NURS – 6501N: Advanced Pathophysiology

DISCUSSION # 1

Factors That Influence Disease

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.

 

To Prepare

· Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.

· Select a disorder from the following list:

· Adrenal insufficiency (Addison’s disease)

· Atherosclerosis

· Cholelithiasis (gallstones)

· Colon cancer

· Cystic fibrosis

· Hemophilia

· Nephrolithiasis (kidney stones)

· Osteoporosis

· Parkinson’s disease

· Tuberculosis

· Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.

· Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.

 

Post a brief description of a patient scenario involving the disorder and the factor you selected. Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

 

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 1, “Cellular Biology”

 

This chapter reviews cellular biology to establish a foundation for exploring the pathophysiology of disease. It also covers the structure and function of cellular components, cell-to-cell adhesions, cellular communication, cellular metabolism, membrane transport, the cell cycle, and tissues.

 

· Chapter 2, “Genes and Genetic Diseases”

 

This chapter explores genetic disorders and factors that impact genetic disorders. It also examines how mutations and chromosomal abnormalities lead to transmission of genetic disorders.

 

· Chapter 4, “Altered Cellular and Tissue Biology”

 

This chapter examines disorders related to cell adaptation, injury, and death. It also explores disorders associated with altered cellular and tissue function as a result of aging.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 2, “Genetic Disease”

 

This chapter reviews the clinical manifestations, pathophysiology, and genetic principles of genetic diseases. It also explores different types of genetic diseases and the mechanisms involved.

 

· Chapter 5, “Neoplasia”

 

This chapter explores various disorders associated with neoplasia. It also covers causes and effects of common cancers and tumors resulting from neoplasia.

 

Required Media

Laureate Education, Inc. (Executive Producer). (2012d). Introduction to advanced pathophysiology. Baltimore, MD: Author.

 

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pathophysiology for the advanced practice nurse.

 

DISCUSSION # 2 (This has 2 Parts)

Discussion A: Maladaptive Responses to Immune Disorders

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?

 

To Prepare

· Review Chapter 6 and Chapter 8 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.

· Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).

· Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.

· Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders.

 

Post a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder.

 

Discussion B: Arthritis

While arthritis impacts nearly 50 million adults in the United States, it is not a disease that is limited to adulthood. Consider the case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was always swollen and that she often wanted to be carried instead of walking on her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder was discovered. Arthritis in children is not uncommon. According to the CDC (2011), an estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition. Due to the prevalence of the disorder in both children and adults, you must understand the pathophysiology and symptoms of arthritis in order to properly diagnose and prescribe treatment.

 

To Prepare

· Review Chapter 37 in the Huether and McCance text and Chapter 24 in the McPhee and Hammer text. Identify the pathophysiology of osteoarthritis and rheumatoid arthritis. Consider the similarities and differences of the disorders.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of and treatment for the disorders.

 

Post a description of the pathophysiology of osteoarthritis and rheumatoid arthritis, including the similarities and differences between the disorders. Then explain how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of treatment for the disorders.

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 6, “Innate Immunity: Inflammation and Wound Healing”

 

This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.

 

· Chapter 7, “Adaptive Immunity”

 

This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.

· Chapter 8, “Infection and Defects in Mechanism of Defense”

 

This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.

· Chapter 9, “Stress and Disease”

 

This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.

· Chapter 10, “Biology of Cancer”

 

This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.

· Chapter 11, “Cancer Epidemiology”

 

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

 

· Chapter 12, “Cancer in Children and Adolescents”

 

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

 

· Chapter 38, “Structure and Function of the Musculoskeletal System”

 

This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.

· Chapter 39, “Alterations of Musculoskeletal Function”

 

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.

· Chapter 40, “Alterations of Musculoskeletal Function in Children”

 

This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.

· Chapter 41, “Structure, Function, and Disorders of the Integument”

 

This chapter begins with an overview of the structure and function of skin. It then covers effects of aging on skin, as well as disorders of the skin, hair, and nails.

· Chapter 42, “Alterations of Integument in Children”

 

This chapter covers alterations of the integument that affect children. These include acne vulgaris, dermatitis, infections of the skin, insect bites and parasites, vascular disorders, and other skin disorders.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 3, “Disorders of the Immune System”

 

This chapter explores the anatomy and physiology of the immune system. It also explores the pathophysiology of various immune disorders such as primary immunodeficiency diseases and AIDS.

· Chapter 8, “Diseases of the Skin”

 

This chapter begins with an overview of the anatomy and physiology of skin. It also explores the pathophysiology of various types of skin lesions and inflammatory skin diseases.

· Chapter 24, “Inflammatory Rheumatic Disease”

 

This chapter explores the pathogenesis of inflammation and its role in rheumatic diseases. It also examines the clinical presentation, etiology, pathophysiology, and clinical manifestations of rheumatic diseases such as gout and rheumatoid arthritis.

