NURS 6051 Discussion Alterations in Cellular Processes
NURS 6051 Discussion Alterations in Cellular Processes
NURS 6051 Discussion Alterations in Cellular Processes
This paper is a case study involving a 27-year-old patient with a history of substance abuse who is found unresponsive by emergency medical services. The patient becomes responsive after being administered naloxone. The essay examines the role of genetics, reasons for patient’s symptoms, physiological response, cells involved, and influence of other characteristics.
Genetics play a role in substance use disorders. For example, opioid use disorder has large risk of being inherited in families. Genes such as OPRM1 variates and A118G also predispose individuals to substance abuse disorder. Individuals of European descent with OPRD1 genes also have high predisposition to opioid use disorder. Additional genes include KCNG2, CNHIH3, KCNC1, RGMA, and APBB2 genes (Crist et al., 2019; Liu et al., 2019).
The patient presented with symptoms such as unresponsiveness due to central nervous system depression by the opiate overdose. The patient became response following the administration of naloxone since its an opiate antagonist that reverses the depressing effects of opiates. The patient reported pain in left hip and forearm because the effects of the opiates had ben reversed, hence, perception of pain. There is also tissue necrosis that may have developed due to poor tissue perfusion from depressed central nervous system, which affected circulation and respiratory system (Parthvi et al., 2019). The patient also developed respiratory acidosis, which increased serum potassium, hence, hyperkalemia and ECG changes.
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The cells involved in the patient’s symptoms include mast cells, neutrophils, and macrophages. These cells induce the induction and transition of the pain the patient experience. Adaptive immune cells such as B and T cells also initiate and resolve pain. Characteristics such as age would change my response in this case study (Machelska & Celik, 2020). For example, the elderly patients have low sensitivity to pain stimuli and potentially worse outcomes due to opiate overdose. These changes will affect the treatment interventions.
In summary, substance abuse has genetic predisposition. The patient developed the given symptoms because of the effects of opioid overdose and naloxone. Age would affect the clinical symptoms and management of opiate overdose.
References
Crist, R. C., Reiner, B. C., & Berrettini, W. H. (2019). A review of opioid addiction genetics. Current Opinion in Psychology, 27, 31–35. https://doi.org/10.1016/j.copsyc.2018.07.014
Liu, M., Jiang, Y., Wedow, R., Li, Y., Brazel, D. M., Chen, F., Datta, G., Davila-Velderrain, J., McGuire, D., Tian, C., Zhan, X., Choquet, H., Docherty, A. R., Faul, J. D., Foerster, J. R., Fritsche, L. G., Gabrielsen, M. E., Gordon, S. D., Haessler, J., … Vrieze, S. (2019). Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use. Nature Genetics, 51(2), Article 2. https://doi.org/10.1038/s41588-018-0307-5
Machelska, H., & Celik, M. Ö. (2020). Opioid Receptors in Immune and Glial Cells—Implications for Pain Control. Frontiers in Immunology, 11. https://www.frontiersin.org/articles/10.3389/fimmu.2020.00300
Parthvi, R., Agrawal, A., Khanijo, S., Tsegaye, A., & Talwar, A. (2019). Acute Opiate Overdose: An Update on Management Strategies in Emergency Department and Critical Care Unit. American Journal of Therapeutics, 26(3), e380. https://doi.org/10.1097/MJT.0000000000000681
Main Question Post
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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 (8thed.). St. Louis, MO: Elsevier
National Center for Biotechnology Information (NCBI). (2021). Adenopathy. https://www.ncbi.nlm.nih.gov/books/NBK513250/
National Center for Biotechnology. (2014) Genetics of allergic diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415518/
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Discussion: Alterations in Cellular Processes
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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.
In this week’s case study, the patient presents with a chief complaint of a sore throat and multiple other
symptoms that resulted in a positive strep test. Strep throat, also known as bacterial pharyngitis, is caused by the presence of Streptococcus group A bacteria that is spread by respiratory droplets and is the most common cause of pharyngitis in children (Chauhan, et al., 2016). In a recent meta-analysis, 37% of children less than 18 years old were diagnosed with Group A Strep and presented to an outpatient center for treatment for a sore throat in comparison to only 15% of adults (Ashurst & Edgerley-Gibb, 2022).
The patient presented with a sore throat, reddened posterior pharynx with white exudate, and 3+ tonsils- all due to the presence and colonization of the streptococcus bacteria. The positive sign of anterior and posterior cervical adenopathy is due to the infection and the body’s response to try and fight the infection. The patient was prescribed ten days’ worth of amoxicillin and after consumption, immediately experienced swelling of the tongue and lips, difficulty breathing, and wheezing. The patient was having an anaphylaxis reaction to the antibiotics. An anaphylaxis response is IgE mediated and results in mast cells releasing a large amount of histamine and leukotrienes that cause bronchospasm and edema (Vaillant, Vashisht, & Zito, 2022).
