NURS 6501 side effects of the transplant procedure and the medications administered Assignment
NURS 6501 side effects of the transplant procedure and the medications administered Assignment
Module 1 Assignment: Case Study Analysis (Advanced PATHO)
The patient developed the symptoms because of the possible side effects of the transplant procedure and the medications administered. It may be impossible for healthcare providers to eliminate all the adverse drug interactions in the patients. The current assignment explains the symptoms evident in the patient’s case and the genes linked with the development of the disease. Also, the paper explains the process of immunosuppression and its effect on the body.
The use of nursing theories is critical to patient care because of the different purposes that they serve. Nursing theories assist in informing every interaction between nurses and patients. Through defining the features of the nurse-patient interaction, these theories shape how nurses develop relationships with patients (Wei et al., 2019). The purpose of most nursing theories is to help nurses identify care needs among patients, articulate what they can do for patients and why they do it, and determine the kind of information to collect to develop care plans. Through theories, nurses can comprehend and evaluate health situations, explain and anticipate certain responses from patients and map out objectives and anticipated outcomes (Bahabadi et al., 2020). These theories also help nurses determine the interventions to deliver, best practices, and selection of productive areas for research. The implication is that nursing theories are fundamental to quality care provision as they help nurses to possess background propositions to offer the best care.
In this, the response to the medication and medical procedure depends on many factors including genetic composition, and could trigger the symptoms. The postoperative procedure was uneventful and the patient was discharged and given anti-rejection drugs as illustrated in the case. There is the possibility that the patient developed transplant rejection leading to renal failure that contributed to the weight gain and the reduced urine output (Kuan & Schwartz, 2021). Furthermore, the sensitization of the body to the foreign organ contributed to the rising of temperate and feeling fatigued.
The genes that contributes to the development renal disease include rs25487 of the XRCC1. The gene makes people vulnerable to end-stage renal disease. Furthermore, the GSTP1 gene is also linked to the C-reactive protein and the ferritin levels. According to Abd EL-Hassib et al. (2021), individuals with the gene have increased risks for oxidative and carbonyl stress. Patients with end-stage renal disease have increased levels of C-reactive proteins which are indicators of increased inflammation. Furthermore, they demonstrate a high oxidative stress level.
Immunosuppression reduces the ability of the body to activate the immune response to the pathogens (Benvenuto et al., 2018). The process may be achieved through the reduction in the number of T-helper cells which recognizes the foreign objects and activate other immune cells to fight the pathogen (Tielemans et al., 2019). Alternatively, the effect may also be induced in the bone marrow. Besides, it reduces the inflammation in the body and the associated symptoms. However, it could be detrimental to the body because of the increased susceptibility to infections (Brown et al., 2017).
Finally, the human system is interconnected, and thus when one organ has been affected the rest may also suffer. In this case, the patient suffered organ transplant rejection and this could lead to increased inflammation. Decreased urine output was an indication of renal failure.
References
Abd EL-Hassib, D. M., Zidan, M. A., El Amawy, M. M., Hegazy, H. A., & Ameen, S. G. (2021). Polymorphism of XRCC1 Arg399Gln may predict for development of end-stage renal disease. A PCR confirmed case-control study. Meta Gene, 29, 100915. https://doi.org/10.1016/j.mgene.2021.100915
Benvenuto, L. J., Anderson, M. R., & Arcasoy, S. M. (2018). New frontiers in immunosuppression. Journal of Thoracic Disease, 10(5), 3141-3155. https://doi.org/10.21037/jtd.2018.04.79
Brown, S. A., Tyrer, F. C., Clarke, A. L., Lloyd-Davies, L. H., Stein, A. G., Tarrant, C., Burton, J. O., & Smith, A. C. (2017). Symptom burden in patients with chronic kidney disease not requiring renal replacement therapy. Clinical Kidney Journal, 10(6), 788-796. https://doi.org/10.1093/ckj/sfx057
Kuan, K., & Schwartz, D. (2021). Educational case: Kidney transplant rejection. Academic Pathology, 8, 237428952110068. https://doi.org/10.1177/23742895211006832
Tielemans, M. M., Van Boekel, G. A., Van Gelder, T., Tjwa, E. T., & Hilbrands, L. B. (2019). Immunosuppressive drugs and the gastrointestinal tract in renal transplant patients. Transplantation Reviews, 33(2), 55-63. https://doi.org/10.1016/j.trre.2018.11.001
Adenocarcinoma of the colon or rectum is a type of cancer that is initiated inside the cells that are responsible for forming glands that produce mucus. This mucus is produced to aid in the lubrication of the rectum and colon. Patients who are positive for Adenocarcinoma of the colon exhibit signs and symptoms such as a change in bowel movements, loss of weight, presence of blood in the stool and a feeling of being tired all the time. The major cause of this disease is old age, genetic disorders, and lifestyle factors. People who engage in activities such as smoking, alcohol abuse, poor diet, obesity and lack of physical activity are at a higher risk of contracting the disease (Kulke et al.,2015). Moreover, old age and being male has also been proven to be probable risk factors. The 65-year old African American patient may have presented the symptoms provided due to his old age and being male.
