NR283 2021 June Discussions Latest (Full)
NR283 Pathophysiology
Week 1 Discussion
Mrs. A
The initial post must include responses to all the questions in this discussion.
Ms. A, age 35, was given a Pap test during a routine medical checkup. The test showed marked dysplasia of cervical cells but no sign of infection.
Discuss the purposes and uses of diagnostic testing and how it applies in this scenario.
Discuss how the following terms might apply to this scenario: prognosis, latent stage, remission, exacerbations, predisposing factors.
Compare and contrast the various types of common cellular adaptations, focusing on dysplasia and the testing for this condition.
Mrs. A’s baby girl, Baby C, who is 3 months old, has had severe watery diarrhea accompanied by fever for 24 hours. She is apathetic and responds weakly to stimulation. The condition has been diagnosed as viral gastroenteritis.
List the major losses resulting from diarrhea and fever.
List other signs or data that would provide helpful information.
Explain several reasons why infants become dehydrated very quickly.
Baby C was tested for PKU shortly after birth (as required by law), the results indicated toxic levels of phenylalanine breakdown products in the blood.
Explain how dietary changes can affect the expression of PKU.
Discuss the cause of the disease and the probable percentages of inheritance of the disease in children the couple might have in the future.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 2 Discussion
J.L
The initial post must include responses to all the questions in this discussion.
JL, a 50-year-old woman, was camping with her 3 children and spouse, fell and broke the left tibia at the ankle. She is in the emergency department, waiting for the fracture to be immobilized. The leg hurts and she note that the ankle is swelling. A diagnosis of a simple fracture and sprain (damage to ligaments) is made.
Discussion Questions
What is the cause of pain and swelling? What can JL expect in the days to come as inflammation resolves and healing begins?
What is the rationale for immobilizing the fractured bone?
JL’s son Matt, age 10 years, has a runny nose and itchy eyes and is irritable. The camping tent was set up in a grassy field, and the boys played several games on the field. Matt is also seen by a health care provider and a diagnosis of allergy to pollen is made.
Explain the rationale for each of Matt’s symptoms.
Identify the type of immune response involved.
Discuss what Matt can expect in the future.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 3 Discussion
Skin and Respiratory System Disorders
The initial post must include responses to all the questions in this discussion.
Mr. J, age 42, is a construction worker in Las Vegas who lives with his daughter and grandson, Sammy. He recently noticed that a mole on his face seemed to be getting larger and darker. At first, he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.
Discussion Questions
Relate Mr. J’s skin changes to the warning signs for malignant melanoma.
Discuss the normal progression of this malignancy. What is the significance of the bone pain that Mr. J is experiencing?
Discuss the treatment available for this patient and the prognosis for recovery.
Discussion Questions
Mr. J is babysitting his grandson Sammy, age 3 years, who ate his dinner and then said his tummy hurt. Mr. J suggested he lie down in the adjacent room while his parents finished dinner. A few minutes later, Mr. J heard Sammy vomiting. He rushed in to lift Sammy up. When vomiting ceased, he noticed Sammy continued to cough and seemed to be choking. He was struggling to breathe, and a wheezing sound was obvious. It appeared that he had aspirated some vomitus. Mr. J drove him to a nearby hospital for examination.
Discuss the specific effects of aspirating vomitus on Sammy, including the probable effects on his bronchi and lungs. Why might one lung be affected more than the other?
Discuss the pathophysiologic changes causing the signs and symptoms and any tests required to clarify the effects on Sammy.
Suggest some reasons for Sammy’s difficulty breathing and wheezing.
Discuss the potential complications of aspiration of vomitus.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 4 Discussion
Mr. X
The initial post must include responses to all the questions in both case studies.
Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Discussion Questions
Relate the pathophysiology of pernicious anemia to the manifestations listed above.
Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.
Discuss other tests that could be performed to diagnose this type of anemia.
Discuss the treatment available and the limitations.
Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.
Discussion Questions
Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs.
Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond.
Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly.
Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 5 Discussion
Mrs. F.
The initial post must include responses to all the questions in both case studies.
Ms. F, 48 years old, has been admitted to the hospital with severe abdominal pain. Earlier that day she had generalized abdominal pain, followed by a severe pain in the lower right quadrant of her abdomen, accompanied by nausea and vomiting. That evening she was feeling slightly improved and the pain seemed to subside somewhat. Later that night, severe, steady abdominal pain developed, with vomiting. A friend took her to the hospital, where examination demonstrated lower right quadrant tenderness and mild abdominal rigidity. Fever and leukocytosis indicated infection. A diagnosis of acute appendicitis, with possible perforation, was indicated, with immediate surgery.
Discussion Questions
Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain. Does this sequence confirm the diagnosis?
Using the pathophysiology, describe the reason for:
the pain subsiding and then recurring.
leukocytosis and fever.
abdominal rigidity.
