NURS 6501 Immune Thrombocytopenia Purpura (ITP) Pathophysiology

NURS 6501 Immune Thrombocytopenia Purpura (ITP) Pathophysiology

According to Chen et al. (2022), immune thrombocytopenia purpura (ITP) pathophysiology is complex since it consists of T-cell and B-cell abnormalities. There are four causes of thrombocytopenia mechanism, which are consumption, hyperproliferation, destruction, and sequestration. In addition, the mechanism involves a significant proportion of cases and increases platelet destruction, which is an impaired platelet production. Therefore, the megakaryopoiesis and thrombopoiesis defect is experienced due to increased platelet destruction (Grodzielski et al., 2019).

The phagocytosis process helps remove the sanitized platelet, which occurs in the sequestration of the anti-platelet IgG antibodies (Carter, 2018). The sanitized platelet happens a few hours compared to the normal platelet half-life of 8 to 9 days. The drug-induced ITP absorption happens in the platelet cell membrane (McCance & Huether, 2019). Therefore, the autoantibodies react against the platelet glycoproteins. Platelet destruction can also occur when abnormal apoptosis occurs in the bone marrow (McCance & Huether, 2019).

Musculoskeletal, metabolic, and multisystem health dysfunctions represent one of the most challenging health conditions that may have a complex challenge to the affected patient (Beefcroft & Hough, 2016). Symptoms of these conditions may range in severity. Musculoskeletal complications can affect the muscle, bone, tendons and joints. A major symptom that patients encounter is pain. Conditions may range from the ones that are sudden and short-lived to the ones that are lifelong and are associated with disability as well as ongoing pain. Among the notable changes that a patient with this condition may experience include persistent pain as well as mobility limitations. In this, the patients who may suffer from the long-term condition may experience severe pain that may be related to the wearing out of the tendons. For some patients with complex conditions, they may experience joint deformity that may be a long term condition, and it may be relatively challenging to treat it. When these abnormal changes occur, the involved patient may find it hard to handle some of the changes in weight, thus affecting some parts of the body (Black, 2016). Although musculoskeletal conditions may arise in many forms as well as a result of different factors, there are many ways that the situation may represent itself. The identification of specific symptoms of the disorder plays an essential role in the development of an approach to assist in the management of the stated condition.

Clinical Manifestation of Immune Thrombocytopenia Purpose (ITP)

Initially, ITP was perceived as a minor injury. However, the purpura and petechiae development occurred every several days, leading to an increase in bleeding from the mucosal site (McCance & Huether, 2019). Patients with ITP show signs like blood in the urine, bleeding gums, and increased bleeding. The main cause of accelerated platelet consumption is increased splenic sequestration or decreased bone marrow production (McCance & Huether, 2019). The lab test helps predict the diagnosis, evaluating the anti-glycoprotein erythrocyte and leukocyte count.

Genetic/Ethnic Considerations of Immune Thrombocytopenia Purpose (ITP)

ITP highly occurs in women (Kjaer et al., 2020). In comparison to acute, the chronic ITP is progressively worse. Acute ITP lasts for approximately one to two months and is common in children (Kjaer et al., 2020). It is not common for a patient to present the intracranial bleeding for the organs or any other sites.ITP is also likely to occur in the newborn as thrombocytopenia.

Conclusion

The patient presents ITP, which is associated with the previous diagnosis of Mononucleosis. It is important to review a patient platelet, which helps determine the anti-platelet antibodies when performing a diagnostic test. ITP highly occurs in women between 20 to 40 years.

References

Carter, C. M. (2018). Alterations in blood components. Comprehensive Toxicology, 249. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7152208/

Chen, D. P., Lin, W. T., Wen, Y. H., & Wang, W. T. (2022). Investigation of the correlation between immune thrombocytopenia and T cell activity-regulated gene polymorphism using functional study. Scientific Reports, 12(1), 1-8. https://www.nature.com/articles/s41598-022-10631-z

Grodzielski, M., Goette, N. P., Glembotsky, A. C., Constanza Baroni Pietto, M., Méndez-Huergo, S. P., Pierdominici, M. S., … & Marta, R. F. (2019). Multiple concomitant mechanisms contribute to low platelet count in patients with immune thrombocytopenia. Scientific Reports, 9(1), 1-10. https://www.nature.com/articles/s41598-018-38086-1

Kjær, M., Geisen, C., Akkök, Ç. A., Wikman, A., Sachs, U., Bussel, J. B., … & Skogen, B. (2020). Strategies to develop a prophylaxis for the prevention of HPA-1a immunization and fetal and neonatal alloimmune thrombocytopenia. Transfusion and Apheresis Science, 59(1), 102712. https://www.sciencedirect.com/science/article/pii/S147305021930285X

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.

This week, you continue to examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these

systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives

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Students will:

Analyze processes related to neurological and musculoskeletal disorders
Identify racial/ethnic variables that may impact physiological functioning
Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here.