Even after antibiotic treatment, some children get recurrent strep throat due to a genetic basis. A study performed by Dr. Shane Crotty and Dr. Jennifer Dan (2019), explored the germinal centers of both children with a normal rate of infection and those with recurrent tonsillitis. Their findings suggested that children with recurring strep throat had smaller germinal centers with fewer B and helper T cells which are responsible for producing antibodies and fighting invading pathogens. Upon further research, it was discovered that the genetic component was identified as two variants in the HLA genomic region which are associated with increased susceptibility to recurrent tonsillitis as well as protecting against the disease. If a child presented with recurring group A streptococcus pharyngitis, it may warrant a different response than treating with just antibiotics, such as referring them to an ENT for a tonsillectomy.
NURS 6051 Discussion Alterations in Cellular Processes References
Ashurst, J. V., & Edgerley-Gibb, L. (2022). Streptococcal Pharyngitis. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK525997/
Chauhan, S., Kashyap, N., Kanga, A., Thakur, K., Sood, A., & Chandel, L. (2016). Genetic diversity among group A streptococcus isolated from throats of healthy and symptomatic children. Journal of Tropical Pediatrics, 62(2), 152-157. doi:10.1093/tropej/fmv092
Crotty, S., & Dan, J. (2019). Recurrent group A streptococcus tonsillitis is an immunosusceptibility disease involving antibody deficiency and aberrant TFH cells. Science Translational Medicine, 11(478). doi:DOI: 10.1126/scitranslmed.aau3776
Vaillant, A. A., Vashisht, R., & Zito, P. M. (2022). Immediate hypersensitivity reactions. StatPearls. doi:https://www.ncbi.nlm.nih.gov/books/NBK513315
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.
Discussion: Alteration in Cellular Processes
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
The role genetics plays in the disease:
Humans have approximately 20,000 to 25,000 genes that make up body structure and function. Having any error in any of the genes can lead to genetic diseases, which are then passed on to future generations (McCance & Huether, 2019, p.133). DNA is a code for all the body’s proteins, which are made up of polypeptides. The body is made up of 20 different types of amino acids and 4 bases (Thymine, Adenine, Guanine and Cytosine). Complementary base pairing is the key to replication of DNA. When a base pair substitute takes place, a mutation can occur. A mutation is any inherited alteration of genetic material (McCance & Heuther, 2019, p.137).
Why the patient is presenting with the specific symptoms described.
The patient is suffering from an anaphylactic reaction due to the amoxicillin consumed. The patient has a temperature of 99.6 F, which is his body’s response to either the positive strep test or the Amoxicillin. The patient is facing a type 1 hypersensitivity reaction, which is an immediate reaction due to the anaphylaxis symptoms starting within 24 hours. Amoxicillin belongs to the Penicillin antibiotic group, which can commonly cause anaphylaxis, and is IgE-mediated. An IgE production is a type I hypersensitivity reaction and can trigger anaphylaxis. Swelling of the tongue and lips and difficulty breathing are all symptoms that the patient experienced, which is apart of the anaphylaxis response (Justiz & Zito, 2019).
The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
The patient is experiencing a type I hypersensitivity reaction, where the immunoglobin IgE is produced and binds to Fc receptors on mast cells and basophils. Once the allergen is encountered, which in this scenario is the Amoxicillin, cytophilic IgE cells are triggered, causing the activation of mast cells and their degranulation of mediators. Histamine is then released as well as other mediators, which caused the allergic reaction. In this scenario, the allergic reaction that took place resulted in edema, bronchoconstriction and inflammation (Justiz & Zito, 2019).
The cells that are involved in this process.
The cells that are involved in this type of hypersensitivity reaction include histamine and lipid mediators such as PAF, LTC4, and PGD2. TNF causes inflammation, eosinophils release cationic granule proteins and eosinophil perodxidase which participates in tissue remodeling. IgE antibodies are produced by the immune system in response to allergens. The Ige cells bind to mast cells and basophils, which contain histamine granules, and cause inflammation. The lip edema and bronchoconstriction are all symptoms that are in response to the hypersensitivity reaction (Justiz & Zito, 2019).
How another characteristic (e.g., gender, genetics) would change your response.
