CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

Sample Answer for CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501 Included After Question

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

RESOURCES

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WEEKLY RESOURCES

BY DAY 7 OF WEEK 3

Complete the Knowledge Check by Day 7.

A Sample Answer For the Assignment: CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

Title: CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

The case study demonstrates a 45-year-old female patient with a chief complaint of shortness of breath, fever, and productive cough with thick green sputum for the past three days. The patient also presents with a history of chronic obstructive pulmonary disease (COPD) and chronic cough history. However, the cough has gotten worse, to the point that it currently interferes with her sleep. She has been using expectorants which have failed to relieve her thick sputum. The chest x-ray results reveal increased anteroposterior diameter and flattened diaphragm. Upon auscultation, the patient displays hyper resonance and coarse rhonchi and rales all through the entire lung fields. This paper illustrates the cardiovascular and cardiopulmonary pathophysiology of the patient’s disease process and the racial and ethnic variables that may affect physiological functioning.

Cardiovascular and Cardiopulmonary Pathophysiologic Processes

Based on the subjective and objective data provided, the patient’s most likely primary diagnosis is COPD. This condition is characterized by emphysema and chronic bronchitis. The pathophysiology of chronic bronchitis is characterized by inflamed bronchial tube lining, leading to shortness of breath, cough, and increased mucus (sputum) production (Dunican et al., 2021). On the other hand, emphysema is characterized by an increased inflammatory response as a result of inhaled cigarette smoke among other noxious partials, destroying the parenchyma of the lungs and disrupting the normal lung deficit and repair mechanism, in addition to narrowing the airways, leading to shortness of breath and excessive mucus production, in addition to cough and fever. The destroyed lung parenchyma displays increased anteroposterior diameter and flattened diaphragm when viewed under X-ray.

Racial/Ethnic Variables

According to Park et al. (2020), Asian and black people, among other minorities in the United States, display a reduced prevalence of COPD compared to whites. This variation is mainly based on environmental factors like cigarette smoke and genetics. Studies show that Asians may have a smaller decline in lung function than whites with the same rate of exposure to cigarette smoke (Han, 2020). On the other hand, Blacks are more susceptible to the negative impact of cigarette smoke compared to other ethnic groups. Concerning genetics, studies show that deficiency in a1-antitrypsin is rare in nonwhites, hence the reduced risks of respiratory complications like COPD (Reddy et al., 2020).

Interactions between Cardiovascular and Cardiopulmonary Process and Impact on the Patient

The pathophysiology of COPD and cardiovascular complications are associated with interactions between cardiac and pulmonary processes such as systemic inflammation, lung hyperinflation, hypoxemia, oxidative stress, exacerbations, and pulmonary hypertension (PH) (Barreiro, Wang, & Tang, 2019). Hyperinflation is characterized by increased residual gas in the lungs after spontaneous exhalation, resulting in an increased burden of COPD and mortality (Dunican et al., 2021). Abnormal lung function resulting from hyperinflation is also associated with compromised cardiac function due to increased pressures in the cardiopulmonary system, reduced cardiac output,  impaired left-ventricular filling, and right-ventricular dysfunction.

Conclusion

The patient in the provided case study presents with symptoms of COPD. This disorder is characterized by emphysema and chronic bronchitis, which present by shortness of breath, productive cough, and fever. Studies show that the pathophysiology of COPD and cardiovascular conditions is associated with an interaction between a decline in lung function and increased pressure in the cardiopulmonary system.

CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

References

Barreiro, E., Wang, X., & Tang, J. (2019). COPD: preclinical models and emerging therapeutic targets. Expert opinion on therapeutic targets, 23(10), 829-838. https://doi.org/10.1080/14728222.2019.1667976

Dunican, E. M., Elicker, B. M., Henry, T., Gierada, D. S., Schiebler, M. L., Anderson, W., … & Fahy, J. V. (2021). Mucus plugs and emphysema in the pathophysiology of airflow obstruction and hypoxemia in smokers. American Journal of Respiratory and Critical Care Medicine, 203(8), 957-968. https://doi.org/10.1164/rccm.202006-2248OC 

Han, M. K. (2020). Chronic obstructive pulmonary disease in women: a biologically focused review with a systematic search strategy. International journal of chronic obstructive pulmonary disease, 15, 711. DOI: 10.2147/COPD.S237228

