Sample Answer for NURS 6051 Discussion Alterations in Cellular Processes Included After Question
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!
A Sample Answer For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes
Title: NURS 6051 Discussion Alterations in Cellular Processes
My scenario is: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L.
- The role genetics plays in the disease.
- The patient could have had a genetic predisposition to substance abuse which contributed to his current situation of an overdose and associated rhabdomyolysis
- Why the patient is presenting with the specific symptoms described.
- The patient is likely presenting with opiate overdose due to history of substance abuse and response to naloxone. Additionally the patient is likely suffering from infection of drug administration sites and AKI rhabdomyolysis from laying on the floor for an extended period of time.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The unconscious state is directly related to the opiate overdose. The necrosis is directly related in response to physical trauma and infection from drug use as well as mechanical trauma from having fallen and remaining in a fixed position. The hyperkalemia is as a result of the AKI caused by rhabdomyolysis from the patient having been down for an extended period of time.
- The cells that are involved in this process.
- Epithelial cells that are damaged as result of the trauma, cells within the kidney responsible for protein clearing as well as potassium excretion,
- How another characteristic (e.g., gender, genetics) would change your response.
- A much older patient would have changed my rationales as they would be at a higher risk for accidental overdose and would be at an increased risk for falls and AKI with multiple comorbidities.
Fuentes, & Venkatram, 2014). Simply put, It is a condition that causes the breakdown of muscles; however, for this post, your definition is more detailed.
A Sample Answer 2 For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes
Title: NURS 6051 Discussion Alterations in Cellular Processes
In your assigned scenario, the patient with the following: had a large amount of necrotic tissue over the greater trochanter and the forearm, Prolonged PR interval and peaked T waves on his EKG, and an elevated serum potassium level of 6.9. In your post, you wrote that the patient’s necrosis could have occurred due to prolonged immobilization and compartment syndrome. Since the event wasn’t witnessed, I would suggest that the patient’s reaction drug of choice caused the Rhabdomyolysis. He Rhabdomyolysis typically manifests in one to three days after a muscle injury but has been known to be very “severe when precipitated by drug overdoses compared to other etiologies” (Adrish, Duncalf, Diaz-Fuentes, & Venkatram, 2014) (Cleveland Clinic, 2023). I agree that the potassium is elevated due to the Rhabdomyolysis, and the prolonged PR interval and peaked T waves were caused by the elevated potassium. The patient’s loss of consciousness could result from a drug overdose or symptom of Rhabdomyolysis.
Lastly, I agree that an older patient is at a higher risk for accidental overdose and falls. Other risk factors for Rhabdomyolysis in a more aging population include extended periods of inactivity; certain medical conditions; severe dehydration, and certain medications (antipsychotic, antidepressant, antiviral diabetic, and statins) (Cleveland Clinic, 2023). Thank you for your post.
References
Adrish, M., Duncalf, R., Diaz-Fuentes, G., & Venkatram, S. (2014). Opioid Overdose with Gluteal Compartment Syndrome and Acute Peripheral Neuropathy. Retrieved June 1, 2023, from National Library of Medicine. National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899172/.
Cleveland Clinic (2023). Rhabdomyolysis. Retrieved June 1, 2023, from Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/21184-rhabdomyolysis#:~:text=Rhabdomyolysis%20symptoms%20can%20range%20from,not%20even%20notice%20muscle%20soreness.
National Institute on Drug Abuse (n.d.). Drug Facts. Genetics: The Blueprint of Health and Disease. Retrieved June 1, 2023, from National Institute of Health: https://nida.nih.gov/publications/drugfacts/genetics-epigenetics-addiction.
A Sample Answer 3 For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes
Title: NURS 6051 Discussion Alterations in Cellular Processes
I like how you connected Rhabdomyolysis and hyperkalemia as a result of this patient being down for an extensive amount of time. Studies have shown that prolonged limb compression (if the patient was lying on their side the entire time they were down) can cause massive Rhabdomylysis that can also cause the patient to have hyperkalemia (Madhusoodanan et al., 2004). This case study has also stated that Creatinine Kinase levels should be checked in all suspected intoxicated patients due to the high chances of their levels being high and could initiate earlier treatment for Rhabdomyolysis. I also agree that age could play a different factor in this case due to the elderly population being at a more increased risk for dehydration and the fact that their risk for Rhabodomyolosis is higher in most cases after falling (Wongrakpanich et al., 2018).
Madhusoodanan, S., Gupta, S., Calleja, G., Bogunovic, O., & Brenner, R. (2004). A Case of Rhabdomyolysis After Intravenous Heroin Use. Primary care companion to the Journal of clinical psychiatry, 6(5), 221–222. https://doi.org/10.4088/pcc.v06n0509Links to an external site.
Wongrakpanich, S., Kallis, C., Prasad, P., Rangaswami, J., & Rosenzweig, A. (2018). The Study of Rhabdomyolysis in the Elderly: An Epidemiological Study and Single Center Experience. Aging and disease, 9(1), 1–7. https://doi.org/10.14336/AD.2017.0304
A Sample Answer 4 For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes
Title: NURS 6051 Discussion Alterations in Cellular Processes
I agree that the unconscious state is directly related to opioid overdose. In the given scenario, the patient was likely lethargic and lying on his left side for a prolonged period. Opioids impact patients’ perception of discomfort, even when awake, which may lead to tissue ischemia and necrosis. Opiate-related ER cases related to crush injuries are on the rise, resulting in muscle necrosis, rhabdomyolysis, and compartment syndrome ((McCance & Huether, 2018),
You stated that the hyperkalemia is due to the AKI caused by rhabdomyolysis from the patient having been down for an extended period. As a result of prolonged immobility, rhabdomyolysis occurs when damaged skeletal muscle cells disintegrate rapidly, releasing toxins such as creatinine kinase (CK) and myoglobin, which are common in opiate users. A contributing factor may be dehydration, vascular constriction, or muscle injury, including compression of the postural muscles in a comatose state (Gupeme et al., 2015). Due to drug action, potassium may shift between the tissue and plasma compartments, thereby altering serum potassium concentrations. The potassium and EKG results suggest that the patient had an overdose related to opiates. Thanks for sharing,
References
Gülpembe, M., Acar, D., Akıllı, N., Çalık, S., Günaydın, Y., Köylü, R., & Başar, C. (2015). Rhabdomyolysis Associated with Opiate Abuse: A Case Report. Journal of Academic Emergency Medicine Case Reports / Akademik Acil Tip Olgu Sunumlari Dergisi, 6(1), 13–15. https://doi.org/10.5152/jaemcr.2015.746
McCance, K.L & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.).