Type 1 hypersensitivity reactions can have a genetic predisposition, as well as environment risk. Testing can be completed to check for type I hypersensitivity allergies, and the best way is to avoid the reactions associated is to avoid the triggers. Type 1 sensitivity can stem from allergies to food and drugs, pollen, environmental agents, insects, and many others. Individuals in a lower socioeconomic status are exposed to environmental factors that tend to trigger the reactions more often. It is also possible to be genetically passed down a higher sensitivity to a type 1 reaction, as certain genes and/or higher levels of IgE antibodies can make one more susceptible. Based on my above answers, I would not change my response to the above questions, as the immune response to type 1 sensitivity reaction would not change based on gender or genetics (Abbas et al., 2022).
NURS 6051 Discussion Alterations in Cellular Processes References
Abbas, M., Moussa, M., & Akel, H. (2022, July 18). Type I hypersensitivity reaction. Retrieved February 27, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK560561/
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions Download Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion
Assignment Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.
Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.
What’s Coming Up in Week 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology.
Practicum – Upcoming Deadline
In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .
For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.
Please take the time to review the Appropriate Preceptors and Field Sites for your courses.
Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.
- Field Experience: College of Nursing Quick Answers
- Field Experience: MSN Nurse Practitioner Practicum Manual
- Student Practicum Resources: NP Student Orientation
Next Week
Week 1: Cellular Processes and the Genetic Environment
One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.
Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.
This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.
Learning Objectives
Students will:
- Evaluate cellular processes and alterations within cellular processes
- Evaluate the impact of the genetic environment on disease
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 1: Cellular Biology; Summary Review
- Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
- Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
- Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
- Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
- Chapter 7: Innate Immunity: Inflammation and Wound Healing
- Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
- Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
- Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
- Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
- Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
- Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Required Media (click to expand/reduce)
Module 1 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 1 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 Discussion and Assignment. (4m)
Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)
Immunity and Inflammation
Note: The approximate length of the media program is 14 minutes.
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
Note: The approximate length of the media program is 15 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 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
- Go to https://evolve.elsevier.com/cs/store?role=student
- Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
- Complete the registration process.
To View the Content for This Text
- Go to https://evolve.elsevier.com/
- Click on Student Site.
- Type in your username and password.
- Click on the Login button.
- Click on the plus sign icon for Resources on the left side of the screen.
- Click on the name of the textbook for this course.
- Expand the menu on the left to locate all the chapters.
- Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
Kidney transplant is an effective treatment for patients suffering from end-stage renal disease. However, some patients develop adverse effects including kidney rejection. The management of kidney transplant rejection depends on the type and patient factors. Therefore, this paper examines why a patient with acute kidney transplant developed the described symptoms, genes associated with kidney transplant rejection and process of immunosuppression.
Why the Patient Presented the Symptoms Described
The patient presented symptoms that include gaining weight, decreased urinary output, fatigue, and running temperatures up to 101 F. The patient gained weight because of the increased body fluid volume level. The kidneys excrete excess fluids from the body. Impaired kidney function as seen in the case study affects the regulation of fluids in the body, hence, its accumulation and weight gain. The decline in renal function also impaired normal urine output. This led to reduced urine production, as seen in the case study. The rejection altered the normal renal function in the excretion process, leading to oliguria. The kidneys also eliminate toxins from the body. This includes excess ammonia in urine. Impaired kidney problems affect the elimination of these toxins, which lead to symptoms such as fatigue, poor concentration, acidosis, and anemia. Therefore, this explains the patient’s experience of fatigue. Patients with end-stage renal disease and those with kidney transplant rejection problems also experience immunosuppression (Rauen et al., 2020). This predisposes them to infections, hence, the fever that the patient has.
Genes Associated with the Development of the Disease
Genes have been linked with kidney transplant rejection. They include cytochrome p450 2EI (CYP2EI), CYP3A5, cytotoxic T-lymphocyte associated protein 4 (CTLA4), C-X-C motif chemokine ligand 8 (CXL8), epoxy hydrolase 2, coagulation factor II thrombin, and coagulation factor V genes. In addition, Forkhead box P3, Fc fragment of IgG receptor IIA, major histocompatibility complex class II, I, DO alpha, and interleukin 1 beta, 2, 2-receptor subunit beta genes also play a role in the development of the rejection in kidney transplant. Genes such as interleukin genes are inflammatory cytokines that inhibits inflammatory processes once a person received an allograft. On the other hand, this gene also downgrades the maturation of antigens and cells that develops host’s immunity following the transplant (Arnold et al., 2022; Spicer & Runkel, 2019; van Vugt et al., 2022). Other genes such as ATP-binding genes increase the body’s resistance towards drugs used in suppressing the immune system following the transplant.