Park, S. L., Cheng, I., Wu, A. H., Porcel, J., Wilkens, L. R., Le Marchand, L., & Setiawan, V. W. (2020). Abstract C096: Ethnic differences of chronic obstructive pulmonary disease (COPD) in the Multiethnic Cohort Study. DOI: 10.1158/1538-7755.DISP18-C096

Reddy, A. T., Lakshmi, S. P., Banno, A., Jadhav, S. K., Pulikkal Kadamberi, I., Kim, S. C., & Reddy, R. C. (2020). Cigarette smoke downregulates Nur77 to exacerbate inflammation in chronic obstructive pulmonary disease (COPD). PloS one, 15(2), e0229256. https://doi.org/10.1371/journal.pone.0229256

A Sample Answer 2 For the Assignment: CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

Title: CARDIOVASCULAR AND RESPIRATORY DISORDERS MODULE 2 NURS 6501

Question 1

2 out of 2 points

CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”

HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

1 of 2 Questions:

Why is HDL considered the “good” cholesterol?

Selected Answer:	HDL carries between 20-25% of the total cholesterol in plasma. It is a good cholesterol since it accumulates the excess cholesterol that exists in body cells for excretion in the liver.
Correct Answer:	HDL is considered the good cholesterol because it collects excess cholesterol in the body cells and transports it to the liver where it is excreted in the body cells and transports it to the liver where it is excreted in the body. HDL carries 20-25% of total plasma cholesterol.
Response Feedback:	[None Given]

Question 2

3 out of 3 points

CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”

His diagnosis is an acute inferior wall myocardial infarction.

2 of 2 Questions:

Explain the role inflammation has in the development of atherosclerosis.

Selected Answer:	Mitochondrial damage caused by chronic inflammatory processes cause inflammation in the heart muscles. These processes cause an increase in the production of free radicals that activate the continuous cycle of chronic inflammation.
Correct Answer:	Inflammation in the heart muscle caused by chronic inflammatory processes leads to mitochondrial damage that results in an increased free radical production that further activates the chronic inflammatory vicious cycle.
Response Feedback:	[None Given]

Question 3

1 out of 1 points

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A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

Question:

What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?

Selected Answer:	The pericardium tends to roughen following inflammation caused by a post-viral syndrome or an underlying autoimmune disease. The roughening is what produces a classic rub that an APRN can hear at the left sternal border and apex of the heart.
Correct Answer:	The inflammation of the pericardium, due to either the underlying autoimmune disease or a post viral syndrome, causes roughening of the pericardium. The roughening of the pericardium causes the classic “rub” which can best be heard at the apex of the heart and left sternal border.
Response Feedback:	[None Given]

Question 4

1 out of 1 points

A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu. Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD).

Question:

Explain how a positive strep test has caused the patient’s symptoms.

Selected Answer:	A pharyngeal infection with GABHs (Group A Beta Hemolytic Streptococcus) often leads to the development of RHD, which is an abnormal response to cell-mediated responses. The inflammatory cascade associated with this process cause exudative and proliferative lesions, and scarring in the valve tissue. Since it is the endocardium which contains valves that is primarily affected, inflammation of the endocardium results to subsequent inflammation of valves.
Correct Answer:	Rheumatic Heart Disease (RHD) only develops after a pharyngeal infection with Group A beta hemolytic streptococcus. It is an abnormal response to humoral and cell-mediated response to M proteins on the microorganisms. The intense inflammation caused by these reactions cause proliferative and exudative lesions in connective tissue. This inflammation causes scarring of the valve tissue. The inflammation usually affects the endocardium which contains the valves. Endocardial inflammation causes swelling of leaflets in the valves.
Response Feedback:	[None Given]

Question 5

1 out of 1 points

The APRN sees a 74-year-old obese female patient who is 2 days post-op after undergoing left total hip replacement. The patient has had severe post op nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says she feels like the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

Question:

Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.

Selected Answer:	When there is injury to a blood vessel, there is platelet adherence to blood vessel walls influenced by antiplatelet substances. When platelets aggregate, they form clots. Therefore, virchow’s triad damaged the blood vessel walls. Since this patient is reportedly obese, inability to engage in physical therapy and an advanced age caused venous stasis,
Correct Answer:	Virchow’s Triad caused damage to the walls of the vessels. When there is injury to the intimal layer of the vessel, antiplatelet substances such as nitric oxide and prostacyclin, along with the expression of collagen on the vessel wall, causes adherence of the platelets to the vessel wall. The platelets become activated then aggregate forming clots. Venous stasis as a result of obesity, patient’s advanced age and inability to go to physical therapy.
Response Feedback:	[None Given]

Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.