NURS 6501 – Advanced Pathophysiology
NURS 6501 – Advanced Pathophysiology week 1 Initial post
The Role of Genetics in the Disease Process
According to the Centers for Disease Control and Prevention (CDC, n. d.), Viruses are the most common cause of a sore throat. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep). Sore throat, swallowing pain, fever, red and swollen tonsils, tiny red spots on the roof of the mouth, or swollen lymph nodes in the front of the neck are common symptoms. It is spread by coming into contact with droplets from an infected person’s cough or sneezing. It is most common in children aged 5 to 15 years old. To prevent the spread of the infection, practice good hand hygiene and cover your mouth and nose when coughing or sneezing. Antibiotics such as penicillin or amoxicillin are frequently used to treat it. Other serious infections caused by Group A streptococci (GAS) in humans include necrotizing fasciitis, rheumatic fever, and glomerulonephritis (CDC, n. d.).
DNA, the most important component of genes, serves as the blueprint for all proteins in the body, allowing genes to influence all aspects of body structure and function. Any change or error in a gene sequence can result in a genetic disease (McCance & Huether, 2019). Differences in host genes give different susceptibility and result in invasive group A Streptococcus (GAS) patients. According to a recent study, children with frequent tonsillitis have a genetically poor immune response to group A strep bacteria (Citroner, 2019). According to the study, it shows two specific form genes which reduced one’s ability to fight strep throat and resulted in recurrent tonsillitis, and one gene variation protected against group A strep infection. According to Galloway-Pena et al. (2018), GAS strains tend to change the sequence of the M protein, which prevents phagocytosis and weakens the host’s immune response, allowing infections to spread to humans. Vaccines against GAS infections target M proteins
The Reasons for Patient’ Presentation with the Specific Symptoms
The body’s immune response to invading microorganisms results in the above-mentioned symptoms. The soreness and white exudate on the tonsils in the throat, redness of the pharynx, and swelling of the cervical adenopathy are all inflammatory responses of innate immunity symptoms caused by Streptococcus bacteria. According to McCance and Huether (2019), “Inflammation is a rapid and nonspecific protective response to cellular injury”. The goal is to prevent further damage to tissue, limit infections, and begin healing. Inflammation manifestations result in redness, heat, swelling, pain, and loss of function and releases fluids like serous and purulent. Fever of 99.6F is an early sign of inflammation. Because many microorganisms that cause infections are sensitive to slight increases in body temperature, a febrile response can be beneficial to the body. Mast cells, endothelial cells, platelets, neutrophils, eosinophils, monocytes, macrophages, dendritic cells, natural killer cells, and lymphocytes are all types of cells that participate in the inflammatory process (McCance & Huether, 2019).
The Reason for Physiologic Response to the Stimulus
Allergies are reactions caused by the immune system as it responds to environmental substances such as amoxicillin in this case study, where the patient is experiencing systemic anaphylaxis symptoms such as tongue swelling, difficulty breathing, and wheezing. The immune system defends the body from foreign antigens. Hypersensitivity or an altered immune response, such as an allergy to an antigen, can, on the other hand, cause disease or damage to the host cell (McCance & Huether, 2019).
The Cells Involved in the Process
Amoxicillin allergy reactions occur when the drugs bind to proteins on target cell plasma membranes and become immunogenic or function as targets of type II reactions. The immune system fights the allergen on the plasma membrane, destroying the cell in the process. The antigen antibiotics in this case study produce type II hypersensitivities in which allergic haptens bind to the surface of the specific cells and elicit an IgG and IgM response (McCance & Huether, 2019). Type II hypersensitivity reactions occur via five distinct mechanisms, with the antigen being destroyed via complement-mediated lysis. Second, antibodies kill cells via phagocytosis by macrophages. The third process is immune destruction mediated by neutrophils. The fourth process involves natural killer cells inducing apoptosis in target cells. The fifth process causes target cells to malfunction. It entails the modulation or obstructing of a receptor’s normal cellular function by an anti-receptor antibody. Endothelial cells, macrophages, neutrophils, and natural killer cells are among the cells involved in the process.
Effect of Gender, Genetics, and Environment
Immune response changes like autoimmunity, hypersensitivity, alloimmunity, or immune-deficiency are multifactorial, with gender, genetic, infections, and environmental factors all playing a role. An Individual’s genetic makeup determines the degree of the immune response against an antigen or insult (McCance & Huether, 2019). Most primary immune deficiencies, for example, are caused by a single gene defect, whereas secondary immune deficiencies are caused by disease or physiologic changes such as aging, stress, trauma, medical treatment, and chronic illness. Some infections like Hepatitis B, Measles, and Aids, and others suppress the immune system. Because of the effect of estrogen, females have stronger innate and adaptive immune responses than males, according to Moulton (2018). Estrogen stimulates humoral responses, B cell differentiation, and the production of immunoglobulins (Ig). In autoimmune diseases, progesterone and androgens are immunosuppressive, whereas estrogens are immunostimulatory (Moulton, 2018). Multiple Sclerosis and Rheumatoid improve during pregnancy as a result of the estrogen effect.
References
Centers for Disease Control and Prevention (CDC). (n. d.). Pharyngitis (strep throat).Retrieved
February 25, 2022, from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
Galloway-Pena, J., DebRoy, S., Li, X., Kalia, A., Shah, B. J., Fowler, V. G.,Shelburne, S. A.