Process of Immunosuppression
Immunosuppression refers to the state in which the ability of the body to fight infections is reduced. The immune system is lowered to a level that it cannot counteract any disease causing organisms from invading the body. The causes of immunosuppression include the use of medications that are used in conditions such as cancer. The other cause is conditions that depress the immune system such as cancer and HIV. Treatments for cancer such as radiotherapy and chemotherapy also cause immunosuppression. The effects of immunosuppression are varied. They include increasing the vulnerability of patients to infections. It also increases costs that patients incur due to frequent hospitalizations (Gupta et al., 2021). Prolonged infections also affect the patients’ quality of life. Patients may also die in cases where the immune system is severely compromised.
NURS 6051 Discussion Alterations in Cellular Processes Conclusion
In conclusion, the patient presented the symptoms because of reduced renal functioning. Genes are involved in the development of kidney transplant rejection. The rejection may result in immunosuppression, which has negative effects on health.
NURS 6051 Discussion Alterations in Cellular Processes References
Arnold, M.-L., Heinemann, F. M., Oesterreich, S., Wilde, B., Gäckler, A., Goldblatt, D., Spriewald, B. M., Horn, P. A., Witzke, O., & Lindemann, M. (2022). Correlation of Fc Receptor Polymorphisms with Pneumococcal Antibodies in Vaccinated Kidney Transplant Recipients. Vaccines, 10(5), Article 5. https://doi.org/10.3390/vaccines10050725
Gupta, R., Woo, K., & Yi, J. A. (2021). Epidemiology of end-stage kidney disease. Seminars in Vascular Surgery, 34(1), 71–78. https://doi.org/10.1053/j.semvascsurg.2021.02.010
Rauen, T., Wied, S., Fitzner, C., Eitner, F., Sommerer, C., Zeier, M., Otte, B., Panzer, U., Budde, K., Benck, U., Mertens, P. R., Kuhlmann, U., Witzke, O., Gross, O., Vielhauer, V., Mann, J. F. E., Hilgers, R.-D., Floege, J., Floege, J., … Hilgers, R.-D. (2020). After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney International, 98(4), 1044–1052. https://doi.org/10.1016/j.kint.2020.04.046
Spicer, P., & Runkel, L. (2019). Costimulatory pathway targets for autoimmune and inflammatory conditions: Clinical successes, failures, and hope for the future. Expert Opinion on Investigational Drugs, 28(2), 99–106. https://doi.org/10.1080/13543784.2019.1557146
van Vugt, L. K., Schagen, M. R., de Weerd, A., Reinders, M. E., de Winter, B. C., & Hesselink, D. A. (2022). Investigational drugs for the treatment of kidney transplant rejection. Expert Opinion on Investigational Drugs, 31(10), 1087–1100. https://doi.org/10.1080/13543784.2022.2130751
This 16-year-old patient was presented to the PCP, and we diagnosed them with strep throat. The cells have gone through an extracellular matrix (McCance & Huether, 2019) and are now injured due to infection. The PCP prescribed the antibiotic to reverse the injury. The damage to the cell itself causes the patient to have a reddened pharynx and enlarged tonsils with white patches. The 16-year-old cells are also experiencing hypertrophy, causing an increase in size in the tonsils.
After this patient took two doses of amoxicillin 500mg, they experienced tongue and lips swelling, difficulty breathing, and audible wheezes. This patient is presenting with anaphylaxis. This is an IgE-mediated reaction. IgE antibodies are produced in the immune system. This is considered a type 1 hypersensitivity reaction. The binding of Fc receptors on mast cells and basophils to IgE triggers mast cells and creates an allergic reaction. Enzymes tryptase cause tissue damage, and TNF causes inflammation (Justiz-Vaillant & Zito, 2019).
Initially, when the patient was presented, they had no known drug allergies. The new drug allergy can connect to the infection, especially if it is recurrent. To verify that the amoxicillin allergy is a true allergy, the PCP can use an allergic test called a radioallergosorbent test (RAST) (Justiz-Vaillant & Zito, 2019).
The patient’s anaphylaxis is generalized and not systemic. A study showed that penicillin was reported for 40.7% of antibiotics causing anaphylaxis. In the same survey, it is said that the female gender is more likely to have drug-induced anaphylaxis. Patients with several comorbidities or other medications may also be at higher risk (Regateiro, Marques, & Gomes, 2020).
Reference:
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions Download Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Regateiro, F. S., Marques, M. L., & Gomes, E. R. (2020). Drug-Induced Anaphylaxis: An Update on Epidemiology and Risk Factors. International Archives of Allergy and Immunology, 181(7), 481–487. https://doi.org/10.1159/000507445
I agree with you that the diagnosis of Group A Streptococcus (GAS) means that there is cellular injury by bacterial pathogens.
