Feb 23, 2024 NURS 6501 Module 7: Case Study Analysis Assignment
NURS 6501 Module 7: Case Study Analysis Assignment
NURS 6501 Module 7: Case Study Analysis Assignment
Case Study Analysis
Genitourinary disorders affect a significant proportion of the population, resulting in low quality of life and increased disease burden. Nurses and other healthcare providers adopt evidence-based interventions to promote optimum outcomes. Therefore, this paper examines a case study involving a 14-year-old female that is brought to the urgent care with complaints of bruises and gum bleeding. The purpose of this assignment is to examine topics that include factors affecting fertility, rise of inflammatory markers in STDs/PID, anemia and different types, and the need for splenectomy after ITP.
The Factors that Affect Fertility (STDs)
The assigned case study does not relate to sexually transmitted infections (STDs). STDs affect fertility. Untreated STDs ascend the reproductive tract to cause tubal damage, inflammation, and scarring, which cause infertility. STDs caused by pathogenic bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis cause morbidities such as pelvic inflammatory disease and tubal factor that are associated with infertility. In addition, pathogenesis such as Trichomonas vaginalis and Mycoplasma genitalium play a role in causing tubal damage and potentiating the likelihood of patients developing infertility(Smolarczyk et al., 2021). The interaction between these causes, patient factors, co-infections, and vaginal microbiome affects fertility.
Why Inflammatory Marker Rise in STD/PID
STD or pelvic inflammatory disease are associated with a significant rise in inflammatory markers. The rise in the inflammatory markers is attributable to the presence of bacteria and other organisms that cause these infections. The presence of these organisms stimulates the immune system to release inflammatory markers such as interleukins 1, 66, and 8 and cytokines(Mokotedi et al., 2019). The role of these inflammatory markers is to respond to the infection by attempting to eliminate the infectious agents from the body.
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Why Prostatitis and Infection Happens
STDs can also cause prostatitis and other secondary infections. Patients affected by prostatitis experience symptoms such as difficult or painful urination because of inflamed prostate gland. Microorganisms such as bacteria associated with STDs and PID may access the prostate gland, resulting in their multiplication and inflammation of the gland. In addition, systemic reaction may arise from STDs and PID. The spread of the bacterial infection through blood and the lymphatic tissue my cause widespread systemic reaction in a patient. Besides, acute prostatitis due to bacterial infections may also contribute to systemic infections(Bielecki et al., 2020). Therefore, this explains the correlation between STDs, PID, prostatitis, and systemic reaction.
Why a Patient would Need a Splenectomy After a Diagnosis of ITP
Splenectomy is considered an effective treatment for patients diagnosed with immune thrombocytopenia (ITP). The spleen plays the crucial role of platelet clearance and production of autoantibodies. It also acts as the niche where immune cells promote antiplatelet antibody formation. The spleen also stores long-lived plasma cells that have anti-platelet antibody producing properties. These functions make the spleen the primary organ involved in ITP pathogenesis. Splenectomy, which entails the surgical removal of the spleen eliminates autoantibody production and platelet clearance site, which improves ITP symptoms. Splenectomy also reduces the risk of relapses of ITP and improved response to medical therapies adopted for ITP(Al-Samkari& Kuter, 2020; Mageau et al., 2022). Patients also benefit from the stabilization in the platelet count in most of the patients who undergo the treatment.
Anemia and Different Kinds of Anemia
Anemia is a condition characterized by the low hemoglobin level below the expected level for a patient’s age and gender. Anemia exists in different types. One of them is microcytic anemia. In microcytic anemia, the red blood cells are smaller than the normal red blood cells because of the inadequate hemoglobin. Normocytic anemia is the other type where there are inadequate red blood cells to meet the body’s needs. Macrocytic anemia is the other type anemia. Macrocytic anemia has features that include abnormally large red blood cells. It arises from defects in the ability of the bone marrow to produce red blood cells. The other sub-types of anemia include iron-deficiency, sideroblastic, thalassemia, and hemolytic anemias(Guo et al., 2019; Tvedten, 2022).
Conclusion
STDs cause infertility. Inflammatory markers rise in PID and STDs. Splenectomy is an effective treatment for ITP. Anemia exists in different types that affect the treatment approaches. ss
Module 7: Case Study Analysis Assignment
Scenario 1: A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.
Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl
Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2
99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.
Scenario 2: 42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO2 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch.
Scenario 3: 67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.
Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO2 95% on room air.
Physical exam revealed pale, anxious female appearing older than stated years.
HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.
Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B12 levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.
Scenario 4: A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.
Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.
Please do a 1- to 2-page case study analysis.
In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):
The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why prostatitis and infection happens. Also explain the causes of systemic reaction.
Why a patient would need a splenectomy after a diagnosis of ITP.
Anemia and the different kinds of anemia (i.e., micro and macrocytic).
Module 7 Assignment: Case Study Analysis
An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.
Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..
An understanding of the symptoms of alterations in systems based on these characteristics 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 as it applies to the scenario you were provided (not all may apply to each scenario):
The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why prostatitis and infection happens. Also explain the causes of systemic reaction.
Why a patient would need a splenectomy after a diagnosis of ITP.
