Question
The Purpose of this assignment is to provide a comprehensive overview of the material that is covered in this course. It aligns with the following course objectives:
Explain the pathophysiologic processes of common diseases and disorders across the lifespan.( BSN Student learning Outcome 4)
Evaluate laboratory and diagnostic tests for common diseases and disorders.(BSN Student learning Outcomes 3, 4)
Correlate underlying pathophysiology with health promotion and risk reduction strategies.(BSN Student learning Outcomes 3, 4, 6, 8)
Examine the influence of genetics, race, ethnicity, and the environment on physiologic processes and response to treatment.(BSN Student learning Outcomes 3, 4, 6, 8)
Instructions: Pretend you have just returned from a Nursing Conference and your employer has asked you to write a summary of what you learned at the conference.
1.) Write an APA-formatted paper that is a minimum of 5 and a maximum of 8 pages in length, excluding title and references pages.
2.) Choose 5 (FIVE) disease processes to write about – Each disease process must be from a different body system!
3.) For each disease process, provide a brief overview of the pathophysiology, etiology, and prevalence. Follow this information with a discussion chosen from one of the following topics (must pick a new topic for each disease process – you may choose to focus on pediatric, adult, older adult, or other special population disease presentation):
Modern pharmacological and non-pharmacological treatments
Lifespan considerations
Diagnostic testing and diagnostic criteria
The nursing process related to care of the patient with the disease
Psychosocial concerns related to the disease process
Community resources – Where can patients go for assistance for the disease? What reputable sources of information are available?
Patient education
Prevention
4.) Once you have chosen the disease processes and topics to write about for each, begin research. You will need to include at least 2 (two) scholarly references from the literature for each topic.
5.) Use level 1 and level 2 headers throughout your paper.
Solution
Term Project Paper
At the nursing conference, the main topics and themes were derived from different ailments across various subjects, ranging from children to the elderly. Particularly, the pathophysiologic processes, diagnostic tests, and the influence of factors such as genetics occurs in various human body systems were defined and discussed. Some of the human body systems explored included the urinary tract, nervous, respiratory, digestive, and musculoskeletal systems, among others. In addition, various aspects concerning preventive measures, critical care nursing, testing and diagnostics criteria, and patient care were point of concern in the nursing field. As such, the underlying pathophysiology processes, etiology aspects of a specific disease, and its respective prevalence were well outlined. Thus, the central theme of the nursing conference was to promote good health among the population by raising awareness of chronic diseases in human body systems. Specifically, acute kidney injury (AKI), rheumatoid arthritis, pneumonia, liver cirrhosis and cerebral palsy diseases were a point of concern for me since they are common cases in our facility.
Acute Kidney Injury (AKI)
The disease affects the kidney, and its pathophysiology is complex and multifactorial. In the beginning, a cellular injury occurs due to insufficient oxygen and metabolic substrates delivery resulting from a reduction in blood flow, leading to endothelial damage, vasoconstriction, and inflammation (Akris & Spanou, 2016). Notably, the kidney is highly susceptible to ischemia injuries, which prevent the epithelial cells from maintaining sufficient intracellular ATP processes, leading to further damage. The depletion of the ATP causes cell injury and may kill the cells through apoptosis or necrosis, resulting in the vulnerability of the nephrons and proximal tubular cells (Akris & Spanou, 2016). Furthermore, the negative effects on the nephron’s functionality may lead to the concentration of the substances from the tubular lumen, where in high concentration are toxic to the epithelial cells. According to Akris and Spanou (2016), approximately 13.3 million people globally are affected by AKI annually, with ischemia, direct kidney damages, and urinary tract blockage as the leading causes of the disease.
Nursing Process for Acute Kidney Injury Care
The primary goal of nurses is to prevent occurrence and recurrence of kidney failure as well as eliminate related injuries. Therefore, the practitioners ensure the provision of adequate care to AKI patients, which include monitoring vital signs, taking accurate measurements of body fluids intake and output, and maintaining a balanced electrolyte (Vera, 2019). The nursing care plans include monitoring fluid volume by checking urine specific gravity and accurately recording the intake and output of all fluids. In addition, observing the decrease of cardiac output by checking heart rate (HR), blood pressure (BP), and Gastrointestinal (GI) for bleeding, accessing skin color, and heart sounds (Vera, 2019). The patients’ nutritional intake and hygiene are also crucial as they provide the required metabolic needs, prevent dehydration, as well as monitor pathogen infection during the treatment period. The treatment process for AKI heavily relies on nurses’ ability to execute their roles accordingly.