Cells get injured from several stimuli. Some could be from hypersensitivity to foreign agents, autoimmune deficiency, and Nutritional imbalance. Others could be through infection, where the pathogens invade and destroy cells with their toxins and together with damaging hypersensitivity reactions. It is interesting to note that cell injury or damage could be through nutritional imbalance. Cells require macronutrients like proteins, carbohydrates, and fat, and micronutrients like vitamins, minerals, and trace elements to function appropriately, when these are not available in cells, cellular injury or damage develops (McCance & Huether, 2019). Additionally, cellular damage could occur when there are too much of micronutrients in the cells, and macronutrients, cell membranes are destroyed which leads to many chronic infections and diseases. Xu et al, ( 2023) in their research showed that there is a correlation between hyperlipidemia and the development of atherosclerosis which could cause chronic diseases mediated by a variety of factors and links, in which there is always an interaction between blood and blood vessel wall.
References
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Xu, N., Ijaz, M., Shi, H., Shahbaz, M., Cai, M., Wang, P., Guo, X., & Ma, L. (2023). Screening of Active Ingredients from Wendan Decoction in Alleviating Palmitic Acid-Induced Endothelial Cell Injury. Molecules, 28(3), 1328. https://doi.org/10.3390/molecules28031328Links to an external site.
After considering all the presenting factors, screening, and symptoms, my diagnosis of the patient’s illness is strep throat caused by group A streptococcus infection (GAS).
The Role Genetics Plays in the Disease
Genes are the building blocks of life and have been identified as a mode of transport for certain biomarkers that make individuals more susceptible to certain diseases. Emerging research has shown that although the disease is not transmitted genetically, genes do have a part to play in one’s susceptibility to group A strep infection. Parks et al. (2020) found that the presence of HLA-DQA1*01:03 allele increases susceptibility to GAS by two times. This means that people with such mutations in their genes are twice more likely to suffer from the disease than others. Other research studies in the field have pointed towards genetic variations that inhibit the immune system response to the disease and make it difficult for some people to build up resistance to GAS.
Why Patient is Presenting Specific Symptoms
According to the Centers for Disease Control and Prevention (2020), all the presenting symptoms including positive anterior and posterior cervical adenopathy reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+, and a low-grade fever (99.6F) are classical symptoms of a strep throat infection. Anterior and posterior cervical adenopathy is the swelling of the neck lymph nodes which is associated with upper respiratory tract infections in children as the body works hard to fight the invading bacteria (Weinstock et al., 2018). Furthermore, the swollen tonsils are an indicator that the infection is overwhelming the tonsils which are primarily responsible for filtering out bacteria. However, the white exudates are pus filled spots that are formed when white blood cells combating the infection attacks tissues in the throat.
The Physiologic Response to the Stimulus and why the Response Occurred
The stimulus in question was the ingestion of Amoxicillin 500mg capsule by the patient as a remedy for the strep throat infection. However, the boy had an anaphylactic reaction to the drug as shown by his symptoms which included swollen tongue and lips, audible wheezing, and difficulty breathing. This response occurred because the patient’s immune system is hypersensitive to the drug and reacted as if it was a harmful substance. Hence it is a type 1 hypersensitivity reaction
The Cells Involved in this Process.
Cells involved in the allergic reaction include mast cells, eosinophils and basophils. Immunoglobin IgE binds to Fc receptors on basophils and mast cells. Upon encountering the ingested Amoxicillin which is the allergen, cytophilic IgE antibodies are triggered which leads to degranulation and the release of histamine and other mediators that trigger the allergic reaction (Justiz & Zito, 2019).
How Another Characteristic (e.g., gender, genetics) Would Change the Response
Studies have shown that women are more likely to have a drug-induced allergic reaction than males (Zhao et al., 2018; Dhopeshwarkar et al., 2019). A possible explanation for this phenomenon is that females possess significantly more mast cells than males. While mast cells protect the body from infections and toxins, the higher amount found in females could lead to exaggerated responses in immunology cases like allergies (Salvati et al., 2019). Therefore, having fewer mast cells may decrease the risk of anaphylaxis. Other researchers have also found a link between hormones like estrogen and anaphylaxis.
References
Dhopeshwarkar N, et al. (2019). Drug-induced anaphylaxis documented in electronic health records. J Allergy Clin Immunol Pract. 7(1):103–11. https://doi.org/10.1016/j.jaip.2018.06.010
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions StatPearls Publishing. Treasure Island, FL. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
Parks, T., Elliott, K., Lamagni, T., Auckland, K., Mentzer, A. J., Guy, R., … & Knight, J. C. (2020). Elevated risk of invasive group A streptococcal disease and host genetic variation in the human leucocyte antigen locus. Genes & Immunity, 21(1), 63-70. https://doi.org/10.1038/s41435-019-0082-zLinks to an external site.