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. NURS 6501 Module 5 Assignment Case Study Analysis

Chapter 15: Structure and Function of the Cardiovascular and Lymphatic Systems (stop at Aging and the nervous system)
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
o Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function; pp. 504–511, pp. 516–530 (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

Required Media (click to expand/reduce)

Khan Academy. (2019b). Ischemic stroke. Retrieved from Https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 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 15, 16, 18, and the sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

Assignment: Case Study Analysis

The symptoms presented in the patient could be influenced by significant changes in the physiological organs and their functions. The body system is made of various organs systems working together. Besides, hemeostasis is the process through which the body ensures that there is balance in the various chemical constituents in the body. The current study focuses on exploring the symptom presentation in the selected patient and explore the possible factors influences the symptoms. The case involves a patient experiencing severe right sided headache with a pain scale of 10/10. The headache had lasted for 2 to 3 days. Furthermore, the patient experiences nausea and vomited three times in last 3 hours. Based on this, the patient is most likely to be having migraine. The current study outlines the neurological and musculoskeletal processes influencing the symptoms development and how they vary based on ethnicity and race.

Neurological and Musculoskeletal Pathophysiology

The condition is caused by the projection in the trigeminovascular systems which results in the disruption in the information transmission from the pericarnial muscle and the skin (Andreou & Edvinsson, 2019). The key symptoms associated with the physiological alteration include fatigue, nausea and yarning among others (McCance & Huether, 2019). The key neurological organs involved in the pathology include pseudounipolar trigeminal nerves. Similarly, the inflammatory reactions in the brain could also be linked to the migraine symptoms. The projections in the trigeminovascular system causes the symptoms related to what the patient experienced. The symptoms include loss of appetite, yarning, fatigue and nausea. The trigeminovascular system transmits the nociceptive information to the brains. Similarly, the collect information from the pericranial muscles and the skins and relay them to the brain (McCance & Huether, 2019).

Ethnic/Racial Variables

The risk and prevalence of migraine vary from one ethnic group to another. The risk for migraine is high among the whites compared to the Asian and African American populations. The variations in the risk patterns are linked to the anthropometric characteristics. Also, the risk for osteomyelitis can also be used to explain the variation (Goadsby et al., 2017).

Interacting Factors

The key interacting factors in the disease progress include age, genetic and possible underlying health conditions. Also, patients’ behavioural patterns could also influence the progress and the outcomes of the disease. For example, patients who fail to seek medical interventions in time are likely to have poor prognosis. Also, stress could worsen the headache and other symptoms associated with migraine disease (Kowalska et al., 2018). . People with stress could also have exacerbated migraine symptoms. The other factors also include age and dietary composition. Therefore, it is important to explore the factors likely to increase the prevalence of migraine in a population group and address them in time

Conclusion

Finally, the patient in this case presents with migraine, a condition characterized by headache and nausea. Also, the patient developed sensitivity to light. It is important that the patient seek urgent medical help to prevent the condition from worsening. The patient in this case had migraine and this is due to the changes in the communication patterns in the trigeminovascular systems.

References

Andreou, A. P., & Edvinsson, L. (2019). Mechanisms of migraine as a chronic evolutive condition. The journal of headache and pain, 20(1), 1-17. https://doi.org/10.1186/s10194-019-1066-0

Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., & Akerman, S. (2017). Pathophysiology of migraine: a disorder of sensory processing. Physiological reviews, 97(2):553-622. doi: 10.1152/physrev.00034.2015.

Kowalska, M., Wize, K., Wieczorek, I., Kozubski, W., & Dorszewska, J. (2018). Migraine and risk factors of vascular diseases. Ischemic Stroke of Brain. https://doi.org/10.5772/intechopen.72570

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Photo Credit: jijomathai – stock.adobe.com

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. 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 the 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 scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient. NURS 6501 Module 5 Assignment Case Study Analysis

Day 7 of Week 8

Submit your Case Study Analysis Assignment by Day 7 of Week 8.

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 “M5Assgn+last name+first initial.(extension)” as the name.
Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 5 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 “M5Assgn+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.

Grading Criteria

To access your rubric:

Module 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 8

To participate in this Assignment:

Module 5 Assignment

What’s Coming Up in Module 6?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 6, you will identify processes related to psychological disorders. You will also examine the neurobiology of various psychological issues and consider variables that may impact physiological functioning and altered physiology.

Week 9 Knowledge Check: Psychological Disorders

In the Week 9 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 6. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 6

Rubric Detail

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Content
Name: NURS_6501_Module5_Case Study_Assignment_Rubric

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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 both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms.
Points Range: 28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 25 (25%) – 27 (27%)
The response describes the patient symptoms.

The response includes accurate, explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate.

The response includes explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by explanations that are vague or based on inappropriate evidence/research.