Required Media

 

Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://www.medmaps.co.uk/beta/

Gastro-oesophageal reflux disease. [Image]. Used with permission of MedMaps.

 

This media provides examples of mind maps for dementia, endocarditis, and gastro-oesophageal reflux disease (GERD).

 

Optional Resources

 

Arthritis Foundation. (2012). Retrieved from http://www.arthritis.org/

 

 

Lupus Foundation of America. (2012). Retrieved from http://www.lupus.org/newsite/index.html

 

DISCUSSION # 3

Pain

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.

To Prepare

· Review this week’s media presentation on the neurological system, as well as Chapter 14 in the Huether and McCance text.

· Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

 

Post a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Learning Resources

 

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 13, “Structure and Function of the Neurologic System”

 

This chapter begins with an overview of the structure and function of the nervous system. It also explains the importance of the central, peripheral, and autonomic nervous systems.

 

· Chapter 14, “Pain, Temperature, Sleep, and Sensory Function”

 

This chapter covers the role of pain, sleep, stress, and the senses on body functions. It also explores alterations involving pain, sleep, stress, and the senses.

 

· Chapter 15, “Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function”

 

This chapter explores disorders of cognitive systems, neuromotor function, tone, movement, and motor performance. It also examines factors that impact these disorders as well as clinical manifestations.

 

· Chapter 16, “Disorders of the Central and Peripheral Nervous Systems and Neuromuscular Junction”

 

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of central and peripheral nervous system disorders. Tumors of the central nervous system are also covered.

 

· Chapter 17, “Alterations of Neurologic Function in Children”

 

This chapter focuses on the pathophysiology, clinical manifestations, evaluation, and treatment of neurologic disorders and brain tumors in children. Normal growth and development is also examined.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 7, “Nervous System Disorders”

 

This chapter begins with an overview of the structure and function of the nervous system to lay a foundation for exploring nervous system disorders. It then examines several nervous system disorders such as Parkinson’s disease, epilepsy, dementia, Alzheimer’s disease, and stroke.

 

· Chapter 12, “Disorders of the Adrenal Medulla”

 

This chapter examines disorders relating to alterations of the adrenal medulla. It classifies disorders by the organ or tissue that is most impacted by the disorder. The pathophysiology, clinical manifestations, symptoms, and signs of the disorders are also covered.

 

· Chapter 19, “Disorders of the Hypothalamus & Pituitary Gland”

 

This chapter covers the structure and function of the hypothalamus and pituitary glands. It also explores disorders of the hypothalamus and pituitary glands.

 

· Chapter 21, “Disorders of the Adrenal Cortex”

 

This chapter begins by exploring the structure and function of the adrenal cortex. It then explores disorders relating to alterations of the adrenal cortex.

Required Media

 

Laureate Education, Inc. (Executive Producer). (2012f). The neurological system. Baltimore, MD: Author.

 

This media presentation outlines the pathophysiology of the neurological system and associated alterations.

 

Optional Resources

 

Alzheimer’s Association. (2016). Retrieved from http://www.alz.org/

 

 

National Multiple Sclerosis Society. (2016). Retrieved from http://www.nationalmssociety.org/index.aspx

 

 

National Parkinson Foundation. (2016). Retrieved from http://www.parkinson.org/

 

 

DISCUSSION # 4

Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

 

To Prepare

· Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.

· Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.

· Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected.

By Day 3

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

 

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 23, “Structure and Function of the Cardiovascular and Lymphatic Systems”

 

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.

 

· Chapter 24, “Alterations of Cardiovascular Function”

 

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

 

· Chapter 25, “Alterations of Cardiovascular Function in Children”

 

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart disease from acquired cardiovascular disorders.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 11, “Cardiovascular Disorders: Vascular Disease”

 

This chapter begins with an overview of the vascular component of the cardiovascular system and how the cardiovascular system is normally regulated. It then describes three common vascular disorders: atherosclerosis, hypertension, and shock.

Required Media

 

Laureate Education, Inc. (Executive Producer). (2012a). Alterations of cardiovascular functions PPT lecture. Baltimore, MD: Author.

 

This media presentation outlines common alterations of cardiovascular function, including disorders of the veins and arteries.

 

Optional Resources

 

American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/

 

 

Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html

 

 

National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/

 

 

DISCUSSION # 5 (This Discussion has 2 Parts)

Discussion A: Cardiovascular Alterations

At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

 

Consider the following scenario:

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

 

To Prepare

· Review the scenario provided, as well as Chapter 25 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

· Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

 

Post a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.

 

Discussion B: Anaphylactic Shock

The treatment of anaphylactic shock varies depending on a patient’s physiological response to the alteration. Immediate medical intervention and emergency room visits are vital for some patients, while others can be treated through basic outpatient care.

