Assignment: Case Study Analysis
An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.
Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.
Effective disease analysis frequently necessitates knowledge that extends beyond the human systems involved. Patient characteristics, as well as racial and ethnic variables, can all have a significant impact.
Understanding the symptoms of system changes based on these characteristics is an important step in the diagnosis and treatment of many diseases. This knowledge can also help APRNs educate patients and guide them through their treatment plans.
An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in 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 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.
CASE STUDY:
Scenario 3: 67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.
Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO2 95% on room air.
Physical exam revealed pale, anxious female appearing older than stated years.
HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.
Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B12 levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.
Assignment (2-page case study analysis)
In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):
· The factors that affect fertility (STDs).
· Why inflammatory markers rise in STD/PID.
· Why prostatitis and infection happens. Also explain the causes of systemic reaction.
· Why a patient would need a splenectomy after a diagnosis of ITP.
· Anemia and the different kinds of anemia (i.e., micro and macrocytic).
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.
Learning Resources
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 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
· Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
· Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
· Chapter 27: Sexually Transmitted Infections, including Summary Review
· Chapter 28: Structure and Function of the Hematological System (stop at Clinical Assessment of the hematological system); Summary Review
· Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
· Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review
Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481
Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview
Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3
Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true
Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.
Factors that affect fertility include sexually transmitted diseases (STDs) like chlamydia and gonorrhea. STDs can cause pelvic inflammatory disease (PID) by spreading from the vagina or cervix into the upper genital tract, including the uterus and fallopian tubes. PID scarring can damage the fallopian tubes and ovaries, making it difficult or impossible for an egg to be fertilized or travel to the uterus. Prompt treatment of STDs can help preserve fertility (Low & Broutet, 2017).
Inflammatory markers typically rise with STDs and PID due to the body’s immune response fighting the infection. White blood cell counts often increase and cytokines are released, causing inflammation in the infected areas. If left untreated, ongoing inflammation can cause scarring as the body tries to wall off the infection.
Prostatitis, or inflammation of the prostate gland, is commonly caused by bacterial infection traveling from other parts of the reproductive tract, such as the urethra. Common culprits include E. coli, Chlamydia, and gonorrhea. The infection triggers an immune response in the prostate, causing swelling. Systemic reactions like fever and fatigue occur as the body fights the infection on a broader level (McCance & Huether, 2019).
A splenectomy may be required for patients with immune thrombocytopenic purpura (ITP) if medication treatments are ineffective. ITP occurs when the body’s immune system mistakenly destroys its own platelets. In severe cases, the spleen can become enlarged and overactive in attempting to remove the platelets from circulation. Surgical removal of the spleen may then allow platelet counts to increase by removing this site of platelet destruction (Kessler, 2019).
The case details describe a microcytic, hypochromic anemia with low iron, supporting a diagnosis of iron deficiency anemia. Microcytic anemias feature small red blood cells and can be caused by iron, vitamin B12 or folate deficiencies. Macrocytic anemias involve large red blood cells and are often a result of vitamin B12 or folate deficiencies. Pernicious anemia is a type of megaloblastic anemia caused by vitamin B12 deficiency and intrinsic factor antibody, preventing vitamin B12 absorption in the stomach (Nagalia, 2019).
In summary, the key factors relate to infertility from STDs, inflammatory response to infection, prostatitis etiology, ITP treatment with splenectomy, and identification of iron deficiency anemia versus other types based on lab results. Let me know if any part needs more explanation
