NU621 Advanced Pathophysiology
Unit 1 Discussion
Myocardial Infarction
Read the following case study and answer the posed questions:
Mr. T., a 45-year-old black man employed as a midlevel corporate manager, came to the doctor’s office seeking a physical examination. He appeared somewhat overweight. He denied taking any medications or smoking, but admitted drinking alcohol. His father and older brother have hypertension (HTN) and his paternal grandfather experienced a myocardial infarction (MI) and a CVA at a young age. Mr. T. stated, “A year ago at a health fair my cholesterol was tested. I was told later by mail that my cholesterol was 250 and I had to recheck my blood pressure.” His Bp at the time of his examination was 159/94, HR 96, weight 275, height 5’11 in.
Explain the progressive pathophysiologic relationship between an MI and the development of left ventricular (LV) failure. What factors affect the severity of LV failure?
Next, visit http://www.cdc.gov/ncbddd/dvt/facts.html (Links to an external site.) and access resources about deep vein thrombosis.
Document the manifestations and management of clients with deep vein thrombosis.
Submit a summary of some of the things you learned from this video.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Look at your course colleagues’ responses.
From your advanced practice mindset reflect on a discussion you would like to have with two of your course colleagues about their responses.
Post a response individually to each of them that expresses your advanced practice nursing role perspective of the data represented in their response.
Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example - if you are a nurse educator (clinical or academic) what are your thoughts about their ability to follow task instructions for constructing the assignment, etc.?; if you a nurse leader what are your thoughts about the success of their application of a process improvement model, etc.?; if you are a nurse practitioner what are your observations about the non-conventional modality presented in the schemata, can you locate any evidence or the foundational basic sciences that support the modality, etc.?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 2 Discussion
COPD
Read the following case study and answer the posed questions:
Mr. Les Brown has been diagnosed with COPD 10 years ago. He has been increasingly shortness of breath doing activities of daily living, needing to rest more frequently and feels he is coughing more often.
Explain the pathophysiology behind the signs and symptoms of COPD
What relationship do you see with Mr. Brown's vital signs – 26 RR, 91% oxygen saturation, temp: 37.8, HR: 93 BP: 150/70
Describe the goals of care for Mr Brown. Make sure to use the COPD gold standards of care( https://goldcopd.org/wp-content/uploads/2018/02/WMS-GOLD-2018-Feb-Final-to-print-v2.pdf (Links to an external site.)) for your plan.
How would you follow up on your proposed plan of care?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive:
Post a response individually to each of them that expresses your advanced practice nursing role perspective of the data represented in their schemata.
Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example - if you are a nurse educator (clinical or academic) what are your thoughts about their ability to follow task instructions for constructing the assignment, etc.?; if you a nurse leader what are your thoughts about the success of their application of a process improvement model, etc.?; if you are a nurse practitioner what are your observations about the non-conventional modality presented in the schemata, can you locate any evidence or the foundational basic sciences that support the modality, etc.?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 3 Discussion
Hyperthyroidism
Read the following case study and answer the posed questions:
Case #1:
History: A 65 year old housewife complains of progressive weight gain of 40 pounds in 1 year, fatigue, dizziness, sluggish memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance.
Physical examination: Vital signs: temperature 96.4oF, pulse 68/minute and regular, BP 108/60, weight 170 lbs, height 5 feet, puffy face, pale, cool, dry skin. The thyroid gland is not palpable, deep tendon reflex time is delayed.
Laboratory studies: CBC and differential WBC are normal. The serum T4 concentration is 3.4 ug/dl (N=4.5-12.5), the serum TSH is .9 uU/ml (N=0.2-3.5), and the serum cholesterol is 275 mg/dl (N<200).
What is the likely diagnosis and what symptoms made you consider that diagnosis?
Which lab data supported the diagnosis?
Explain-Hypothalamic-Pituitary-Thyroid axis and interrelationship.
Case #2:
J.R. is a 58-year old man who presented with a 6-week history of polyuria, polydipsia, polyphagia, weight loss, fatigue, and blurred vision. A random glucose test performed on day of his visit and was 359 mg/dl. The patient denied any symptoms of numbness, tingling in hands or feet, dysuria, chest pain, cough or fevers. He had no prior history of diabetes and no family history of diabetes.