Salvati, L., Vitiello, G., & Parronchi, P. (2019). Gender differences in anaphylaxis. Current Opinion in Allergy and Clinical Immunology, 19(5), 417-424.
Weinstock, M. S., Patel, N. A., & Smith, L. P. (2018). Pediatric cervical lymphadenopathy. Pediatrics in review, 39(9), 433-443. https://doi.org/10.1542/pir.2017-0249
Zhao Y, et al. (2018). Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database. Int J Clin Pharm. 40(5):1349–58. https://doi.org/10.1007/s11096-017-0535-2
NURS 6051 Discussion Alterations in Cellular Processes Rubric Detail
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Peer response #1
Courtney, I agree that the patient’s condition of drug dependency may stem from a genetic predisposition towards substance abuse. It has been demonstrated through twin and familial studies that genetic elements do place individuals at risk for becoming dependent on alcohol, tobacco, and drugs all due to their genetic makeup (NIDA, 2019). Therefore, addiction is a complex disease that is chronic, difficult to treat, and have consequences that are extremely damaging (NIDA, 2018).
The patient had an unknown down time when found unresponsive from a drug overdose which was treated with Narcan. Narcan is a lifesaving reversal agent for opioid overdose used to block the effects of the opioids and to restore normal breathing (CDC, n.d.-a). It was also noted that the patient had necrotic injury to his greater trochanter and forearm, prolonged PR intervals, peaked T waves, and K+ 6.9 which is a good assumption that the patient may be in rhabdomyolysis. Rhabdomyolysis is a rapid breakdown of muscle that releases the muscle contents into the blood (CDC, n.d.-b). The patient hypoxic injury to his hip and forearm is caused by ischemia (a lack of oxygen supply to the tissue) and a decrease in ATP which is the cause of the cell death known as necrosis; the ATP failure to generate led to cell death (McCance & Huether 2019). Also, the elevated potassium (K+) know as hyperkalemia is a result of a shift of K+ from ICF to ECF resulting from cell membrane permeability change such as cell hypoxia due to the decrease efficiency of cell membrane active transport causing K+ to leak into the ECF (McCance & Huether 2019). As a result of the elevated K+ there are changes in the ECG such as prolonged PR intervals and peaked T waves. Finally, the depressed respiratory condition was because of the opioid overdose which placed the patient in respiratory acidosis from ineffective gas exchange.
References
Centers for Disease Control and Prevention (CDC). (n.d.-a). Lifesaving Naloxone. https://www.cdc.gov/stopoverdose/naloxone/index.htmlLinks to an external site.
Centers for Disease Control and Prevention (CDC). (n.d.-b). What is Rhabdo? | NIOSH | CDC. https://www.cdc.gov/niosh/topics/rhabdo/what.html
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier
NIDA. 2018, June 6. Understanding Drug Use and Addiction DrugFacts. Retrieved from https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction on 2023, June 3
NIDA. 2019, August 5. Genetics and Epigenetics of Addiction DrugFacts. Retrieved from https://nida.nih.gov/publications/drugfacts/genetics-epigenetics-addiction on 2023, June 3
Content
Name: NURS_6501_Discussion_Rubric
| Excellent | Good | Fair | Poor | ||
| Main Posting | Points Range: 45 (45%) – 50 (50%)Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.Supported by at least three current, credible sources.Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. | Points Range: 40 (40%) – 44 (44%)Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.At least 75% of post has exceptional depth and breadth.Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 35 (35%) – 39 (39%)Responds to some of the Discussion question(s).One or two criteria are not addressed or are superficially addressed.Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 34 (34%)Does not respond to the Discussion question(s) adequately.Lacks depth or superficially addresses criteria.Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | Points Range: 10 (10%) – 10 (10%)Posts main post by Day 3. | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)Does not post main post by Day 3. | |
| First Response | Points Range: 17 (17%) – 18 (18%)Response exhibits synthesis, critical thinking, and application to practice settings.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 15 (15%) – 16 (16%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 13 (13%) – 14 (14%)Response is on topic and may have some depth.Responses posted in the Discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 12 (12%)Response may not be on topic and lacks depth.Responses posted in the Discussion lack effective professional communication.Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | Points Range: 16 (16%) – 17 (17%)Response exhibits synthesis, critical thinking, and application to practice settings.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 14 (14%) – 15 (15%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 12 (12%) – 13 (13%)Response is on topic and may have some depth.Responses posted in the Discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 11 (11%)Response may not be on topic and lacks depth.Responses posted in the Discussion lack effective professional communication.Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | Points Range: 5 (5%) – 5 (5%)Meets requirements for participation by posting on 3 different days. | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)Does not meet requirements for participation by posting on 3 different days. | |