(2018). Identification of a chimeric emm gene and novel emm pattern in currently
circulating strains of emm4 Group A Streptococcus. Microbial Genomics, 4(11),
e000235. https://doi.org/10.1099/mgen.0.000235
George Citroner (2019, February). Here’s why certain kids repeatedly get strep throat: New
research sheds light on repeated strep throat infections. Retrieved from
https://www.healthline.com/health-news/why-your-kid-keeps-getting-strept
throat#Removing-tonsils-not-always-the-best-solution
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in
adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Moulton, V. R. (2018). Sex hormones in acquired immunity and autoimmune disease. Frontiers
in Immunology, 9. https://doi-org.ezp.waldenulibrary.org/10.3389/fimmu.2018.02279
REPLY QUOTE EMAIL AUTHOR
2 months ago
RE: Discussion Initial post
COLLAPSE
Thanks for your discussion on the patient case. The patient is experiencing an allergic reaction to the antibiotic. Anaphylaxis is a medical emergency is overlooked from time to time. This could result in the patient dying. Emergency treatment can mean a matter of life & death. Recognizing the signs/symptoms & intervening with appropriate treatment is essential. Prevention is very important. Avoiding the offending agent is necessary. Good information on the role of genetics and disease.
Dr.
REPLY QUOTE EMAIL AUTHOR
2 months ago
RE: Discussion Initial post
COLLAPSE
Very good post on breaking down the various step that lead to the infection and also possible causes of the child’s reaction. IgE a type 1 mediated hypersensitivity reaction occurs commonly against environmental antigens which also contributed to some autoimmune and alloimmune disease, with histamine been it’s most common mediator. Histamine affects several target cells acting through H1 receptor cells and induces bronchial constriction, increased permeability and causing edema, all symptoms the child presented with after taking the prescribed medication to treat his strep throat.
Reference:
McCance,K,l. & Huether,S.E. (2019) Pathophysiology; The biologic basis for disease in adults and children( 8thed.) St.Louis,M.O; evolve.elsevier
NURS 6501 – Advanced Pathophysiology
Advanced practice nurses must be equipped with an in-depth understanding of pathophysiological disease processes across the lifespan. In this course, students focus on understanding the biophysiological processes, the deviations from these processes, and an in-depth examination of the scientific concepts related to the biology of disease processes. Advanced practice nursing students learn how normal organ systems function and how organ systems are interrelated to help the body maintain homeostasis. Through knowledge of pathophysiological disease processes, students gain the information needed to develop appropriate treatment plans for patients across the lifespan. Students explore a variety of topics, such as immunity, inflammation, cancer genetics, and cardiovascular disease. They also examine a range of disease processes, including hematologic, renal, neurologic, gastrointestinal, and reproductive disorders. NURS 6501 – Advanced Pathophysiology.
Week 1: Cellular Processes and the Genetic Environment
One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.
Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.
This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.
Learning Objectives
Students will:
Evaluate cellular processes and alterations within cellular processes
Evaluate the impact of the genetic environment on disease
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 1: Cellular Biology; Summary Review
Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
Chapter 7: Innate Immunity: Inflammation and Wound Healing
Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls
Required Media (click to expand/reduce)
Module 1 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)
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Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)
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Immunity and Inflammation
Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk
Note: The approximate length of the media program is 14 minutes.
Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M
Note: The approximate length of the media program is 15 minutes.
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
Go to https://evolve.elsevier.com/cs/store?role=student
Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
Complete the registration process.
To View the Content for This Text
Go to https://evolve.elsevier.com/
Click on Student Site.
Type in your username and password.
Click on the Login button.
Click on the plus sign icon for Resources on the left side of the screen.
Click on the name of the textbook for this course.
Expand the menu on the left to locate all the chapters.
Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
Discussion: Alterations in Cellular Processes
Photo Credit: Getty Images
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
To prepare:
By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
The role genetics plays in the disease.
Why the patient is presenting with the specific symptoms described.
The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
The cells that are involved in this process.
How another characteristic (e.g., gender, genetics) would change your response.
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion
Assignment
Part 1
Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.
Field Experience: MSN Nurse Practitioner Practicum Manual
Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.
Part 2
This mandatory assignment is an acknowledgement that you fully understand the course guidelines.
By Day 3 of Week 1
Submit your Assignment.
Submission and Grading Information
Submit Your Assignment by Day 3 of Week 1.
To complete this assignment, follow the link below and answer the questions provided.
Week 1 Assignment
Week 2: Altered Physiology
With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.
This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.
This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.
Learning Objectives
Students will:
Evaluate cellular processes and alterations within cellular processes
Analyze alterations in the immune system that result in disease processes
Identify racial/ethnic variables that may impact physiological functioning
Evaluate the impact of patient characteristics on disorders and altered physiology
Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Module 1 Assignment: Case Study Analysis
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.
Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.
Photo Credit: Getty Images/Hero Images
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
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.
Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Module 1 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Module 1 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
To participate in this Assignment:
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
To go to the next Module:
Module 2
Week 3: Concepts of Cardiovascular and Respiratory Disorders
The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.
Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.
This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives
Students will:
Analyze concepts and principles of pathophysiology across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Module 2 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 2 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and Assignment. (4m)
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Cardiovascular Respiratory Disorders – Week 3 (16m)
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Pneumonia
MedCram. (2015, September 14). Pneumonia explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo
Note: The approximate length of the media program is 13 minutes.
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/
Knowledge Check: Cardiovascular and Respiratory Disorders
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
myocardial infarction
endocarditis
myocarditis
valvular disorders
lipid panels
coagulation
clotting cascade
deep vein thrombosis
hypertension
heart failure
COPD
asthma
pneumonias
Photo Credit: Getty Images/Science Photo Library RF
Complete the Knowledge Check by Day 7 of Week 3
To complete this Knowledge Check:
Module 2 Knowledge Check
What’s Coming Up in Week 4?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology.
Next Week
To go to the next week:
