NURS 6051 Case Study Analysis

NURS 6051 Case Study Analysis
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.
Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.
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An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis in which you:
Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.
NURS 6051 Case Study Analysis
By Day 7 of Week 2
Submit your Case Study Analysis Assignment by Day 7 of Week 2.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.
Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Introduction
This study is based on the underlying condition of a 42-year-old patient who has been presenting in the emergency department with redness, swelling, and pain in his right calf. The patient history indicates that he had developed a cut with the string trimmer while working in the yard, and he has cleaned it with water from the garden hose. He also covered it with a large bandage. After a few days, he developed a high fever and reaches the ED for care. The patient needs immediate care, resulting in the development of adverse effects like organ dysfunction, etc. This study constitutes how the signs and symptoms developed, followed by the genes associated and the process of immunosuppression.
System Development
The patient had developed a wound infection which, if not managed, can result in septic disease. The wound constituted of germs and bacteria, and the patient had not cleaned this sufficiently. The bacteria grew under the damaged skin spreading to sensitive tissues present. As a result of the infection, the inflammatory response has stimulated, and inflammatory molecules are released. These inflammatory mediators like white blood cells (WBCs) further produce free radicals and enzymes, resulting in tissue damage and nerve damage.
Therefore, pain is generated, which is caused by the stimulation of pain receptors. The wound site develops a swelling due to the excess movement of white blood cells and fluid into the injured area. The infected tissues and nerves are put under extra pressure with the swelling and causing pain. The formation of wound clots is also an inflammatory response of the body, so the site becomes red (Stone, Basit & Burns, 2020).
During an infection, the body makes up an excess of inflammatory cells, which are the WBCs that work effectively to kill the bacteria. In addition, the increased production of white blood cells may affect the hypothalamus, which shifts the average body temperature upwards. It occurs as the bacteria releases pyrogens in the body, generating the immune response (Prajitha, Athira & Mohanan, 2018; Balli & Sharan, 2020).
Genes That Associated with The Development of The Disease
The genes that are associated with the development of the infection include IL4, IL10, and NRAMP1. As a result of the disease from the bacteria, the inflammatory response is generating by interleukins like IL6, etc. The interleukin genes of IL4 and IL10 producing cytokines induced to make the anti-inflammatory response, restoring the balance after the cytokines storm. The IL4 is present in the eosinophils, basophils, and Th2 cells. The IL10 plays a central role in the development of the anti-inflammatory response and maintaining homeostasis. Both the genes, IL4 and IL10, are pleiotropic. They are also known to produce inflammatory responses, but they recruit to produce anti-inflammatory cytokines when controlling hyper inflammation. The proteins produced by IL4 and IL10 directly suppress the role of Th1 cells (Nedelopoulou et al., 2020). The NRAMP1 gene produces the NRAMP1 protein, an integral membrane protein expressed in the lysosome activity inducing cells macrophages and monocytes. However, the NRAMP1 is also known to have pleiotropic effects and is the gene responsible for producing disease resistance and can lead to the development of immunosuppression (Known, Jo & Park, 2018).
The Process of Immunosuppression and The Effect It Has On The Body Systems
Patients who do not have the ability or have reduced capacity for fighting bacteria and other microorganisms in the body. A cytokine-mediated inflammatory response had seen during a sepsis infection resulting in a hyper-inflammatory phase (Cytokine storm) followed by the immunosuppressive phase. Sepsis infection had characterized by the excess production of cytokine-mediated inflammatory mediators. Some evidence also suggests that the body also generates anti-inflammatory compounds as the inflammatory mediators are extra.
Immunosuppression can be caused due to various reasons like an underlying disease, age, genetics, medication, and surgery. The infection of sepsis activates the apoptosis of cellular B and T cells which are immune cells. As the apoptotic cells induce the activation of the dendritic cells, they have an increased role in the anti-inflammatory response in sepsis. The apoptosis of T cells further induces the downregulation of the CD4+ and CD8+ cells. This process is known as autophagy and contributes to immunosuppression. As the body’s immune cells are hyperactive, the cells also become exhausted, which can cause immunosuppression (Ono et al., 2018).
Conclusion
The patient presented to the emergency department has developed a wound infection, and there was a need for immediate management. As a result of the condition, the patient developed signs of pain, inflammation, and high fever, indicating sepsis. Sepsis results in immunosuppression which has multiple mechanisms like apoptosis of the immune cells. The genes responsible for the development of sepsis include NRAMP1, IL4, and IL10. Therefore, understanding these aspects of sepsis will make infection management easier for the nurse and reduce further risk.
References
Balli, S., & Sharan, S. (2020). Physiology, Fever (Hyperthermia). StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK562334/
Kwon, H. K., Jo, W. R., & Park, H. J. (2018). Immune-enhancing activity of C. militaris fermented with Pediococcus pentosaceus (GRC-ON89A) in CY-induced immunosuppressed model. BMC complementary and alternative medicine, 18(1), 1-14. https://doi.org/10.1186/s12906-018-2133-9
Nedelkopoulou, N., Dhawan, A., Xinias, I., Gidaris, D., & Farmaki, E. (2020). Interleukin 10: the critical role of a pleiotropic cytokine in food allergy. Allergologia et immunopathologia. https://doi.org/10.1016/j.aller.2019.10.003
Ono, S., Tsujimoto, H., Hiraki, S., & Aosasa, S. (2018). Mechanisms of sepsis-induced immunosuppression and immunological modification therapies for sepsis. Annals of gastroenterological surgery, 2(5), 351–358. https://doi.org/10.1002/ags3.12194
Prajitha, N., Athira, S. S., & Mohanan, P. V. (2018). Pyrogens, a polypeptide produces fever by metabolic changes in hypothalamus: mechanisms and detections. Immunology letters, 204, 38-46. https://pubmed.ncbi.nlm.nih.gov/30336182/
Stone, W. L., Basit, H., & Burns, B. (2020). Pathology, inflammation. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK534820/
NURS_6501_Module1_Case Study_Assignment_Rubric
Grid View
List View
Excellent Good Fair Poor
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:
Explain why you think the patient presented the symptoms described.
28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms.
The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.
25 (25%) – 27 (27%)
The response describes the patient symptoms.
The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.
23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate.
The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.
0 (0%) – 22 (22%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.
The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.
Identify the genes that may be associated with the development of the disease.
23 (23%) – 25 (25%)
The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.
20 (20%) – 22 (22%)
The response includes an accurate analysis of the genes that may be associated with the development of the disease.
18 (18%) – 19 (19%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.
0 (0%) – 17 (17%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.
Explain the process of immunosuppression and the effect it has on body systems.
28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.
25 (25%) – 27 (27%)
The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.
23 (23%) – 24 (24%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
0 (0%) – 17 (17%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
3 (3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Purpose, introduction, and conclusion of the assignment are vague or off topic.
0 (0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (? 5) APA format errors. Total Points: 100 Name: NURS_6501_Module1_Case Study

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