Category: Pathophysiology

Our discussion, this week, will focus on the thyroid.
Respond to the following statements and questions, using the included case study, in your discussion submission.
Discussion Assignment:
Thyroid hormones exert their effects on cells in a manner similar to steroid hormones; describe the mechanism of action of thyroid hormones.
Why would an imbalance in thyroid hormones have such widespread effects on the body?
Why was goiter observed in George’s case?
Why would calcium homeostasis be impaired in response to removal of the thyroid gland?
What could be used to specifically destroy the thyroid gland and have minimal effects on other cells and tissues in the body?
Case Study:
George is a thirty five year old hardware clerk. During his routine physical he casually mentions to his physician that he seems to be sweating more profusely than normal and most rooms that once were comfortable are now too “hot”. At home a room that his wife and children find to be comfortable causes him to sweat profusely. George also reports that he seems to be losing weight even though his appetite has increased. He also complains that he has a shortened attention span and that he always wants to be moving around. Despite the fact that he feels fatigued, George claims to have difficulty sleeping and seems to have more frequent bowel movements, occasionally accompanied by diarrhea. The physician discovers George has lost 15 pounds since his last physical. In checking his chart, the physician finds that George has a negative history for chronic illnesses, does not smoke, and has a low risk for cardiovascular disease. He does however have a positive family history for autoimmune diseases. His father suffers from idiopathic thrombocytopenia, his mother has been diagnosed with rheumatoid arthritis and his oldest sister was recently diagnosed with systemic lupus erythematosus.
Results of George’s physical examination were within normal ranges with the exception of the following: he demonstrated tachycardia, loud heart sounds, and apparent cardiac arrhythmias accompanied by slight hypertension. These arrhythmias were confirmed by electrocardiogram to be supraventricular in origin. George’s eyeballs appeared large and protruding and his hair was fine and soft. He was also beginning to demonstrate some degree of alopecia. George was also observed to have palmar erythema. palpation of the neck revealed the presence of goiter. Results of blood tests indicated elevated concentrations of thyroid hormones (thyroxin and triiodothyronine), hypercalcemia, and decreased circulating concentrations of lipids. Based on the physical characteristics and the results of the blood tests, George’s physician suspected that George was suffering from some form of hyperthyroidism and sent him to an endocrinologist to confirm the initial diagnosis.
Following the initial consultation and examination, the endocrinologist ordered tests to determine whether George was indeed hyperthyroid. The test results indicated an elevation in the concentration of thyroid hormones in the blood and the presence of thyroid-stimulating antibodies. These antibodies specifically stimulate the thyroid gland by binding with the thyroid stimulating hormone receptor located on the plasma membrane of the follicular cells of the thyroid gland. Based on these results, the endocrinologist concluded that George had Grave’s disease, a form of hyperthyroidism believed to be autoimmune in nature. George was presented with a number of possible treatment options. These included treatment with chemicals (propylthiouracil and methimazole) that decrease the production of thyroid hormones by the thyroid gland, radioisotopic destruction of the thyroid gland by the use of 131I, and surgical removal of the thyroid gland. After considering all the options, especially the possible effects of radiation on gamete development, George chose surgery. Following successful surgery, George was prescribed synthetic thyroid hormone to ensure that his body was receiving adequate thyroid hormone and told to return within 2 months for a follow-up evaluation of circulating thyroid hormone concentrations. He was also cautioned to carefully monitor his calcium intake.

Week 6: Digital Study Tool
Points 20
Submitting a text entry box, a website url, a media recording, or a file upload
Available until Jun 30 at 11:59pm
This week, you will have the opportunity to unleash your creativity in order to help you and your classmates study.  
For this assignment you will be able to create an infographic or video presentation and upload it here for grading.
Assignment Instructions:
1. Select one of the topics below.
Alterations in Cognitive Systems, (Chapter 16, p. 351)
Alterations in Cerebral Hemodynamics, (Chapter 16, p. 367)
Alterations in Neuromotor Function (Chapter 16, p. 370)
Central Nervous System Disorders (Chapter 17, p. 384)
Peripheral Nervous System Disorders (Chapter 17, p. 405)
Tumors of the Central Nervous System (Chapter 17, p. 406)
Alterations of Neurologic Function in Children (Chapter 18, p. 414)
2. Explore the topic and gather the information needed to teach your fellow learners.
3. Please create these items using infographics (Canva.com) or video (Powtoon.com). If you would like to use a different media source, please email your Instructor first for permission.