Liver Cirrhosis
Liver cirrhosis is characterized by hepatic architecture distortion, which is associated with fibrotic septa vascularization of areas that regenerate hepatocyte nodules. Notably, the disease causes weakened hepatocyte function, intrahepatic resistance increase, and growth of hepatocellular carcinoma in adults (Butterworth, 2019). The signs and symptoms include of liver cirrhosis include jaundice, which appears on the skin, mucous membranes, and cornea area as a yellow discoloration (Butterworth, 2019). Jaundice is caused by an increase in serum bilirubin as a result of hepatocyte excretory dysfunctionality (Butterworth, 2019). Additionally, loss of hair pattern in males, gynecomastia (which occurs as a result of increased levels of estradiol), and spider naevus (a result of elevated estradiol levels in the liver), are also signs of liver cirrhosis (Butterworth, 2019). The pathophysiology of the disease in adults include, ammonia metabolism dysregulation and oxidative stress enhancement, and increasing inosine, which cause palmar fascia contraction and fibrosis (Butterworth, 2019). Furthermore, the diminishing normal angle between nailbed and fold as well as hemochromatosis and cirrhosis, mainly in alcoholics, are among the pathophysiological process in a liver cirrhosis patient (Butterworth, 2019). However, etiological aspects of cirrhosis include alcohol, infections from hepatitis B, C, and D, Wilson’s disease, autoimmune hepatitis, non-alcoholic fatty liver disease (NAFLD), and biliary tract disease in adults (Butterworth, 2019). Moreover, liver cirrhosis is a global problem with a prevalence of 4.5% to 9.5% in the general population, with adults’ population being the most affected by chronic liver ailment (Goldberg et al., 2017). Notably, liver cirrhosis destroys liver tissues, which is irreversible despite measures to prevent further damages.
Patient Education on Liver Cirrhosis
Adults diagnosed with liver cirrhosis tend to be issued with home care procedures to minimize the damages caused by diseases. Medical doctors instruct patients who are suffering from liver cirrhosis in abstinence from alcoholic beverages to reduce and prevent further damage to the organ (Mount Nittany Health, 2019). Liver disease patients are instructed with an appropriate diet to follow, such as healthy food consumption free of added table salt, canned food, dried, packaged and fast foods, and limited herbs seasoning of food during preparations (Mount Nittany Health, 2019). Additionally, supplements, medicines, and vaccines are recommended to be taken as prescribed by the physician (Mount Nittany Health, 2019). Hence, a liver cirrhosis patient needs to prodder education to enable them to follow the instructed regimen to regain a healthy immune system and to boost healing and increase their life span.
Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is an immune-mediated inflammatory disease that occurs in the lining of body joints. In RA, the synovial lining layer is significantly hypertrophied, and the subintimal area in the synovium heavily infiltrated with inflammatory cells such as macrophages, mononuclear cells, T and B lymphocytes, and mast cells (Johns Hopkins Arthritis Center, n.d.). Moreover, due to the elaboration of proteolytic enzymes, the cartilage’s resilience, integrity, and water content are impaired, resulting in the destruction of the bone by the osteoclasts activation. Notably, there is a significant collection of fluids in the synovial cavity that cause plasma filtration, which has high protein content (Johns Hopkins Arthritis Center, n.d.). Although the cause of the autoimmune disorder is not precisely known, studies show that the disease results from an interaction between environmental triggers, genetic susceptibility, and chance. The Johns Hopkins Arthritis Center (n.d.) place the global prevalence rate of the autoimmune disease at approximately 1%. Notably, the disease affects all populations, with an annual incidence of approximately 3 cases per 10,000 people globally (Johns Hopkins Arthritis Center, n.d.). Despite its rare occurrence, I found that I had interacted with a middle-aged victim, hom at first I diagnosed with osteoarthritis; hence, I needed to understand more regarding its diagnostic testing and criteria.