| Total Points: 100 | |||||
Name: NURS_6501_Discussion_Rubric
Main Question Post
The boy in the scenario was being treated with amoxicillin due to his positive rapid strep test and symptoms. Common symptoms include fever, red swollen tonsils, purulent tonsils, pain when swallowing, petechiae, odynophagia, and swollen lymph nodes (CDC, 2021). His local symptoms of inflammation involve vascular changes and leakage into the tissues (McNance & Huether, 2019). The redness and swelling are due to increased blood flow to the area from vasodilation. Capillaries dilate and allow white blood cells to leak into the infected area. His pain is from the increased pressure on the tissues from the accumulation of fluids in the area. The purulent exudate is the end result of phagocytizing cells dying in the area and being eliminated through epithelial tissue in the throat. These cells have already reached maturity and cannot replicate anymore. They are also sensitive to the acidic environment of the body, so they die after performing their immunological duties (McCance & Huether, 2019). The lymphatic system is the reason for the anterior and posterior cervical adenopathy. Lymphatic channels transport body fluids from the infection site to nodules. These nodules are swollen due to fluid shifts. The nodes act as a processing center introducing the invaders to B-cells, T-cells, and macrophages that reside in the nodes (NCBI, 2021). The immune system analyses the invaders and is able to fine tune its response.
The physiologic response to the amoxicillin was a type 1 hypersensitivity response. Cells in the body saw amoxicillin as a threat and started an inflammatory immune response. It all begins with mast cells. Mast cells line skin, blood vessels, and lung tissue. They can be activated by injury, chemicals, adaptive immune responses, or recognizing molecular patterns of viruses and bacteria (McCance & Huether, 2019). Immunoglobulin E (IgE), a chemical floating in blood plasm, binds to mast cells causing the release prostaglandins, interleukins, leukotrienes, and histamine through a process called degranulation. Mast cells also release chemicals that attract neutrophils and eosinophils to sites of injury where they phagocytose foreign invaders to the body. Histamine is the most important chemical in this reaction. When it binds to the H1 receptor it causes hives, vasodilation, bronchoconstriction, hypotension, and increased mucous production. This allows phagocytes such as neutrophils, eosinophils, and dendritic cells to enter the injured area. Red blood cells (RBCs), other body fluids, along with all white blood cells pass through causing edema to the affected areas. All of this extra fluid responding to the threat caused edema to his tongue, lips, airway and increased secretion of lung tissues. This is an urgent issue as it leads to airway compromise which is life threatening.
Strep throat is seen more in children than adults, especially ages five to 15 (CDC, 2018). Crowded areas such as schools and daycare centers increase risk of transmission (CDC, 2018). As of late, the quarantine has kept children at home so this could be slowing the spread. He is on the high end of the age for those children getting strep throat, but his social situation can also influence it.
Genetic factors play a role too. Approximately ten percent of all U.S. patients report having allergies to a penicillin class antibiotic in their past (CDC, n.d.). Parents can pass down allergies through genetics (NCBI, 2014). This is why it is a good idea to have children tested for allergies when they are younger. That way severe allergic reactions can be anticipated, and life-threatening situations can be avoided.
Thanks,
Centers for Disease Control (CDC). (n.d.) Is it really a penicillin allergy? https://www.cdc.gov/antibiotic-use/community/pdfs/penicillin-factsheet.pdf
Centers for Disease Control (CDC). (2021, January 12) Strep throat: all you need to know. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html
Centers for Disease Control (CDC). (2018, November) Group A streptococcal (gas) disease. https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
McCance, K., & Huethe, S. (2019) Pathophysiology the biologic basis for disease in adults and children (8thed.). St. Louis, MO: Elsevier
National Center for Biotechnology Information (NCBI). (2021). Adenopathy. https://www.ncbi.nlm.nih.gov/books/NBK513250/
National Center for Biotechnology. (2014) Genetics of allergic diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415518/
Discussion: Alterations in Cellular Processes
Photo Credit: Getty Images
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
To prepare:
- By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your response.
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
it is true that cells are the basic structural components of the body and are specialized to conduct different functions in the body. The central dogma also illustrates the pivotal role of genes in dictating the specialization of cells and subsequent events. Disease can alter the nature of cells thereby interfering with the normal cell functions. I find your case analysis quite intriguing, there are many patients who complain of sore throat that is related to allergic conditions and your analysis through genetic involvement is informative (Centers for Disease Control and Prevention,2021).