Admission non-fasting serum glucose 268 mg/dl (N=<180 mg/dl), HbA1c 9.6% (N=4-6.1%). Electrolytes, BUN and creatinine were normal. Physical examination revealed weight of 190 pounds, height 5'6.5" . The rest of the examination was unremarkable, i.e., no signs of retinopathy or neuropathy.
What are the mechanisms of blurred vision which was part of his initial symptoms?
Are there correlations between his abnormal blood chemistries and his other symptoms?
Identify the cardiovascular and microvascular risk factors in the history, physical examination, and laboratory data in this patient.
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
Do you agree with your peers’ diagnosis?
Take an opposing view to a peer and present an alternative approach.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 4 Discussion
Digestive Function
Read the following case study and answer the posed questions
Case #1: A 64-year-old man presents to the emergency department (Links to an external site.) with abdominal pain and distention, as well as constipation of 8 days’ duration. He denies vomiting, fever, diarrhea, or dysuria. Except for hypertension, he is otherwise healthy with no prior surgeries.
His vital signs are normal except for a borderline pulse of 99 bpm. His physical examination is unremarkable except for his abdomen, which is large, rotund, and tympanitic. There is diffuse tenderness everywhere in the abdomen.
What history would you want to obtain?
What differential diagnoses would you consider?
List and describe the specific diagnostic tests you might order to determine cause of his concern?
Case #2:
Kyle is a 58-year-old man who is experiencing lower abdominal discomfort nausea and diarrhea lasting 2 days. He thought he had eaten something that “disturbed his stomach” but since this has lasted so long, he is afraid it’s something serious.
As you obtain a history from this patient what differential diagnoses are you considering. Give rational for your choices.
Discuss the pathophysiologic relationship between nausea and vomiting?
Three days after Kyle's initial visit his labs confirmed a diagnosis of cirrhosis.
Discuss the pathophysiologic relationship between cirrhosis and portal hypertension.
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position and suggestions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
Do you agree with your peers’ diagnosis?
Take an alternate view and offer a potential alternate approach.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 5 Discussion
Back Pain
Read the following case study and answer the posed questions
Case #1: 49-year-female assembly worker at automotive manufacturer presents to your clinic complaining of increasing back pain over the last week. Back pain is in the central low back region and radiates into both gluteal regions – no leg pain. Has been off work for the last 6/12 with no improvement in pain.
Create a list of possible differential diagnoses?
Discuss the evidence you would need to obtain to rule in or rule out each differential?
What additional aspects of the history and physical examination could provide relevant information to help in the diagnosis?
Case #2: A 65-year-old Caucasian female has a follow up appointment with a family orthopedist after visiting the emergency department for a wrist fracture. The orthopedist then turns her case over to you to schedule a bone mineral density (BMD) testing. Results of the BMD test show a T-score of 3.0, indicating osteoporosis. Her past medical history includes mild hypertension which is currently managed with propranolol. She also takes a daily multivitamin. She drinks and smokes occasionally and she has no children or spouse.
What is the difference between degenerative bone disease and osteoporosis? Explain the pathology of each.
What treatment options should be discussed with the patient?
What lifestyle changes should be recommended to the patient?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
Comment on at least 2 answers and rationale given by your colleagues that differ from yours.
Take an opposing view to a peer and present a logical argument supporting the opposite opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 6 Discussion
Neurologic Disorders
Read the following case study and answer the posed questions
Case #1: For over 15 years, James, aged 64, has had severe, intermittent headaches. These headaches are characterized by an intense burning pain on one side of his head, accompanied by tearing in his eye and a runny nose. When they strike, the attacks typically occur several times a day and usually last about an hour. James can be headache free for months at a time, but the attacks always return.
Describe the pathology of a headache.
Based on the different etiologies for headaches which of those fit this patients situation?
What additional aspects of the history and physical examination could provide relevant information to help in the diagnosis?
Based on the history provided and using the following diagnostic tool https://headaches.org/resources/the-complete-headache-chart/ (Links to an external site.) as a quick reference of the guideline, you diagnose migraine without aura. List the evidence that supports your diagnosis.
Case #2: Mr. Smith is a new patient with a history of recent stroke approximately 3 months ago. He was hospitalized in another state, but you don't have his records now. The patient's wife is extremely anxious and worried about him because he hasn’t been “acting right”. She wants him checked out. She does not think he had hypertension but adds "he does not like to go to doctors."
Regarding the patient's available history, create a detailed plan of care for this patient.
In recognition of the morbidity of recurrent brain ischemia, the evidence-based recommendations for the prevention of future stroke among survivors of ischemic stroke or TIA can be found in the current AHA/ASA Recommendations for Antithrombotic Therapy for Noncardioembolic Stroke or TIA https://www.ahajournals.org/doi/pdf/10.1161/str.0000000000000024 (Links to an external site.). Based on these current guidelines what goals would you recommend for this patient to insure prevention of another brain ischemic event?
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
Look at your course colleagues’ responses.
Post a response individually to each of them that expresses your advanced practice nursing role perspective of the data represented in their schemata.
Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example - if you are a nurse educator (clinical or academic) what are your thoughts about their ability to follow task instructions for constructing the assignment, etc.?; if you a nurse leader what are your thoughts about the success of their application of a process improvement model, etc.?; if you are a nurse practitioner what are your observations about the non-conventional modality presented in the schemata, can you locate any evidence or the foundational basic sciences that support the modality, etc.?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 7 Discussion
Pathophysiologic Diagnosis
Case #1: A 55-year-old woman presents to the office with bloody urine and dysuria
of 12-hour duration. She was recently married and has never had similar
symptoms. She denies chills and fever. On physical examination she is afebrile, has normal vital signs, and has mild tenderness in the midline above the pubis. Her urinalysis shows too many to count (TNTC) red blood cells.se
What is the definition of bacteriuria?
What additional history do you need to make a diagnosis?
What diagnostic studies would you order and why?
Case #2: A 23-year-old woman was married a year ago. Since then, she has experienced five attacks of acute cystitis, all characterized by dysuria, increased frequency, and urgency. Each infection responded to short-term treatment with trimethoprim sulfamethoxazole. The recurrences occurred at intervals of 3 weeks to 3 months following completion of antibiotic therapy. For the past two days, the woman has been experiencing acute flank pain, microscopic hematuria, dysuria, increased frequency, and urgency.
Her vital signs are T = 37.9°C, P = 106, R = 22, and BP = 130/75 mm Hg. Physical examination reveals costovertebral tenderness, mild tenderness to palpation in the suprapubic area, but no other abnormalities.
What are possible reasons for this woman’s pain? List possible differential diagnosis and explain each?
What diagnostic tests should you order to confirm diagnosis?
What are the possible causes of recurrent lower UTIs?
What are the differences when comparing prerenal acute renal failure, intrarenal acute renal failure, and postrenal acute renal failure? Give examples of each.
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
Look at your course colleagues’ PDSA model schemata.
Review the ‘P’ and the ‘S’ of your course colleagues’ schemata from your advanced practice nursing role perspective – educator, leader or practitioner. From your advanced practice mindset reflect on a discussion you would like to have with two of your course colleagues about their schemata.
Post a response individually to each of them that expresses your advanced practice nursing role perspective of the data represented in their schemata.
Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example - if you are a nurse educator (clinical or academic) what are your thoughts about their ability to follow task instructions for constructing the assignment, etc.?; if you a nurse leader what are your thoughts about the success of their application of a process improvement model, etc.?; if you are a nurse practitioner what are your observations about the non-conventional modality presented in the schemata, can you locate any evidence or the foundational basic sciences that support the modality, etc.?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
NU621 Advanced Pathophysiology
Unit 8 Discussion
Reflection
Please respond to the following questions based upon these course objectives:
Integrate nursing and related sciences into the delivery of advanced nursing care to diverse populations. (AACNI.1)
Incorporate current and emerging genetic/genomic evidence in providing advanced nursing care to individuals, families, and communities while accounting for patient values and clinical judgment. (AACN I.2)
Compare normal anatomy and physiology to alterations in function and regulation of body organs and systems in response to stressors. (AACN I.1)
Please answer the following questions with supporting examples and full explanations.
For each of the learning objectives, provide an analysis of how the course supported each objective.
Explain how the material learned in this course, based upon the objectives, will be applicable to professional application.
Provide evidence (citations and references) to support your statements and opinions. Responses to these questions are due by Tuesday at midnight.