Consider the January 2012 report of a 6-year-old girl who went to her school nurse complaining of hives and shortness of breath. Since the school did not have any medication under her name to use for treatment and was not equipped to handle her condition, she was sent to an emergency room where she was pronounced dead. This situation has raised numerous questions about the progression of allergic reactions, how to treat students with severe allergies, how to treat students who develop allergic reactions for the first time, and the availability of epinephrine in schools. If you were the nurse at the girl’s school, how would you have handled the situation? How do you know when it is appropriate to treat patients yourself and when to refer them to emergency care?

 

To Prepare

· Review “Anaphylactic Shock” in Chapter 24 of the Huether and McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text, and the Jacobsen and Gratton article in the Learning Resources.

· Identify the multisystem physiologic progression that occurs in anaphylactic shock. Think about how these multisystem events can occur in a very short period of time.

· Consider when you should refer patients to emergency care versus treating as an outpatient.

· Select two patient factors different from the one you selected in this week’s first Discussion: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the process of anaphylactic shock.

 

Post an explanation of the physiological progression that occurs in anaphylactic shock. Then, describe the circumstances under which you would refer patients for emergency care versus treating as an outpatient. Finally, explain how the patient factors you selected might impact the process of anaphylactic shock.

 

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 23, “Structure and Function of the Cardiovascular and Lymphatic Systems”

 

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.

 

· Chapter 24, “Alterations of Cardiovascular Function”

 

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

 

· Chapter 25, “Alterations of Cardiovascular Function in Children”

 

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart diseases from acquired cardiovascular disorders.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 10, “Cardiovascular Disorders: Heart Disease”

 

This chapter begins by exploring the normal structure and function of the heart. It then examines the etiology, pathophysiology, and clinical manifestations of five heart disorders: arrhythmias, congestive heart failure, valvular heart disease, coronary artery disease, and pericardial disease.

Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock.Prehospital Emergency Care, 15(1), 61–66.

Retrieved from the Walden Library databases.

 

This article provides information relating to the diagnosis and management of anaphylactic shock. It also explores difficulties encountered when diagnosing uncommon clinical presentations of anaphylactic shock.

 

Optional Resources

 

American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/

 

 

Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html

 

 

National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/

 

DISCUSSION # 6

Respiratory Alterations

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder. Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders.

 

Consider the following three scenarios:

Scenario 1:

Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection.

 

Scenario 2:

Kevin is a 6-year-old boy who is brought in for evaluation by his parents. The parents are concerned that he has a really deep cough that he just can’t seem to get over. The history reveals that he was in his usual state of good health until approximately 1 week ago when he developed a profound cough. His parents say that it is deep and sounds like he is barking. He coughs so hard that sometimes he actually vomits. The cough is productive for mucus, but there is no blood in it. Kevin has had a low-grade temperature but nothing really high. His parents do not have a thermometer and don’t know for sure how high it got. His past medical history is negative. He has never had childhood asthma or RSV. His mother says that they moved around a lot in his first 2 years and she is not sure that his immunizations are up to date. She does not have a current vaccination record.

 

Scenario 3:

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

 

To Prepare

· Review the three scenarios, as well as Chapter 27 and Chapter 28 in the Huether and McCance text.

· Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described.

· Identify the pathophysiology of the alteration that you associated with the cough.

· Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the disorder.

 

Post a description of the disorder and underlying respiratory alteration associated with the type of cough in your selected scenario. Then, explain the pathophysiology of the respiratory alteration. Finally, explain how the factors you selected might impact the disorder.

 

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

 

· Chapter 26, “Structure and Function of the Pulmonary System”

 

This chapter provides information relating to the structure and function of the pulmonary system to illustrate normal pulmonary function. It focuses on gas transport to build the foundation for examining alterations of pulmonary function.

 

· Chapter 27, “Alterations of Pulmonary Function”

 

This chapter examines clinical manifestations of pulmonary alterations and disorders of the chest wall and pleura. It covers the pathophysiology, clinical manifestations, evaluation, and treatment of obstructive lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema.

 

· Chapter 28, “Alterations of Pulmonary Function in Children”

 

This chapter focuses on alterations of pulmonary function that affect children. These alterations include disorders of the upper and lower airways.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

 

· Chapter 9, “Pulmonary Disease”

 

This chapter begins with an overview of normal structure and function of the lungs to provide a foundation for examining various lung diseases such as asthma and chronic obstructive pulmonary disease (COPD).

Required Media

 

Laureate Education, Inc. (Executive Producer). (2012e). Mid-course review. Baltimore, MD: Author.

 

This media is an interactive mid-course review covering course content.