Anemia and the different kinds of anemia (i.e., micro and macrocytic).
Day 7 of Week 10
Submit your Case Study Analysis Assignment by Day 7 of Week 10
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 “M7Assgn+last name+first initial.(extension)” as the name.
Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 7 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 “M7Assgn+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 7 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Module 7 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 10
To participate in this Assignment:
Module 7 Assignment
What’s Coming Up in Module 8?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.
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Week 11 Knowledge Check: Pediatrics
In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. 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.
Week 11 Final Exam: Pediatrics
Photo Credit: Giii / iStock / Getty Images Plus / Getty Images
In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam 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 Final Exam, since the resources cover the topics addressed. Plan
Next Module
To go to the next module:
Module 8
Week 10: Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders
Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.
Understanding these differences in traits and their impact on pathophysiology can better equip acute care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.
This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives
Students will:
Analyze concepts and principles of pathophysiology across the life span
Analyze processes related to women’s and men’s health, infections, and hematologic disorders
Identify 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 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
Chapter 27: Sexually Transmitted Infections, including Summary Review
Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review
Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review
Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481
Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview
Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3
Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true
Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.
Document: NURS 6501 Final Exam Review (PDF document)
Note: Use this document to help you as you review for your Final Exam in Week 11.
Required Media (click to expand/reduce)
Module 7 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 7 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m)
Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia
Note: The approximate length of the media program is 5 minutes.
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 24, 26, 28, and 30 that relate to the reproductive and hematological 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/
Various factors affect fertility. The presence of the STDs such as Chlamydia and gonorrhea are examples of some of the common forms of STDs that lead to infertility in a person. The reason inflammatory markers tend to rise in STD/PID is the high level of white cell count. The high level of white cells count indicates that the pelvic inflammatory disease is excessively severe (Low, N. & Broutet N. J. 2017). Hence, the inflammatory response is an indication of the presence of an infection and is a response as the first line of defense (Chaparro & Suchdev, 2019).
Acute bacterial prostatitis is caused by the presence of common strains of bacteria. The infections begin when the bacteria that are present in the urine find their way onto the prostate area. Most of the time, the common forms of treatment entail antibiotics to ensure that the infection is effectively treated. Notably, prostate massage should not be performed for patients that have acute prostatitis condition, given that it will end up causing sepsis (Le, 2016). It is rare to witness sepsis that arises from prostatitis but can occur among patients whose immunity has been compromised.
A patient that has been diagnosed with ITP needs splenectomy given that the immune system of the patient treats the platelets as foreign material to the body and hence will destroy them. The spleen is the part that is responsible for the removal of the damaged platelets from the body. For this reason, removing the spleen of the patient is a strategy that will ensure that there are more platelets in the body (Chaparro & Suchdev, 2019).
The presence of macrocytic anemia is an indication that the red blood cells have low levels of hemoglobin in the body. Hemoglobin is a form of protein that contains high levels of iron that is responsible for the transportation of oxygen around the body. The underlying causes of macrocytic anemia include deficiency in B-12 or folate in the body (Le, 2016). For this reason, the condition is sometimes called vitamin deficiency anemia.
Microcytic anemia is defined as a state in which there is the presence of small and hypochromic red blood cells in the peripheral of the blood smear that is characterized by a low level of the MCV. A low level of MVC means less than 83 microns 3. Hence, the most common cause of microcytic anemia is iron deficiency.
The different kinds of anemia include:
Hypochromic microcytic anemias include iron-deficient anemia, thalassemia, and sideroblastic anemia.
Normochromic microcytic anemia
Anemia of inflammation of chronic diseases including infectious diseases such as tuberculosis, HIV/AIDS, and inflammatory diseases such as rheumatoid arthritis.
Hypochromic microcytic anemias are caused by a genetic condition that is regarded as congenital spherocytic anemia.
Other causes of microcytic anemia include:
Lead toxicity
Copper deficiency
Excess zinc leading to deficiency in copper
Excessive alcohol consumption
Drug abuse
References
Chaparro, C. M., & Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology, and etiology in low‐ and middle‐income countries. Annals of the New York Academy of Sciences. https://doi.org/10.1111/nyas.14092
Le, C. H. (2016). The prevalence of anemia and moderate-severe anemia in the US population (NHANES 2003-2012). PLOS ONE, 11(11), e0166635. https://doi.org/10.1371/journal.pone.0166635
Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481
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Name: NURS_6501_Module7_Case Study_Assignment_Rubric
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Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following as it relates to the case you were assigned (omit section that does not pertain to your case, faculty will give full points for that section):
Explain the factors that affect fertility (STDs)
Points Range: 23 (23%) – 25 (25%)
The response accurately and thoroughly describes the patient symptoms.
The response includes accurate, clear, and detailed explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.
Points Range: 20 (20%) – 22 (22%)
The response describes the patient symptoms.
The response includes accurate, explanations of the processes related to women’s and men’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.
Points Range: 18 (18%) – 19 (19%)
The response describes the patient symptoms in a manner that is vague or inaccurate.
The response includes explanations of the processes related to women’s and men’s health, infections, and hematologic disorders, with explanations that are vague or based on inappropriate evidence/research
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