NURS 6051 Discussion Alterations in Cellular Processes -

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

A Sample Answer For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes

Title: NURS 6051 Discussion Alterations in Cellular Processes

This scenario provided describes a 16-year-old patient who presents with symptoms of streptococcal pharyngitis. Streptococcal pharyngitis is caused by Group A Streptococcus (GAS). The treatment for this gram-positive bacterium is typically amoxicillin or penicillin (Ashurst & Edgerley-Gibb, n.d.). The purpose of this discussion post is to examine the disease, symptomology, and cellular mechanisms of the scenario that was described involving the patient.

The Genetics Role

Studies indicate that there may be a genetic component that predisposes children to streptococcal pharyngitis. Anti-SpeA is anti-streptococcal pyrogenic exotoxin, an antibody that is specific to combating Group A Streptococcus. If a patient is Anti-SpeA deficient, they are more susceptible to contracting infections such as streptococcus pharyngitis (Dan et al, 2019). Soderholm et al state in their 2018 study that certain signaling components such as serine/threonine kinase IL-1 make patients less likely to contract infections such as streptococcus pharyngitis. If a patient is lacking these signaling components, they are more likely to contract infections.

Symptom Presentation

According to the scenario presented, the patient presented with a low grade fever, enlarged, reddened pharynx with white exudate, sore throat, and cervical adenopathy. GAS is typically transmitted through contact with secretions from and infected person. Once infected, the inflammatory response is activated by the presence of phagocytes and toxins in the blood. Swelling, pain, fever, and erythema are characteristics of the inflammatory response (McCance & Huether, 2019). Due to the inflammation of the pharynx, exudate is produced, containing neutrophils, leukocytes, and proteins. This is a part of the defense mechanism involved in removing the infectious virus.

The Physiologic Response

As previously stated, streptococcal pharyngitis is transmitted through contact with secretions from an infected person. The incubation period for streptococcal pharyngitis is 2-5 days. Once the bacteria enter the host, it attaches to epithelial cells and attacks the cells of the host, initiating the inflammatory response. The release of toxins into the system induces the symptoms the patient presented with including swelling, redness, pain, and fever.

The Cells Involved in this Process

There are many different cells involved in the inflammatory process. These cells include mast cells, neutrophils, macrophages, and cytokines. Mast cells induce inflammatory processes through mediator release. Neutrophils are involved with the ingestion of cellular debris, bacteria, and dead cells. Macrophages have several functions during the inflammatory response including chemotactic factors, wound repair, activation of the adaptive immune response. Cytokines bind to target cells to induce the synthesis of cellular products (McCance & Huether, 2019).

How Age Affects the Response

The age group most affected by streptococcal pharyngitis is children. As people age, they main gain immunity from streptococcal pharyngitis. Dan et al (2019) suggest that anti-SpeA antibodies in adults provide immunity against streptococcal pharyngitis. Therefore, the incidence of streptococcal pharyngitis is less likely to occur in adults than children. Age affects the likelihood that a patient will become infected with streptococcal pharyngitis.

References

Ashurst, J., & Edgerley-Gibb, L. (n.d.). Streptococcal pharyngitis – statpearls – NCBI bookshelf. Retrieved February 27, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK525997/

Dan, J. M., Havenar-Daughton, C., Kendric, K., Al-Kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, P., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Lindestam Arlehamn, C. S., Sette, A., Nizet, V., Bothwell, M., Brigger, M., & Crotty, S. (2019). Recurrent group A Streptococcus tonsillitis is an immunosusceptibility disease involving antibody deficiency and aberrant T_FH cells. Science translational medicine, 11(478), eaau3776. https://doi.org/10.1126/scitranslmed.aau3776Links to an external site.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children. Innate Immunity: Inflammation and wound healing. (8th ed., pp 191-217). St. Louis, MO: Mosby/Elsevier.

Soderholm, A. T., Barnett, T. C., Sweet, M. J., & Walker, M. J. (2018). Group A streptococcal pharyngitis: Immune responses involved in bacterial clearance and GAS-associated immunopathologies. Journal of leukocyte biology, 103(2), 193–213. https://doi.org/10.1189/jlb.4MR0617-227RRLinks to an external site.

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 2 For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes

Title: NURS 6051 Discussion Alterations in Cellular Processes

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.

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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 (8^thed.). 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/

A Sample Answer 3 For the Assignment: NURS 6051 Discussion Alterations in Cellular Processes

Title: NURS 6051 Discussion Alterations in Cellular Processes

I agree that genetics does play a role in opioid addiction and substance abuse. “Family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup” (National Institute on Drug Abuse, n.d.). Variations in genes contribute to predisposition to drug addiction (National Institute on Drug Abuse, n.d.). Opioid addiction can cause several health-related uses, including Rhabdomyolysis (Adrish, Duncalf, Diaz-Fuentes, & Venkatram, 2014). However, one cannot inherit Rhabdomyolysis (Adrish, Duncalf, Diaz-Fuentes, & Venkatram, 2014). Simply put, It is a condition that causes the breakdown of muscles; however, for this post, your definition is more detailed.

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.

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