Feb 23, 2024 NURS 6501 Module 2 Assignment Case Study Analysis
NURS 6501 Module 2 Assignment Case Study Analysis
NURS 6501 Module 2 Assignment Case Study Analysis
A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling.
Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia.
Question 1 of 4:
Describe the positive symptoms of schizophrenia and relate those symptoms to the case study patient.
Selected Answer:
Some of the positive symptoms of schizophrenia are olfactory, auditory, somatic-tactile hallucinations. conversing and commenting voices. Patients may also experience delusions of reference, control, mind reading, persecution, grandiosity, and guilt, and somatic symptoms of thought withdrawal, insertion, and broadcasting. Some of the thought disorder symptoms that most schizophrenic patients exhibit include incoherence, derailment, distractible speech, illogicality, and circumstantially. Bizzare behaviors exhibited include an agitated and aggressive status, being repetitively stereotyped, sexual, and social behavior. The patient in this case scenario presented with persecution, auditory hallucinations, and a disheveled appearance.
Correct Answer:
Positive symptoms of schizophrenia include hallucinations that may be auditory, olfactory, somatic-tactile, visual, voices commenting, and voices conversing. Delusions are also positive symptoms and include delusion of being controlled, delusion of mind reading, delusion of reference, delusion of grandiosity, guilt, persecution, somatic thought broadcasting, thought insertion and thought withdrawal.
Thought disorder symptoms include distractible speech, incoherence, illogicality, circumstantially, and derailment. Bizarre behaviors are other positive symptoms of schizophrenia. Those behaviors include aggressiveness and agitated states, clothing appearance, repetitive stereotyped, and social and sexual behavior.
This patient exhibited signs of auditory hallucinations, disheveled appearance, and persecution.
Response Feedback:
[None Given]
An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.
Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.
Photo Credit: yodiyim / Adobe Stock
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Module 2: Case Study Analysis Assignment
By Day 1 of Week 3, choose a case study scenario for this term and assign the scenario to your students in your section. Please post by copying and pasting the case study scenario in the “Course Announcements” section of the course. Students will need their assigned scenario to complete the Assignment for this module. Note: These case study scenarios will be rotated throughout each term to reduce any academic integrity issues. For each term, please use one case study scenario at a time. Please contact your lead faculty member if you have any questions.
Scenario 1: 76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now has to sleep on two pillows in order to get enough air.
Scenario 2: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF)
Scenario 3: 11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. Mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields.
Scenario 4: 45-year-old woman presents with chief complaint of 3-day duration of shortness of breath, cough with thick green sputum production, and fevers. Patient has history of COPD with chronic cough but states the cough has gotten much worse and is interfering with her sleep. Sputum is thicker and harder for her to expectorate. CXR reveals flattened diaphragm and increased AP diameter. Auscultation demonstrates hyper resonance and coarse rales and rhonchi throughout all lung fields.
An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Assignment (1- to 2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
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By Day 7 of Week 4
Submit your Case Study Analysis Assignment by Day 7 of Week 4
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “M2Assgn+last name+first initial.(extension)” as the name.
Click the Module 2 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M2Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Module 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Module 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 4
To participate in this Assignment:
Module 2 Assignment
What’s Coming Up in Module 3?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 3, you will analyze processes related to gastrointestinal and hepatobiliary disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.
Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders
In Week 5 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 3. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check since the resources cover the topics addressed. Plan your time accordingly.
Next Module
To go to the next Module:
Module 3
Week 4: Alterations in the Cardiovascular and Respiratory Systems
Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.
This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.
Learning Objectives
Students will:
Analyze processes related to cardiovascular and respiratory disorders
Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
Analyze racial/ethnic variables that may impact physiological functioning
Evaluate the impact of patient characteristics on disorders and altered physiology
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
Chapter 35: Structure and Function of the Pulmonary System; Summary Review
Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review
Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.
Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062
Note: The above article was first presented in the Week 3 resources. If you read it previously you are encouraged to review it this week.
Required Media (click to expand/reduce)
Alterations in the Cardiovascular and Respiratory Systems – Week 4 (15m)
Pneumonia
MedCram. (2015, September 14). Pneumonia explained clearly by MedCram [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo
Note: The approximate length of the media program is 13 minutes.