As a learner in Pathophysiology, it’s important to take the information you are absorbing from your coursework and connect it to real life.  Throughout the semester you will be invited to make  connections by locating, reviewing,  and summarizing current and relevant journal articles.
Use the following link to learn how to find and evaluate an online source: https://www.nia.nih.gov/health/online-health-information-it-reliable#whereLinks to an external site.
Please follow the instructions below:
Locate a current (medical or scientific) news or journal article based on one of the topics listed below:
Inflammatory Response (ch 6)
Antibodies/Antigens (ch 7)
Type II Hypersensitivity (ch 8)
Type IV Hypersensitivity (ch 8)
Note: As you read through the article, think about how it connects to Pathophysiology and why is it relevant.
Provide a write-up summarizing  the article.  Within your document, include how the information connects to Pathophysiology, and why it is relevant. 
Aim to include 150 – 200 words in the summary.
Remember to cite your source(s) in APA Format!
https://www.news-medical.net/news/20240521/Watch-Medical-residents-are-increasingly-avoiding-abortion-ban-states.aspx

Discussion Assignment: Referencing the ROME mnemonic listed below, submit a discussion post supported by at least one reference explaining the significance of the following lab results. Submit your results as your discussion contribution.
In this week’s reading material, you are learning about the importance of acid-base balance in maintaining homeostasis. The acid-base balance must be maintained within a narrow range in order for the body to function normally. Please read over the following case study to address the questions below. Please reference the ROME mnemonic listed below as needed. Don’t forget to cite your sources! 
Mrs. Breathless is a 45-year-old female nurse with a history of asthma. She reports to the ED in the early morning with shortness of breath, blurred vision, headache, and restlessness. After several laboratory tests, the following ABG (arterial blood gases) lab results are confirmed:  
Blood pH=7.30 
PaCO2 = 46 mm Hg 
HCO3 = 24 mEq/L.  
Based on the results of her ABG, which acid-base imbalance is Mrs. Breathless likely experiencing? Justify your answer by referencing the ROME mnemonic. 
What is the underlying pathophysiology of this disorder? What type of compensation is likely to take place? 
Why do you think Mrs. Breathless developed this imbalance? What are some of the contributing factors leading to this? 
RO-ME:
Respiratory Opposite: When pH is up, PaCO2 is down = Alkalosis, When pH is down, PaCO2 is up = Acidosis
Metabolic Equal: When pH is up, HCO3 is up = Alkalosis, When pH is down, HCO3 is down = Acidosis
https://www.news-medical.net/news/20240514/Experts-advocate-for-terminology-change-in-brain-injury-research.aspx

Discussion Assignment: Referencing the ROME mnemonic listed below, submit a discussion post supported by at least one reference explaining the significance of the following lab results. Submit your results as your discussion contribution.
In this week’s reading material, you are learning about the importance of acid-base balance in maintaining homeostasis. The acid-base balance must be maintained within a narrow range in order for the body to function normally. Please read over the following case study to address the questions below. Please reference the ROME mnemonic listed below as needed. Don’t forget to cite your sources! 
Mrs. Breathless is a 45-year-old female nurse with a history of asthma. She reports to the ED in the early morning with shortness of breath, blurred vision, headache, and restlessness. After several laboratory tests, the following ABG (arterial blood gases) lab results are confirmed:  
Blood pH=7.30 
PaCO2 = 46 mm Hg 
HCO3 = 24 mEq/L.  
Based on the results of her ABG, which acid-base imbalance is Mrs. Breathless likely experiencing? Justify your answer by referencing the ROME mnemonic. 
What is the underlying pathophysiology of this disorder? What type of compensation is likely to take place? 
Why do you think Mrs. Breathless developed this imbalance? What are some of the contributing factors leading to this? 

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, her skin is warm and flushed, and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.
You get more information from A.M. and learn the following:
She had some readings on her glucometer which were reading ‘high’
She vomits almost every time she takes in fluid
She hasn’t voided for a day but voided a great deal the day before
She’s been sleeping long hours and finally woke up this morning and decided to seek care
Vital Sign
Temperature                      
101.3° F (tympanic)
Blood pressure
88/46 mmHg
Heart rate
132 beats/minute
Respiratory rate
36 breaths/min, deep
Oxygen saturation % (SpO2)
91% on room air
Lab results
Serum glucose
657 mg/dl
Serum potassium
6.2 mEq/L
Urine ketones
Positive
What is the disorder and its pathophysiology that you expect the health care provider to diagnose?
Describe the etiology of the disorder A.M is experiencing.
Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
Instructions:
Summarize the questions above and formulate what may be happening with A.M.
Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.
You can find useful reference materials for this assignment in the School of Nursing guide: https://guides.rasmussen.edu/nursing/referenceebooks
Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa
Case study adapted from:
Harding, M.M. & Snyder, J.S. (2015). Winningham’s critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from: https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336.