Points Range: 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 explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms, or the explanations are vague or based on inappropriate evidence/research.
Explain how the highlighted processes interact to affect the patient.
Points Range: 28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 25 (25%) – 27 (27%)
The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 23 (23%) – 24 (24%)
The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research.

Points Range: 0 (0%) – 22 (22%)
The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research.
Explain any racial/ethnic variables that may impact physiological functioning.
Points Range: 23 (23%) – 25 (25%)
The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 20 (20%) – 22 (22%)
The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 18 (18%) – 19 (19%)
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations that are based on inappropriate evidence/research.

Points Range: 0 (0%) – 17 (17%)
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research.
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.
Points Range: 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.

Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

The purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

The purpose, introduction, and conclusion of the assignment are vague or off topic.

Points Range: 0 (0%) – 3 (3%)
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
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.

Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.

Points Range: 0 (0%) – 3 (3%)
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, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.

Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.

Points Range: 3 (3%) – 3 (3%)
Contains several (3 or 4) APA format errors.

Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100

After evaluating the details given in the case study there is a high probability that the symptoms are associated with migraines. Migraine is a neurological illness that may cause a range of symptoms in individuals. Individuals with this condition frequently encounter problems such as extreme crippling headaches, sensations of tingling and numbness, articulation difficulties, intensified sound sensitivity, light sensitivity, vomiting, and nausea (Weatherspoon, 2017). Furthermore, there is commonly a trend of migraine headaches in the family after evaluation of family background with patients. Symptoms may last for days or hours, and pain that is experienced sometimes disrupts the day-to-day practices. Certain people state that they experience aura during or prior to the period of headache. The aura can result in blind spots, flashing lights, or even obstruction (Weatherspoon, 2017).

Racial/Ethnic Variables That May Impact Physiological Functioning

When looking at the population of people with migraine headaches, there are certain racial differences. In Caucasian women, the incidence of migraines is a little higher. The percentage of Caucasian women suffering from migraines is 20% while that of Asian Americans and African Americans is 9% and 16% respectively. Related phenomena have been found while examining males with migraines (Tao, 2017) where Caucasians account for 8% while Asian Americans and African Americans account for 4% and 7% respectively (Chawia, 2019). Studies have also demonstrated that the racial effects differ in regard to clinical manifestations. In African American people suffering from migraines, vomiting and nausea were less common, but the pain registered was significantly high (Tao, 2017). Nevertheless, African Americans experienced less weak points. In addition, studies have established that in people with migraines, socioeconomic aspects can be established. This is assumed to involve healthcare access, habits, and diets (Chawia, 2019). When examining racial disparities, in conjunction with socio-economic factors and genetic elements, it is considered that these elements directly affect the diagnosis of migraine headaches.

Process Interactions Impacting Patient

Migraine studies tend to leave numerous research gaps as to why patients suffering from migraines present symptoms that are so different. Alterations in brainstem connections involving the trigeminal nerve have been reported to be associated with migraine headaches. Further studies reveal that there is a link associated with brain chemical imbalance involving mostly calcitonin gene-related peptides and serotonin (Chawai, 2019).

Moreover, several elements can be linked to the occurrence of migraine headaches in a diverse patient population. One of the likely factors includes hormonal shifts in women with migraines (Weatherspoon, 2017). Fluctuations of levels of estrogen prior to or after menstruation, the beginning of menopause, and pregnancy have been found to cause migraines (Lagman-Bartolome & Lay, 2019). Another factor is hormone replacement therapy and the intake of contraceptive pills. They have been shown to exacerbate migraines and decrease the time between incidents. Higher stress levels, as well as the usage of alcohol and OTC medications, are also associated with migraines. Certain individuals may discover that sensory triggers may affect migraine incidents. Some of these include loud sounds, secondhand smoke, smells like perfume, sunlight, and bright light, which may cause migraines. Environmental elements like weather changes have been found to often be associated with migraine headaches, particularly that of elevated biometric pressure. Lastly, food additives including aspartame and monosodium glutamate are among factors that can trigger migraines (Weatherspoon, 2017).

References

Chawia, J. (2019, November 9). How does the prevalence of migraine headache vary by race? Latest Medical News, Clinical Trials, Guidelines – Today on Medscape. https://www.medscape.com/answers/1142556-170218/how-does-the-prevalence-of-migraine-headache-vary-by-race.

Lagman-Bartolome, A. M., & Lay, C. (2019). Migraine in women. Neurologic Clinics, 37(4), 835-845.

Tao, F. (2017). Migraine Prevalence and its Differences among Races and Ethnicities in the United States (2010-2015) (Doctoral dissertation, UC Irvine).

Weatherspoon, D. (2017, December 20). Everything you want to know about migraine. Healthline. https://www.healthline.com/health/migraine.

Name: NURS_6501_Module5_Case Study_Assignment_Rubric