Complete
Write a 2- to 3-page paper that addresses the following:
Compare the pathophysiology of chronic venous insufficiency
and deep venous thrombosis. Describe how venous thrombosis is different from
arterial thrombosis.
Explain how the patient factor you selected might impact the
pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe
treatment of these disorders for a patient based on the factor you selected.
Construct two mind maps—one for chronic venous insufficiency
and one for deep venous thrombosis. Include the epidemiology, pathophysiology,
and clinical presentation, as well as the diagnosis and treatment you explained
in your paper.
Week 6 assignment
Assignment: Asthma
Complications of asthma can be sudden. Consider the case of
Bradley Wilson, a young boy who had several medical conditions. He appeared in
good health when he went to school, returned home, and ate dinner. However,
when he later went outside to play, he came back inside wheezing. An ambulance
took him to the hospital where he was pronounced dead (Briscoe, 2012). In
another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the
middle of the night and ran to her grandfather’s bedroom to tell him she
couldn’t breathe. By the time paramedics arrived, she had passed out and was
pronounced dead at the hospital (Glissman, 2012). These situations continue to
outline the importance of recognizing symptoms of asthma and providing
immediate treatment, as well as distinguishing minor symptoms from serious,
life-threatening symptoms. Since these symptoms and attacks are often induced
by a trigger, as an advanced practice nurse, you must be able to help patients
identify their triggers and recommend appropriate treatment options. For this
reason, you need to understand the pathophysiological mechanisms of chronic
asthma and acute asthma exacerbation.
To Prepare
Review “Asthma” in Chapter 27 of the Huether and McCance
text. Identify the pathophysiological mechanisms of chronic asthma and acute
asthma exacerbation. Consider how these disorders are similar and different.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think
about how the factor you selected might impact the pathophysiology of both
disorders. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on the factor you selected.
Review the “Mind maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct two mind
maps—one for chronic asthma and one for acute asthma exacerbation. Consider the
epidemiology and clinical presentation of both chronic asthma and acute asthma
exacerbation.
To Complete
Write a 2- to 3-page paper that addresses the following:
Describe the pathophysiological mechanisms of chronic asthma
and acute asthma exacerbation. Be sure to explain the changes in the arterial
blood gas patterns during an exacerbation.
Explain how the factor you selected might impact the
pathophysiology of both disorders. Describe how you would diagnose and
prescribe treatment for a patient based on the factor you selected.
Construct two mind maps—one for chronic asthma and one for
acute asthma exacerbation. Include the epidemiology, pathophysiology, and
clinical presentation, as well as the diagnosis and treatment you explained in
your paper.
Week 8 assignment
Gastrointestinal
Tract: Disorders of Motility
Jamie is a 3-month-old female who presents with her mother
for evaluation of “throwing up.” Mom reports that Jamie has been throwing up
pretty much all the time since she was born. Jamie does not seem to be sick. In
fact, she drinks her formula vigorously and often acts hungry. Jamie has normal
soft brown bowel movements every day and, overall, seems like a happy and
contented baby. She smiles readily and does not cry often. Other than the fact
that she often throws up after drinking a bottle, she seems to be a very
healthy, happy infant. A more precise history suggests that Jamie does not
exactly throw up—she does not heave or act unwell—but rather it just seems that
almost every time she drinks a bottle she regurgitates a milky substance. Mom
thought that she might be allergic to her formula and switched her to a
hypoallergenic formula. It didn’t appear to help at all, and now Mom is very
concerned.
Cases like these are not uncommon. The mother was concerned
and thinking her daughter may have an allergy; she changed to a different
formula. However, sometimes babies have immature GI tracts that can lead to
physiology reflux as they adapt to normal life outside the uterus. Parents
often do not consider this possibility, prompting them to change formulas
rather than seeking medical care. As in the case study above, GI alterations
can often be difficult to identify because many cause similar symptoms. This
same issue also arises with adults—adults may present with symptoms that have
various potential causes. When evaluating patients, it is important for the
advanced practice nurse to know the types of questions he or she needs to ask
to obtain the appropriate information for diagnosis. For this reason, you must
have an understanding of common GI disorders such as gastroesophageal reflux
disease (GERD), peptic ulcer disease (PUD), and gastritis.
To Prepare
Review this week’s media presentation on the gastrointestinal
system.
Review Chapter 35 in the Huether and McCance text. Identify
the normal pathophysiology of gastric acid stimulation and production.
Review Chapter 37 in the Huether and McCance text. Consider
the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer
disease (PUD), and gastritis. Think about how these disorders are similar and
different.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider
how the factor you selected might impact the pathophysiology of GERD, PUD, and
gastritis. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on this factor.
Review the “Mind Maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct a mind map for
gastritis. Consider the epidemiology and clinical presentation of gastritis.
To Complete
Write a 2- to 3-page paper that addresses the following:
Describe the normal pathophysiology of gastric acid
stimulation and production. Explain the changes that occur to gastric acid
stimulation and production with GERD, PUD, and gastritis disorders.
Explain how the factor you selected might impact the
pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose
and prescribe treatment of these disorders for a patient based on the factor
you selected.
Construct a mind map for gastritis. Include the epidemiology,
pathophysiology, and clinical presentation, as well as the diagnosis and
treatment you explained in your paper.
Week 10 assignment
The Pathophysiology of Disorders
During the last 5 weeks, you have explored various body
systems: neurological, cardiovascular, respiratory, and hematological. These
four systems work together along with other body systems to complete a myriad
of functions. For this reason, when disorders occur within one body system, it
can create potentially devastating effects throughout the entire body. For
instance, Parkinson’s disease is a disorder of the central nervous system, yet
its alterations actually affect multiple body systems from the cardiovascular
system to the gastrointestinal system. In this Assignment, you examine
alterations associated with disorders, as well as the impact of the alterations
on multiple body systems.
To Prepare
From the list below, select a disorder of interest to you:
Alzheimer’s disease
Asthma in children
Chronic obstructive pulmonary disease (COPD)
Congestive heart failure
Hepatic disease (liver disease)
Hypertension
Hyperthyroidism and hypothyroidism
Seizures
Sepsis
Identify alterations associated with your selected disorder.
Consider the pathophysiology of the alterations. Think about how these
alterations produce pathophysiological changes in at least two body systems.
Reflect on how patient factors such as genetics, gender,
ethnicity, age, and behavior might impact the pathophysiology of the
alterations you identified, as well as the diagnosis and treatment of your
selected disorder.
Review the “Mind maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct a mind map for
the disorder you selected. Consider the epidemiology and clinical presentation
of your selected disorder.
To Complete
Develop a 5- to 10-slide PowerPoint presentation that
addresses the following:
Describe your selected disorder, as well as associated
alterations. Explain the pathophysiology of the alterations, including changes
that occur in at least two body systems.
Explain how genetics, gender, ethnicity, age, and behavior
might impact the pathophysiology of the alterations you identified, as well as
diagnosis and treatment of your selected disorder.
Construct a mind map for the disorder you selected. Include
the epidemiology, pathophysiology of alterations, risk factors, and clinical
presentation, as well as the diagnosis and treatment of the disorder.
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