(Previously reviewed in Week 3)
Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/
The assigned case study demonstrates a middle age female patient with chief complaints of dyspnea, fever, and cough with thick green sputum production for 3 days. The patient also has a history of COPD and chronic cough, which has gotten worse over the past few days affecting her sleep. Upon examination, it was noted that the patient’s diaphragm had flattened, AP diameter increased, hyper resonance on auscultation with rhonchi, and coarse rales throughout all lung fields. The purpose of this discussion is to provide an analysis of the patient described above and the cardiovascular and cardiopulmonary pathophysiologic processes that contributed to the patient’s symptoms.
Pathophysiologic Processes
The patient presents with a history of COPD and chronic cough with thick green sputum. The current symptoms of dyspnea, cough, and fever indicate exacerbation of COPD with complications of a respiratory infection (Hikichi et al., 2018). The patient’s shortness of breath resulted from the obstructed airways secondary to inflammation, sputum hypersecretion, and airway remodeling. Reduced elastic recoil of the lung caused by emphysema and airway obstruction leads to dynamic hyperinflation and incomplete air expelling (Santus et al., 2019). Accumulation of the mucus leads to coughing by the patient as an attempt to try and clear the airways. The increased production of thick green sputum and fever are signs of bacterial infection in COPD exacerbation.
Racial/Ethnic Variables
There is limited evidence on the racial/ethnic variables in the characteristics and progress of COPD. Non-Hispanic whites have however been reported to have the highest burden associated with symptoms of chronic bronchitis and cardiovascular diseases as comorbidities of COPD (Park et al., 2021). African Americans on the other hand, have reported the highest incidences of dyspnea due to lifestyle habits like smoking and reduced exercise capacity (Lee et al., 2018). Korean patients on the other hand were more likely to be underweight as compared to other ethnic groups, hence reduced COPD symptoms and complications (D’Cruz et al., 2020). Generally, the ethnic variables in COPD are due to sociodemographic differences in lifestyle habits, education, and cultural beliefs among other factors.
How Process interact to Affect the Patient
As discussed above, the pathophysiology of COPD involves the interaction of both cardiovascular and cardiopulmonary processes. Impairments in the cardiopulmonary functioning leading to COPD are associated with several risk factors including smoking, exposure to chemicals, race, age, and history of asthma (Hikichi et al., 2018). Such risk factors contribute to pathologic changes in the small (peripheral) bronchioles, large (central) airways, and lung parenchyma. Structural changes of the airways include ciliary abnormalities, focal squamous metaplasia, atrophy, inflammation, airway smooth muscle hyperplasia, and bronchial wall thickening leading to chronic bronchitis (Santus et al., 2019). Permanent enlargement of the airspaces from the distal to the terminal bronchioles also leads to a significant decline in the surface area of the alveoli available for gas exchange causing emphysema. The above mechanisms contribute to the patient’s symptoms such as shortness of breath, chronic cough, increased sputum production, and fever.
Conclusion
The middle-aged patient in the provided case study presents with symptoms indicating COPD exacerbation. Several cardiopulmonary processes contribute to the development of the patient’s condition such as the small (peripheral) bronchioles, large (central) airways, and the lung parenchyma. However, with a comprehensive understanding of the pathophysiology of the patient’s condition, it will be easier for the clinician to develop the most effective treatment plan.
References
D’Cruz, R. F., Murphy, P. B., & Kaltsakas, G. (2020). Sleep-disordered breathing and chronic obstructive pulmonary disease: a narrative review on classification, pathophysiology and clinical outcomes. Journal of Thoracic Disease, 12(S2), S202–S216. https://doi.org/10.21037/jtd-cus-2020-006
Hikichi, M., Hashimoto, S., & Gon, Y. (2018). Asthma and COPD overlap the pathophysiology of ACO. Allergology International, 67(2), 179–186. https://doi.org/10.1016/j.alit.2018.01.001
Lee, H., Shin, S. H., Gu, S., Zhao, D., Kang, D., Joi, Y. R., Suh, G. Y., Pastor-Barriuso, R., Guallar, E., Cho, J., & Park, H. Y. (2018). Racial differences in comorbidity profile among patients with chronic obstructive pulmonary disease. BMC Medicine, 16(1). https://doi.org/10.1186/s12916-018-1159-7
Park, H. Y., Lee, H., Kang, D., Choi, H. S., Ryu, Y. H., Jung, K.-S., Sin, D. D., Cho, J., & Yoo, K. H. (2021). Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea. Therapeutic Advances in Chronic Disease, 12, 204062232098245. https://doi.org/10.1177/2040622320982455
Santus, P., Pecchiari, M., Tursi, F., Valenti, V., Saad, M., & Radovanovic, D. (2019). The Airways’ Mechanical Stress in Lung Disease: Implications for COPD Pathophysiology and Treatment Evaluation. Canadian Respiratory Journal. https://www.hindawi.com/journals/crj/2019/3546056/
The case study depicts a 42-year-old male who comes to the ED with a two-day history of pain during urination, low back pain, inability to fully empty the bladder, severe perineal pain, fever, and chills. The pain worsens when he stands up and is relieved to some degree by lying down. He has a fever, tachycardia, and tachypnea. The patient has an enlarged, tender, and swollen prostate that is warm to touch on DRE. The purpose of this paper is to discuss Prostatitis as it relates to this patient.