Ms. T, age 28 years, has noticed urgency, frequency, and dysuria recently, as well as an unusual odor to the urine. Urinalysis indicated a heavy concentration of Escherichia coli in the urine, some pus, and WBCs. Ms. T was prescribed antibiotics, which she took for the first few days. This seemed to give her relief, but she then stopped taking the medication. Within a few days, the symptoms returned, but she decided to “just live with it.”
Discussion Questions
Explain why women are predisposed to cystitis.
What preventive measures are important in reducing recurrence?
Discuss other signs and symptoms that may indicate cystitis.
What potential problems may she experience if she does not adhere to the treatment prescribed?
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 6 Discussion
Mrs. A
The initial post must include responses to all the questions in both case studies.
Mrs. A has been taking high doses of glucocorticoids for much of the past 2 years to control severe rheumatoid arthritis. She has now developed hypertension and type 2 diabetes and would like to stop taking the cortisone because of the unwanted changes in her appearance.
Discussion Questions
How does Cushing’s syndrome affect the individual?
Discuss how hypertension and diabetes have developed and the potential complications of these conditions.
Discuss other potential problems that Mrs. A may experience resulting from long-term use of glucocorticoids.
Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her medical history revealed that over the past 3 years, she has suffered fractures of her femur and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial job, drives to work, and she “does not have time for exercise.” She reports that she consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has not seen her physician recently nor had a recommended bone density test because of the time and cost involved.
Discussion Questions
Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present, and how does each predispose to decreased bone density?
Explain the cause of pathological fractures in this patient.
How could osteoporosis have been prevented in Mrs. L?
Discuss the treatments available to the patient.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Sub-Concepts with Exemplar |
|
|
NR283 Pathophysiology
Week 7 Discussion
A
The initial post must include responses to all the questions in both case studies.
A 28-year-old soldier returns from Iraq and begins experiencing periodic bouts of anxiety. She complains that she wakes up frequently and cannot get a full night of sleep. Recently, she also has been getting frequent headaches and noticed a few ulcers in her mouth. A physical examination and lab tests do not reveal any local or systemic disease.
Discussion Questions
Based on the patient history and the signs and symptoms, discuss how stress is related to her condition.
Discuss other stress-related problems that this patient might experience if her coping strategies are not effective.
Discuss the potential strategies for coping with the stress.
Mr. K is a 32-year-old man who was found in his apartment at 2 AM, babbling incoherently and apparently experiencing hallucinations. His friends report that he had been to a party that night and, since the recent breakup of his marriage and loss of his job, he tends to overdo it at social events. They report that during the evening, he consumed very little alcohol but did take a small pill given to him by another partygoer. Paramedics could find no puncture marks and no powder in or around the nose, but his blood pressure was elevated, as was his body temperature. He appeared dehydrated and agitated.
Discussion Questions
Based on patient history, reports from his friends, and the signs and symptoms noted by the paramedics, identify substances that Mr. K might have consumed.
Based on patient history, discuss the social factors that predisposed him to substance abuse.
Discuss any additional problems that he might encounter if he continues his present course of substance abuse.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Subconcepts With Exemplar |
|
|
NR283 Pathophysiology
Week 8 Discussion
Ms. X
The initial post must include responses to all the questions in both case studies.
Ms. X, a 32-year-old Hispanic woman, has had a history of intermittent pleuritic chest pain and joint pain for the past several years. Recently, she went to her physician because she noticed that an erythematous, butterfly-shaped rash had appeared on her face. Further lab tests indicated protein in her urine. Her blood test indicated the presence of numerous antinuclear antibodies, especially anti-DNA, and mature neutrophils containing nuclear material. A diagnosis of systemic lupus erythematosus (SLE) was made. (Refer to Chapter 7, Immunity)
Discuss possible reasons why SLE was not diagnosed earlier.
Discuss how the presence of antibodies can cause such widespread damage in organ systems.
Discuss treatments for SLE and a prognosis for the patient in this case.
Mr. F, age 46 years, has had a persistent unproductive cough for several months that did not respond to cough medications. Recently, he has developed a productive cough accompanied by fatigue, anorexia, and night sweats.
Examination indicated abnormal chest sounds and weight loss. A chest radiograph showed a small cavity and infiltrate, the tuberculin test was positive, and the sputum sample contained a small amount of blood and numerous acid-fast bacilli, confirming the diagnosis of active tuberculosis. (Refer to Chapter 13, Respiratory Disorders)
Discuss the pathologic changes occurring during the development of active tuberculosis.
Discuss the transmission of TB and the conditions predisposing to the development of TB.
Discuss the treatment of tuberculosis and the precautions involved for health care personnel coming into contact with the patient.
Suggest how family members or co-workers can protect themselves.
|
Weekly Outcomes |
Weekly Objectives |
|
|
|
Main Topics and Concepts |
Subconcepts With Exemplar |
|
|
-
Rating:
/5
Solution: NR283 2021 June Discussions Latest (Full)