NURS 6501 Week 3 Concepts of Cardiovascular and Respiratory Disorders

NURS 6501 Week 3 Concepts of Cardiovascular and Respiratory Disorders

NURS 6501 Week 3 Concepts of Cardiovascular and Respiratory Disorders

The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.

Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.

This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

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

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)

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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 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
  • Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
  • Chapter 35: Structure and Function of the Pulmonary System; Summary Review
  • Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery  hypertension); Summary Review

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

Required Media (click to expand/reduce)

Module 2 Overview with Dr. Tara Harris 

Dr. Tara Harris reviews the structure of Module 2 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and Assignment. (4m)

Cardiovascular Respiratory Disorders – Week 3 (16m)

Pneumonia

MedCram. (2015, September 14). Pneumonia explained clearly by MedCram.com [Video file]. Retrieved from https://www.youtube.com/watch?v=nqyPECmkSeo

Note: The approximate length of the media program is 13 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 32, 33, 35, and 36 that relate to cardiorespiratory systems and alteration in cardiorespiratory 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/

Knowledge Check: Cardiovascular and Respiratory Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

    • myocardial infarction
    • endocarditis
    • myocarditis
    • valvular disorders
    • lipid panels
    • coagulation
    • clotting cascade
    • deep vein thrombosis
    • hypertension
    • heart failure
    • COPD
    • asthma
    • pneumonias

Photo Credit: Getty Images/Science Photo Library RF

Complete the Knowledge Check by Day 7 of Week 3

To complete this Knowledge Check:

Module 2 Knowledge Check

What’s Coming Up in Week 4?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty ImagesNURS 6501 Week 3 Concepts of Cardiovascular and Respiratory Disorders

Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology.

Next Week

To go to the next week:

Week 4

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Scenario 1: Myocardial Infarction

CC: “I woke up this morning at 6 a.m. with numbness in my left arm and pain in my chest. It feels tight right here (mid-sternal).” “My dad had a heart attack when he was 56-years-old and I am scared because I am 56-years-old.”

HPI: Patient is a 56-year-old Caucasian male who presents to Express Hospital  Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states this started this morning and has been getting worse, pointing to the mid-sternal area, “it feels like an elephant is sitting on my chest and having a hard time breathing”. He rates the pain as 9/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, or lightheadedness. Nitroglycerin 0.4 mg tablet sublingual x 1 which decreased pain to 7/10.

Lipid panel reveals Total Cholesterol 424 mg/dl, high density lipoprotein (HDL) 26 mg/dl, Low Density Lipoprotein (LDL) 166 mg/dl, Triglycerides 702 mg/dl, Very Low-Density Lipoprotein (VLDL) 64 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

Question:

1.     How does inflammation contribute to the development of atherosclerosis?

Selected Answer: Inflammation is part of your body’s immune response to an illness or injury. When you have a wound or an infection, inflammation helps fight off germs and facilitates healing. A buildup of cholesterol and other substances in your arteries  can set off an inflammatory response. For example, If you have too many cholesterol particles in your blood, cholesterol may buildup on your artery walls . Eventually, deposits called plaques may form. The deposits may narrow or block your arteries
Correct Answer: Inflammation in the heart muscle caused by chronic inflammatory processes leads to mitochondrial damage that results in an increased free radical production that further activates the chronic inflammatory vicious cycle.
Response Feedback: [None Given]
Scenario 4: Deep Venous Thrombosis (DVT)

A 81-year-old obese female patient who 48 hours post-op left total hip replacement. The patient has had severe nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

Question:

1.     Given the history of the patient explain what contributed to the development of a deep venous thrombosis (DVT)
Selected Answer: given patient history factors that may contribute to her developing deep vein thrombosis, age, surgery, immobility, and dehydration
Correct Answer: Virchow’s Triad caused damage to the walls of the vessels. When there is injury to the intimal layer of the vessel, antiplatelet substances such as nitric oxide and prostacyclin, along with the expression of collagen on the vessel wall, causes adherence of the platelets to the vessel wall. The platelets become activated then aggregate forming clots. Venous stasis because of obesity, patient’s advanced age and inability to go to physical therapy.
Response Feedback: [None Given]

·  Question 5

4 out of 4 points

Scenario 5:  COPD

A 66-year-old female with a 50 pack/year history of cigarette smoking had a CT scan and was diagnosed with emphysema.  He asks if this means he has chronic obstructive pulmonary disease (COPD).

Question:

1.     There is a clear relationship between emphysema and COPD, explain the pathophysiology of emphysema and the relationship to COPD.
Selected Answer: Emphysema is one of the lung conditions included in the term COPD. Normal lung tissue resembles a sponge; however, the lungs of people with emphysema look like an old used sponge, with large holes in them and a limited ability to “spring-back” into shape.

Emphysema is a progressive disease, that usually starts slowly with small holes between the alveoli, which eventually collapse to form larger air spaces. Old air gets trapped in these air spaces, which makes it difficult for people to inhale fresh air. Blood flow through the alveoli is also impaired meaning that people with emphysema not only struggle to breathe but have trouble receiving enough oxygen.

Cigarette smoking is by far the biggest cause of emphysema, but also the most preventable. Emphysema is more common with age and in males, and it tends to run in families. Other causes include air pollution, airway reactivity, and a deficiency of alpha-1-antitrypsin.

The main difference between emphysema and COPD is that emphysema is a progressive lung disease caused by over-inflation of the alveoli and COPD is an umbrella term used to describe a group of lung conditions emphysema is one of them. A person with emphysema has COPD; however, not everybody with COPD has emphysema.
Correct Answer: Emphysema is a disease of the airways that causes permanent enlargement of the gas exchange airways. It is accompanied by destruction of the alveolar walls do not appear to be fibrotic. Chronic exposure to irritants recruit neutrophils, macrophages, and lymphocytes to the lung resulting in progressive damage from inflammatory oxidative stress. Emphysema is characterized by destruction of alveoli leading to decreased surface area for gas exchange that causes significant ventilation/perfusion mismatch.
Response Feedback: [None Given]