Diagnostic Testing and Diagnostic Criteria
The diagnostic criteria involve assessing numerical scores in the four domains of RA which are, acute phase reactants, serology, joint involvement, and symptoms duration. Clinically, if a middle-aged patient scores 6 or more points in the assessment, they are classified as having RA, following the classification criteria by ACR/EULAR, which was developed in 2010 (Mayo Clinic, 2019). Notably, the autoimmune dysfunction markers, RF and ACPA are defined in a range of values for the laboratory tests using the upper limit normal (ULN), which lies between the low positive and high-positive values. The low positive is three times less than ULN while the high-positive is three times greate, and the ESR and CRP levels scores are either normal or abnormal per laboratory standards (Mayo Clinic, 2019). The doctor may also recommend imaging tests that show the progression of the disease within the middle-aged population (Mayo Clinic, 2019). The diagnostic tests and criteria are thorough to ensure that cases are not confused with osteoarthritis among the middle-age adults.
Pneumonia
Pneumonia is an infection that occurs in the lung parenchyma. Notably, there are two classifications of pneumonia, namely, community and hospital-acquired pneumonia. Subsequently, there are several ways a patient in a hospital or a healthy individual can contract the lung infection, which is caused by bacteria, such as pneumococcus, Moraxella Catarrhalis, group A streptococcus, legionella, chlamydia, and mycoplasma (Vardhmaan et al., 2020). Pneumonia caused by viruses, such as syncytial, parainfluenza, adenoviruses, is detected from the nasopharynx of a patient. Fungal causes such as Coccidioides, Blastomyces, and Histoplasma are common in patients with common ailments such as HIV/AIDS as well as those who receive organ transfusion (Vardhmaan et al., 2020). Nonetheless, inflammation occurring in the lung parenchyma is caused by disturbance of defense mechanisms, such as complement-mediated and humoral found in X-linked agammaglobulinemia ailments (Vardhmaan et al., 2020). Additionally, secretions accumulation, such as bronchial obstruction and cystic fibrosis, is commonly observed in lung inflammation cases. Patients suffering from substance abuse have dysfunctional cough reflex resulting in the vulnerability of pneumonia (Vardhmaan et al., 2020). According to World Health Organisation (n.d), 150 million pneumonia cases occur every year among children below five years, which accounts for hospitalization of between 10 to 20 million, whereas 90% of hospital-related pneumonia among children occurs in developing nations (Baker et al., 2017). When pneumonia is left untreated, can lead to sepsis and dysfunction of multi-organ, resulting in the death of patients. Therefore, it is a lethal infection across all ages irrespective of the causes.
Pneumonia Prevention
Lung parenchyma infection among children is preventable through a vaccination, which reduces the severity of pneumonia disease caused by bacteria and viruses. Particulalrly, vaccinating children aginst whooping cough, measles, Hib, and pneumococcus has been noted as an effective direct measure against pneumonia in children (‘Pneumonia,’ n.d.). The defences of children against the infection can also be derived from improved and proper dieting and avoidance of polluted areas. Specifically, among infants, exclusive breasfeeding is a vital process that also helps in defensive mechanisms against diseases and the duration of illness of the child becomes sick (‘Pneumonia,’ n.d.). Environmental factors, such as indoor pollution, should also be considered and reduced. For children with HIV, cotrimoxazole (an antibiotic) is also given on a daily basis to reduce the risk of contracting the lung infection (‘Pneumonia,’ n.d.). Hence, primary and secondary prevention measures against the flu are the best way to avoid the disease.
Cerebral Palsy (CP) in Children
Cerebral palsy (CP) causes destructive damages in preterm babies’ white matter in the periventricular region and also destroys the brainstem and gray matter of newborns. The brain is susceptible to periventricular leukomalacia (PVL), which results from inflammation and ischemia (CDC, 2019). In addition, the brain is susceptible to Intraventricular hemorrhage (IVH), which is the bleeding from the brain cells origin to its ventricles. Subsequently, the PVL ventricles develop late, making them vulnerable to the IVH since there is excess production of pro-inflammatory cytokines due to cell loss in the hypoxic-ischemic (CDC, 2019). Since the leading cause of CP is not known, several risk factors are associated with its etiology and they include premature births, multiple gestations, intrauterine infections, and pregnancy complications, which are antenatal factors. The perinatal factors, such as complications during labor and delivery and birth asphyxia, the postnatal threats, such as meningitis and head trauma, and obstetrical care factors like antibiotics and corticosteroids are also identified as risk factors (CDC, 2019). According to the CDC, the prevalence of CP ranges from 1.5 to more than 4 in 1000 live births in children (CDC, 2019). The disease can be categorized as idiopathic; thus, it is imperative for nurses to understand it from a holistic perspective.