Mutations in the pair of genes (POLE and POLD1) have all been associated with the development of Adenocarcinoma of the colon. Most deaths relating to colon cancer have also been linked to the metastatic disease. A metastasis-associated in colon cancer 1(MACC1) gene has been isolated as the one responsible for contributing to the metastatic disease. It has a transcriptional factor that influences how the hepatocyte growth factor is expressed. These two genes are responsible for the proliferation, scattering, and invasion of cancer cells. Moreover, they are responsible for the growth of tumors (Maliha, Krittiya, Aneeqa, Wai & Scott,2017)
Colorectal cancer originates from epithelial cells lining of the rectum present in the gastrointestinal tract. This occurs as a result of mutations that occur in the Wnt signaling pathway hence increasing the signaling activity (Lin, Chang, Liou, Su, Tsao, & Huang,2018). These mutations can both be acquired or inherited. Its immunosuppression procedure involves mutation of the APC gene. This gene prevents the accumulation of β-catenin protein. In the absence of the APC, β-catenin can accumulate and move to the nucleus then activate the arrangement of proto-oncogenes. Even though these genes are crucial for stem cell renewal, they can also lead to cancer when expresses inappropriately at high levels.
References
Kulke MH, Shah MH, Benson AB rd., Bergsland E, Berlin JD, Blaszkowsky LS, et al (2015). Neuroendocrine tumors, version 1. J Natl Compr Canc Netw .2015;13:78-108.
Lin KH, Chang NJ, Liou LR, Su MS, Tsao MJ. &Huang ML. (2018). Metachronous adenocarcinoma and large cell neuroendocrine carcinoma of the colon. Formos J Surg [serial online]; 51:76-80. Available from: http://www.e-fjs.org/text.asp?2018/51/2/76/231140
Maliha K, Krittiya, Aneeqa S, Wai C, & Scott K, (2017). Early-Onset Signet-Ring Cell Adenocarcinoma of the Colon: A Case Report and Review of the Literature. Case Reports in Oncological Medicine. Volume 2017 |Article ID 2832180 | 7 pages | https://doi.org/10.1155/2017/2832180
Scenario 4: A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.
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.
Submit your Case Study Analysis Assignment by Day 7 of Week 2.
Module 1 Assignment: 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.
Photo Credit: Getty Images/Hero Images
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.
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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.
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.
Grading Criteria
To access your rubric:
Module 1 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Module 1 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
To participate in this Assignment:
Module 1 Assignment
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 2, you will analyze processes related to cardiovascular and respiratory disorders. To do this, you will analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.
Week 3 Knowledge Check: Cardiovascular and Respiratory Disorders
In the Week 3 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 2. 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
Module 2
Week 2: Altered Physiology
With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.
This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.
This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.
Learning Objectives
Students will:
- Evaluate cellular processes and alterations within cellular processes
- Analyze alterations in the immune system that result in disease processes
- Identify racial/ethnic variables that may impact physiological functioning
- Evaluate the impact of patient characteristics on disorders and altered physiology
Learning Resources
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McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
- Chapter 1: Cellular Biology; Summary Review
- Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents(pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
- Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases,
- Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
- Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
- Chapter 7: Innate Immunity: Inflammation and Wound Healing
- Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
- Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
- Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
- Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
- Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
- Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.
Required Media (click to expand/reduce)
Foundational Concepts of Cellular Pathophysiology – Week 2 (8m)
Immunity and Inflammation
Note: The approximate length of the media program is 14 minutes.
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
Note: The approximate length of the media program is 15 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 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
- Go to https://evolve.elsevier.com/cs/store?role=student
- Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
- Complete the registration process.
To View the Content for This Text
- Go to https://evolve.elsevier.com/
- Click on Student Site.
- Type in your username and password.
- Click on the Login button.
- Click on the plus sign icon for Resources on the left side of the screen.
- Click on the name of the textbook for this course.
- Expand the menu on the left to locate all the chapters.
- Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
One of the most useful components of patient care is a correct diagnosis which leads to offering a patient the correct treatment. Central to correct diagnosis and treatment is an understanding of the cell, and cell behavior as come conditions may have various circumstances and factors affecting their onset, hence making them more complex (Karaca & Aslan, 2018). Therefore, understanding the cells and cell behavior needs to be integrated with ethnic and racial variables, patient characteristics, environment, and genes. This week’s assignment deals with a patient cases study where the symptoms presented by the patient will be analyzed using various discussion questions.
Why the Patient Presented With the Symptoms
The patient has presented with various symptoms such as fevers, constipation, and crampy left lower quadrant pain. After refusing colonoscopy for some time, the patient eventually went for one, which revealed a positive test for adenocarcinoma of the colon. Even though the patient went for colonoscopy after resolution of the acute diverticulitis, the symptoms presented at the clinic point to a recurring case of acute diverticulitis. The patient has the three most common symptoms of diverticulitis (fever, constipation, and pain in the lower left quadrant). The condition is more an individual’s lifetime and therefore could be troubling the patient. The patient also eats a diet lacking in fiber and is obese, which are all factors leading to the development of the condition.
Genes That May Be Associated With the Development of the Condition
According to Strate & Morris (2019), diverticulitis may result from a complex interaction of gut microbiome, genetics, medications, lifestyle factors, and diet. Even though it has been agreed that genetics play a substantial role in the development of the condition, only a few genes have been implicated. However, a recent study reported that one of the genes that can be implicated in the development of diverticulitis is the laminin β 4 gene (LAMB4) (Coble et al.,2017). Prior to the findings regarding LAMB4, the Tumor necrosis factor superfamily member 15 (TNFSF15) gene was also found to be associated with the development of diverticulitis.
The Process of Immunosuppression and the Effect It Has On Body Systems
Immunosuppression refers to reduced immune system activation. While some parts of the immune system may possess immunosuppressive effects, immunosuppression can be also be induced (Xe, 2020). The process can be induced by the administration of medications belonging to the class of antidepressants, in some cases to allow organ transplant or bone marrow transplant to prevent a possible rejection. The process of immunosuppression may come from the blockage of intracellular pathways necessary for recognizing antigen or other immune response systems or when the immune effector cells are killed (Xe, 2020). Immunosuppression, especially when persistent, exposes an individual to the risk of cancer, especially virus-connected cancers. The effects of immunosuppression induced by ultraviolet ratio or ionizing or pharmaceutical drugs depend on the dosage or the intensity used as higher dosage or intensity lead to enhanced effects on the body systems (Xe, 2020). Even though not common, immunosuppression induced for an organ transplant can lead to metastatic tumor cells or occult tumors within the organs or tissues. The occult metastatic melanoma is dangerous for the individual receiving the transplanted organ and tissue.
Conclusion
In conclusion, as an APRN, it is important to understand effective patient diagnosis for effective treatment. It allows careful analysis of symptoms to come up with the best management strategy. This write-up has explored a case study of a patient presenting with various symptoms. After an analysis, it was noted that the symptoms could be coming from recurring diverticulitis.
References
Coble, J. L., Sheldon, K. E., Yue, F., Salameh, T. J., Harris, III, L. R., Deiling, S., … & Broach, J. R. (2017). Identification of a rare LAMB4 variant associated with familial diverticulitis through exome sequencing. Human molecular genetics, 26(16), 3212-3220. https://doi.org/10.1093/hmg/ddx204.
Karaca, T., & Aslan, S. (2018). Effect of ‘nursing terminologies and classifications’ course on nursing students’ perception of nursing diagnosis. Nurse education today, 67, 114-117. https://doi.org/10.1016/j.nedt.2018.05.011
Strate, L. L., & Morris, A. M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298. https://doi.org/10.1053/j.gastro.2018.12.033.
He, X. (Ed.). (2020). Immunosuppression. BoD–Books on Demand.
Rubric Detail
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Content
Name: NURS_6501_Module1_Case Study_Assignment_Rubric
| 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. |
Points Range: 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. |
Points Range: 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. |
Points Range: 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. |
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 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. | Points Range: 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. |
Points Range: 20 (20%) – 22 (22%)
The response includes an accurate analysis of the genes that may be associated with the development of the disease. |
Points Range: 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. |
Points Range: 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. | Points Range: 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. |
Points Range: 25 (25%) – 27 (27%)
The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems. |
Points Range: 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. |
Points Range: 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. |
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. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. |
Points Range: 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. |
Points Range: 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 |
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 (3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. |
Points Range: 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. | 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%) – 2 (2%)
Contains many (≥ 5) APA format errors. |
|
| Total Points: 100 | |||||