Why Prostatitis and Infection Happens
Prostatitis is an infection of the prostate characterized by painful inflammation of the prostate. Acute bacterial Prostatitis occurs when pathogens enter the prostate gland through the urethra via the prostatic ducts or intraprostatic reflux of urine. Pathogens may also get to the prostate through direct inoculation, for instance, by prostate biopsy or transurethral procedures like cystoscopy and catheterization (Zhang et al., 2020). Prostatitis is mostly caused by Escherichia coli. Other causative organisms include Pseudomonas, Klebsiella, Proteus, and Enterococcus species (Karami et al., 2022). Patients with a lower urinary tract infection (UTI) have a higher risk since pathogens travel from the lower genital tract through the urethra to the prostate, causing inflammation.
The patient has symptoms characteristic of lower UTI, like dysuria, inability to fully empty the bladder, fever, chills, and tachycardia. The pathogens likely traveled to the prostate through the urethra. This caused prostate inflammation, evidenced by DRE findings of an enlarged, tender, and swollen prostate that is warm to touch. Prostatic tenderness indicates bacterial infection (Kanani et al., 2021). The patient presents with clinical manifestations of Acute Bacterial Prostatitis like perineal pain, low back pain, and urinary retention with an inability to void
Tissue invasion occurs in bacterial Prostatitis, which presents with systemic symptoms like fever, chills, malaise, and muscle pain. Furthermore, a generalized sepsis syndrome may occur, presenting with tachypnea, tachycardia, and sometimes hypotension (Kanani et al., 2021). The patient has systemic symptoms like tachypnea, tachycardia, fever, and chills.
Conclusion
Bacterial Prostatitis occurs when pathogens migrate from the lower urinary tract to the prostate through the urethra. The pathogens can also be inoculated during treatment or catheterization. This causes inflammation of the prostate, causing enlargement, tenderness, and swelling. Acute bacterial Prostatitis often causes systemic symptoms of fever, chills, malaise, tachycardia, and tachypnea.
References
Kanani, S., Mujtaba, N., & Sadler, P. (2021). Acute and chronic prostatitis. InnovAiT, 14(1), 33-37. https://doi.org/10.1177/1755738020966359
Karami, A. A., Javadi, A., Salehi, S., Nasirian, N., Maali, A., Bakhshalizadeh Shadkam, M., Najari, M., Rousta, Z., & Alizadeh, S. A. (2022). Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens. Iranian journal of microbiology, 14(2), 161–167. https://doi.org/10.18502/ijm.v14i2.9182
Zhang, J., Liang, C., Shang, X., & Li, H. (2020). Chronic prostatitis/chronic pelvic pain syndrome: a disease or symptom? Current perspectives on diagnosis, treatment, and prognosis. American Journal of Men’s Health, 14(1), 1557988320903200. https://doi.org/10.1177/1557988320903
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Name: NURS_6501_Module2_Case Study_Assignment_Rubric
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Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:
Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.
Points Range: 28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms.
The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.
Points Range: 25 (25%) – 27 (27%)
The response describes the patient symptoms.
The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.
Points Range: 23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate.
The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research.
Points Range: 0 (0%) – 22 (22%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.
The response does not include reasons for either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research.
Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.
Points Range: 28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.
Points Range: 25 (25%) – 27 (27%)
The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.
Points Range: 2
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