 

Optional Resources

 

American Lung Association. (2012). Retrieved from http://www.lung.org/

 

 

Asthma and Allergy Foundation of America. (2012). Retrieved from http://www.aafa.org

 

 

Cystic Fibrosis Foundation. (2012). Retrieved from http://www.cff.org/

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Assignment 3: Concept Synthesis Paper on Personal Nursing Philosophy

 

Overview

 

You are required to submit a scholarly paper in which you will identify, describe, research, and apply the concepts that underlie your personal philosophy for professional nursing practice.

 

This will help you identify your own values and beliefs about the established metaparadigms and metatheories of the discipline. It will also help you identify and articulate concepts relevant to your specific practice. This paper is intended to be an exercise in clarification and organization of your professional foundation. You are also required to provide a list of assumptions from personal nursing practice that illustrate the concepts and framework of your theory.

 

Your paper should follow a format that includes:

 

Nursing Autobiography: A brief (1 page) discussion of your background in nursing.

 

my background :   In regards to the professional field, I received my BSN degree in Habana Cuba in 1996 and received my RN license in the State of Florida on October 13, 2014. My nursing practice was as emergency care nursing and internal medicine unit at “Calixto Garcia Hospital”, Cuba for three years, where provide care for patients with life-threatening medical conditions and look after patients who have experienced invasive surgery, accidents and/or trauma. Careful assessment and monitoring of patient progress in order to watch for sudden or subtle changes in a patient’s medical condition that might require emergency intervention and heart monitoring as well as treatment adjustments.

 

Moreover,  I have been in the medical field in United State for more than 13 years working in Home Health Service and Rehabilitation Center in Miami. In my work experience I have been required to demonstrate many of the skills for the Family Nurse Practitioner. I have also undertaken leadership role during my career monitoring nursing students. I have done so successfully and have enjoyed this experience.

 

 

 

• The Four Metaparadigms:Identification, discussion, and documentation from the literature of your perspective on the basic four metaparadigms/concepts of patient, nurse, health, and environment.

 

• Two Practice-Specific Concepts: Identification, discussion, and documentation from the literature of your perspective on at least two other concepts specific to your own practice.

 

• List of Propositions: A numbered list of at least five propositions or assumption statements that clearly connect the concepts described.

 

Consider the following questions as you complete your various tasks related to this assignment.

 

1.	How do I define and employ the four basic metaparadigms of nursing theory in my professional practice?
2.	What are the major concepts I employ that are unique to my professional practice?
3.	What philosophies and theories from the literature of nursing and other disciplines/domains are consistent with these concepts?
4.	How are the concepts of transcultural nursing, the health promotion model, skill acquisition, role theory, and change theory specifically integrated into my philosophy and practice?
5.	What research supports these theories and concepts?
6.	How do I integrate role and change theory into my professional practice and how may these theories be applied to the organization in which I practice?

 

The paper is to be thoroughly researched and well documented, with relevant material from the nursing theorists presented incorporated into the paper. Use the current edition of the APAManual throughout the paper. Sources should focus on references from nursing theory but may also include conceptual and theoretical material from other professional domains. The paper, excluding references or appendices, is to be limited to 9 pages. Writing should be succinct and well organized, as it is impossible for the facilitator to evaluate form and content separately. References have to be peer review less than 5 years old

 

Due date 11/23/2016

 

Your philosophy/framework is to be given a title that is appropriate to its content and emphasis.

 

Grading of the paper will be based on the following:

 

Grading Criteria:	Maximum Points
Nursing Autobiography
The nursing autobiography included personal experiences in the field of nursing.	8
Provided an account of the current professional role of the student.	8
Included factors that guided decision making.	8
Quality of Essay
Enlisted the four metaparadigms.	8
The essay included a definition of the four metaparadigms of nursing with reference to professional practice.	8
The essay mentioned how the metapardigms were employed in nursing practice.	8
The essay enlisted two practice-specific concepts.	8
The essay included clinical examples for each of the chosen concepts.	8
The clinical examples illustrated the concepts in a manner, which further clarified the students’ use of the conceptual material.	8
The essay demonstrated consistency between concepts, assumptions, and clinical application.	8

 

The essay identified and discussed students’ perspective on two other concepts specific to their practice.	8
The essay included a numbered list of at least 5 propositions or assumptions.	8
The concepts were connected and integrated to reveal a meaningful sequence.	8
The essay demonstrated clarification and organization of the students’ professional foundation.	8
The essay demonstrated evidence of critical thinking in analysis and response.	8
The essay demonstrated understanding and integration of lecture material, reading assignments, and sources consulted.	8
Essay was well written, well organized, and articulate.	8
Presentation Criteria
The paper clearly demonstrated understanding of theoretical principles (i.e., concept development, definitions, assumptions, etc.)	3
The paper revealed clarity, organization, and articulation of ideas.	3
The paper showed that ideas were well-documented.	3
The paper revealed the breadth of research effort.	2
The paper demonstrated appropriate use of APA format in references and citations.	3
Total	150

 

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