Name: NURS_6501_Discussion_Rubric
| Excellent | Good | Fair | Poor | ||
| Main Posting | Points Range: 45 (45%) – 50 (50%)
Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 40 (40%) – 44 (44%)
Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 35 (35%) – 39 (39%)
Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 34 (34%)
Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | Points Range: 10 (10%) – 10 (10%)
Posts main post by Day 3. |
Points Range: 0 (0%) – 0 (0%)
N/A |
Points Range: 0 (0%) – 0 (0%)
N/A |
Points Range: 0 (0%) – 0 (0%)
Does not post main post by Day 3. |
|
| First Response | Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
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| Second Response | Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
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| Participation | Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on 3 different days. |
Points Range: 0 (0%) – 0 (0%)
N/A |
Points Range: 0 (0%) – 0 (0%)
N/A |
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
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| Total Points: 100 | |||||
Name: NURS_6501_Discussion_Rubric
A Sample Answer For the Assignment:
Title:
NURS 6051 Discussion Alterations in Cellular Processes
Main Question Post
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Hello Colleagues,
The boy in the scenario was being treated with amoxicillin due to his positive rapid strep test and symptoms. Common symptoms include fever, red swollen tonsils, purulent tonsils, pain when swallowing, petechiae, odynophagia, and swollen lymph nodes (CDC, 2021). His local symptoms of inflammation involve vascular changes and leakage into the tissues (McNance & Huether, 2019). The redness and swelling are due to increased blood flow to the area from vasodilation. Capillaries dilate and allow white blood cells to leak into the infected area. His pain is from the increased pressure on the tissues from the accumulation of fluids in the area. The purulent exudate is the end result of phagocytizing cells dying in the area and being eliminated through epithelial tissue in the throat. These cells have already reached maturity and cannot replicate anymore. They are also sensitive to the acidic environment of the body, so they die after performing their immunological duties (McCance & Huether, 2019). The lymphatic system is the reason for the anterior and posterior cervical adenopathy. Lymphatic channels transport body fluids from the infection site to nodules. These nodules are swollen due to fluid shifts. The nodes act as a processing center introducing the invaders to B-cells, T-cells, and macrophages that reside in the nodes (NCBI, 2021). The immune system analyses the invaders and is able to fine tune its response.
The physiologic response to the amoxicillin was a type 1 hypersensitivity response. Cells in the body saw amoxicillin as a threat and started an inflammatory immune response. It all begins with mast cells. Mast cells line skin, blood vessels, and lung tissue. They can be activated by injury, chemicals, adaptive immune responses, or recognizing molecular patterns of viruses and bacteria (McCance & Huether, 2019). Immunoglobulin E (IgE), a chemical floating in blood plasm, binds to mast cells causing the release prostaglandins, interleukins, leukotrienes, and histamine through a process called degranulation. Mast cells also release chemicals that attract neutrophils and eosinophils to sites of injury where they phagocytose foreign invaders to the body. Histamine is the most important chemical in this reaction. When it binds to the H1 receptor it causes hives, vasodilation, bronchoconstriction, hypotension, and increased mucous production. This allows phagocytes such as neutrophils, eosinophils, and dendritic cells to enter the injured area. Red blood cells (RBCs), other body fluids, along with all white blood cells pass through causing edema to the affected areas. All of this extra fluid responding to the threat caused edema to his tongue, lips, airway and increased secretion of lung tissues. This is an urgent issue as it leads to airway compromise which is life threatening.
Strep throat is seen more in children than adults, especially ages five to 15 (CDC, 2018). Crowded areas such as schools and daycare centers increase risk of transmission (CDC, 2018). As of late, the quarantine has kept children at home so this could be slowing the spread. He is on the high end of the age for those children getting strep throat, but his social situation can also influence it.
Genetic factors play a role too. Approximately ten percent of all U.S. patients report having allergies to a penicillin class antibiotic in their past (CDC, n.d.). Parents can pass down allergies through genetics (NCBI, 2014). This is why it is a good idea to have children tested for allergies when they are younger. That way severe allergic reactions can be anticipated, and life-threatening situations can be avoided.
Thanks,
Centers for Disease Control (CDC). (n.d.) Is it really a penicillin allergy? https://www.cdc.gov/antibiotic-use/community/pdfs/penicillin-factsheet.pdf
Centers for Disease Control (CDC). (2021, January 12) Strep throat: all you need to know. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html
Centers for Disease Control (CDC). (2018, November) Group A streptococcal (gas) disease. https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
McCance, K., & Huethe, S. (2019) Pathophysiology the biologic basis for disease in adults and children (8thed.). St. Louis, MO: Elsevier
National Center for Biotechnology Information (NCBI). (2021). Adenopathy. https://www.ncbi.nlm.nih.gov/books/NBK513250/
National Center for Biotechnology. (2014) Genetics of allergic diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415518/
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