Hematopoietic: 
J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy. 
Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries. 
Case Study Questions
Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?
The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia. 
In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.
Cardiovascular 
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills. 
Case Study Questions
For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors.
What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event?
Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?
How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event.
Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer.
Submission Instructions:
Include both case studies in your post.
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. 
Grading Rubric 
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points 
Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points 
Identifies and demonstrates an accomplished understanding of most issues, problems, and concepts.
Fair – 1-3 points
Identifies and demonstrates an acceptable understanding of most issues, problems, and concepts.
Poor – 0 points
Identifies and demonstrates an unacceptable understanding of most issues, problems, and concepts. Or nothing was posted.
5 points
Use of Citations, Writing Mechanics, and APA Formatting Guidelines
Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. Or nothing was posted.
3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded, or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
2 points
Total Points  10

Using the case study below, prepare a 2 – 3-page paper.
A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, her skin is warm and flushed, and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.
You get more information from A.M. and learn the following:
She had some readings on her glucometer which were reading ‘high’
She vomits almost every time she takes in fluid
She hasn’t voided for a day but voided a great deal the day before
She’s been sleeping long hours and finally woke up this morning and decided to seek care
Vital Sign
Temperature                      
101.3° F (tympanic)
Blood pressure
88/46 mmHg
Heart rate
132 beats/minute
Respiratory rate
36 breaths/min, deep
Oxygen saturation % (SpO2)
91% on room air
Lab results
Serum glucose
657 mg/dl
Serum potassium
6.2 mEq/L
Urine ketones
Positive
What is the disorder and its pathophysiology that you expect the health care provider to diagnose?
Describe the etiology of the disorder A.M is experiencing.
Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
Instructions:
Summarize the questions above and formulate what may be happening with A.M.
Use at least one scholarly source to support your findings. Examples of scholarly sources include academic journals, textbooks, reference texts, and CINAHL nursing guides. Be sure to cite your sources in-text and on a References page using APA format.
Use of internet sites / sources will not be approved references for this and future assignments.
Have questions about APA? Visit the online APA guide: https://guides.rasmussen.edu/apa
Case study adapted from:
Harding, M.M. & Snyder, J.S. (2015). Winningham’s critical thinking cases in nursing: Medical-surgical, pediatric, maternity, and psychiatric. Retrieved from: https://ebookcentral.proquest.com/lib/ras/detail.action?docID=2072336.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Cardiovascular/Pulmonary PowerPoint Presentation
Goal: Develop a PowerPoint presentation on hypertension discussed in the McCance text.
The presentation must provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level. The presentation must educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder. Patient education for management, cultural, and spiritual considerations for care must also be addressed. The presentation must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Format Requirements: 
Presentation is original work and logically organized.
Followed APA format including citation of references.
Power point presentation with 10-15 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).
Content Requirements: 
Select a cardiovascular or pulmonary disorder.
Provide information about the incidence, prevalence, and pathophysiology of the disease/disorder to the cellular level.
Educate advanced practice nurses on assessment and care/treatment, including genetics/genomics—specific for this disorder.
Provide patient education for management, cultural, and spiritual considerations for care must also be addressed.
Must specifically address how the disease/disorder affects 1 of the following age groups: infant/child, adult, or elderly.
Submission Requirements
Complete and submit the assignment on module 7 by 11:59 PM ET Friday
Attention: Complete and submit the assignment by 11:59 PM ET Friday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
You can expect feedback from the instructor within 48 to 72 hours from the Friday due date. 
Grading Rubric 
Your assignment will be graded according to the grading rubric.
Presentation Rubric
Presentation Rubric
Criteria Ratings Pts
Identification of Main Issues/Problems
4 pts
Distinguished
Identify and demonstrate a sophisticated understanding of the issues/problems.
3 pts
Excellent
Identifies and demonstrate an accomplished understanding of most of issues/problems.
2 pts
Fair
Identifies and demonstrate an an acceptable understanding of most of issues/problems.
1 pts
Poor
Identifies and demonstrate an unacceptable understanding of most of issues/problems.
/ 4 pts
Analysis and Evaluation of Issues/Probelms
4 pts
Distinguished
Presents an insightful, thorough analysis and evaluation of issues/problems.
3 pts
Excellent
Presents a thorough analysis and evaluation of most of the issues/problems.
2 pts
Fair
Presents a superficial or incomplete analysis and evaluation of issues/problems.
1 pts
Poor
Presents unacceptable analysis and evaluation of issues/problems.
/ 4 pts
Demonstrates a Conceptual Understanding
4 pts
Distinguished
Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.
3 pts
Excellent
Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.
2 pts
Fair
Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.
1 pts
Poor
Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.
/ 4 pts
Use of Citations to Course Readings and Additional Research/Literature
4 pts
Distinguished
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.
3 pts
Excellent
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
2 pts
Fair
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
1 pts
Poor
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.
/ 4 pts
Writing Mechanics and APA Formatting Guidelines
view longer description
4 pts
Full Marks
Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.
3 pts
Excellent
Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.
2 pts
Fair
Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.
1 pts
Poor
Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.
/ 4 pts
Total Points: 0