Lifespan Considerations
Primarily, life expectancy for children with cerebral palsy is determined by personal factors. However, certain factors affect them if they do not receive significant lifestyle supports and health care (Verschuren, Smorenburg, Luiking, Bell, Barber, & Peterson, 2018). Therefore, it is vital to manage the conditions, such as increased disabilities and impairments, to maximize the life span of children with CP (Verschuren et al., 2018). Notably, the extent of impairment significantly influences lifespan. In addition, patients with severe mobility from CP are highly dependent on others, which may jeopardize the quality of their life. In addition, seizures and difficulties in feeding may shorten the lifespan of children with CP, as repeated attack cases may cause injuries and oxygen insufficiency (Verschuren et al., 2018. Ultimately, visual impairment and intellectual disability significantly reduce the lifespan of children with CP (Verschuren et al., 2018). Indeed, CP can be considered as a debilitating disease that requires constant care provision to increase the lifespan of the affected children.
Conclusion
The seminar focused on the evaluation of various pathophysiological processes, etiological aspects of common disorders found in several body systems, as well as prevalence in the overall population. The discussed disorders, liver cirrhosis, pneumonia, rheumatoid arthritis, and acute kidney injury, are common or often confused with other ailments. However, relevant disease information, such as testing and diagnostics criteria, prevalence, and lifespan, among others inform nursing processes involved in providing the best critical care for patients. Hence, the nursing conference was a success as it provided insights into various nursing processes that are crucial in improving oneself and overall promotion of a healthy population.
References
Baker, K., Alfvén, T., Mucunguzi, A., Wharton-Smith, A., Dantzer, E., Habte, T., … & Sebsibe, A. (2019). Performance of four respiratory rate counters to support community health workers to detect the symptoms of pneumonia in children in low resource settings: a prospective, multicentre, hospital-based, single-blinded, comparative trial. EClinicalMedicine, 12, 20-30. https://doi.org/10.1016/j.eclinm.2019.05.013
Boyden, S. D., Hossain, I. N., Wohlfahrt, A., & Lee, Y. C. (2016). Non-inflammatory causes of pain in patients with rheumatoid arthritis. Current rheumatology reports, 18(6), 30. https://doi.org/10.1007/s11926-016-0581-0
Butterworth, R. F. (2019). Hepatic encephalopathy in cirrhosis: pathology and pathophysiology. Drugs, 79(1), 17-21. https://doi.org/10.1007/s40265-018-1017-0
CDC. (2019, Apr. 30). Cerebral Palsy (CP). Retrieved from https://www.cdc.gov/ncbddd/cp/data.html
Goldberg, D., Ditah, I. C., Saeian, K., Lalehzari, M., Aronsohn, A., Gorospe, E. C., & Charlton, M. (2017). Changes in the prevalence of hepatitis C virus infection, nonalcoholic steatohepatitis, and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation. Gastroenterology, 152(5), 1090-1099. https://doi.org/10.1053/j.gastro.2017.01.003
Johns Hopkins Arthritis Center. (n.d.). RA Pathophysiology. Retrieved from https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-pathophysiology-2/
Makris, K., & Spanou, L. (2016). Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. The Clinical Biochemist. Reviews, 37(2), 85–98. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198510/
Mayo Clinic. (2019, March 1). Rheumatoid Arthirits. Retrieved from https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653
Mount Nittany Health, 2019. Discharge Instructions for Cirrhosis of the Liver. The StayWell Company. Retrieved from: https://www.mountnittany.org/articles/healthsheets/1795
Pneumonia. (N.d). World Health Organization (WHO). Retrieved from https://www.who.int/news-room/fact-sheets/detail/pneumonia#:~:text=Prevention,effective%20way%20to%20prevent%20pneumonia.
Verschuren, O., Smorenburg, A. R., Luiking, Y., Bell, K., Barber, L., & Peterson, M. D. (2018). Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: a narrative review of the literature. Journal of Cachexia, Sarcopenia and Muscle, 9(3), 453-464. DOI: 10.1002/jcsm.12287
Vardhmaan, J., Rishik, V., Gizem, Y., Abhishek, B., 2020. Pneumonia Pathology. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK526116/
Vera, M. (2019, April 12). Acute Renal Failure Nursing Care Plans. Retrieved from https://nurseslabs.com/6-acute-renal-failure-nursing-care-plans/
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