Group A streptococcus pharyngitis among children and adolescents is common and the identification of the genes associated with the common occurrence provides an avenue for solving the menace. Hypersensitivity relation to genetic composition also provides a better understanding of the recurrence of such cases (McCance & Huether, 2019). I also think that the bod defense system is triggered by recognition of the pathogen and the process of acting against the identified antigen leads to the symptoms, which include inflammation that would be felt as sore throat.
I agree hat the physiological processes upon identification of the antigen includes a variety of cells mediators that take part in the inflammatory pathway. These processes cause heat, swelling and redness. The patient characteristics that define different responses include age as age relates to immunity. Children are more susceptible to some diseases as compared to adults. Elderly people are also prone to some diseases that are not so common among young adults. Allergy to drugs also links to age as the allergy increases with age (Soderholm et al., 2018). I concur with you that severe allergic reaction would definitely be a concern
NURS 6051 Discussion Alterations in Cellular Processes References
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 immunopathology. Journal of leukocyte biology, 103(2), 193-213.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in
adults and children (8th ed.). Mosby/Elsevier.
Centers for Disease Control and Prevention. (2021, November 23). Pharyngitis (strep throat): Information for clinicians. Retrieved March 1, 2022, from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion
Assignment Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.
Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.
What’s Coming Up in Week 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology.
Practicum – Upcoming Deadline
In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .
For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.
Please take the time to review the Appropriate Preceptors and Field Sites for your courses.
Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.
- Field Experience: College of Nursing Quick Answers
- Field Experience: MSN Nurse Practitioner Practicum Manual
- Student Practicum Resources: NP Student Orientation
Next Week
Week 1: Cellular Processes and the Genetic Environment
One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.
Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.
This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.
Learning Objectives
Students will:
- Evaluate cellular processes and alterations within cellular processes
- Evaluate the impact of the genetic environment on disease
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 1: Cellular Biology; Summary Review
- Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
- Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
- Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
- Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
- Chapter 7: Innate Immunity: Inflammation and Wound Healing
- Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
- Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
- Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
- Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
- Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
- Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Required Media (click to expand/reduce)
Module 1 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 1 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 Discussion and Assignment. (4m)
Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)
Immunity and Inflammation
Note: The approximate length of the media program is 14 minutes.
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
Note: The approximate length of the media program is 15 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 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
- Go to https://evolve.elsevier.com/cs/store?role=student
- Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
- Complete the registration process.
To View the Content for This Text
- Go to https://evolve.elsevier.com/
- Click on Student Site.
- Type in your username and password.
- Click on the Login button.
- Click on the plus sign icon for Resources on the left side of the screen.
- Click on the name of the textbook for this course.
- Expand the menu on the left to locate all the chapters.
- Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
NURS 6051 Discussion Alterations in Cellular Processes Rubric Detail
Select Grid View or List View to change the rubric’s layout.
NURS 6051 Discussion Alterations in Cellular Processes Content
Name: NURS_6501_Discussion_Rubric
| Excellent | Good | Fair | Poor | ||
| Main Posting | Points Range: 45 (45%) – 50 (50%)Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.Supported by at least three current, credible sources.Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. | Points Range: 40 (40%) – 44 (44%)Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.At least 75% of post has exceptional depth and breadth.Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 35 (35%) – 39 (39%)Responds to some of the Discussion question(s).One or two criteria are not addressed or are superficially addressed.Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 34 (34%)Does not respond to the Discussion question(s) adequately.Lacks depth or superficially addresses criteria.Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | Points Range: 10 (10%) – 10 (10%)Posts main post by Day 3. | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)Does not post main post by Day 3. | |
| First Response | Points Range: 17 (17%) – 18 (18%)Response exhibits synthesis, critical thinking, and application to practice settings.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 15 (15%) – 16 (16%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 13 (13%) – 14 (14%)Response is on topic and may have some depth.Responses posted in the Discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 12 (12%)Response may not be on topic and lacks depth.Responses posted in the Discussion lack effective professional communication.Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | Points Range: 16 (16%) – 17 (17%)Response exhibits synthesis, critical thinking, and application to practice settings.Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
Points Range: 14 (14%) – 15 (15%)Response exhibits critical thinking and application to practice settings.Communication is professional and respectful to colleagues.Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 12 (12%) – 13 (13%)Response is on topic and may have some depth.Responses posted in the Discussion may lack effective professional communication.Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 11 (11%)Response may not be on topic and lacks depth.Responses posted in the Discussion lack effective professional communication.Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | Points Range: 5 (5%) – 5 (5%)Meets requirements for participation by posting on 3 different days. | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)N/A | Points Range: 0 (0%) – 0 (0%)Does not meet requirements for participation by posting on 3 different days. | |
| Total Points: 100 | |||||
Name: NURS_6501_Discussion_Rubric
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