Nursing
Describe the pathophysiology of gout.
Gut is a disorder of purine metabolism (Desai, Steiger & Anders, 2017). It occurs when uric acid crystallizes as monosodium urate. It precipitates and forms deposits in joints, tendons, and surrounding tissues. It leads to inflammation in these areas.
Explain why a patient with gout is more likely to develop renal calculi.
A gout patient is likely to develop renal calculi since gout leads to a significant increase in uric acid levels in the blood (Desai, Steiger & Anders, 2017). It leads to the formation of crystals in the kidneys and joints, leading to kidney stones.
What is Lyme disease and what patient factors may have increased his risk developing Lyme disease?
Lyme disease is a bacterial disease that can be transmitted to humans from infected ticks. It mostly occurs as a growing red rash at the tick bites (McCance & Huether, 2019). A patient factor that may have caused this infection is his outdoor activities. He reports that he recently cleared underbrush in his backyard. An infected tick may have bitten him then.
What is osteoporosis and how does it develop?
Osteoporosis is a condition that affects bones. It makes the bones weak and more likely to break (McCance & Huether, 2019). It can be diagnoses when a person gets an accident and gets a fracture. The disease develops when the bone density in a person than the average for his or her age. Increased bone resorption also leads to the development of the condition. Lack of formation of new bone during remodeling also causes osteoporosis to develop.
Explain why patients with rheumatoid arthritis exhibit these symptoms and how does it differ from osteoarthritis?
A patient with rheumatoid arthritis exhibits the symptoms because her immunity fails to work the way it should. The condition makes the immune system attack the joints, causing them to ache and fail to function (McCance & Huether, 2019). The condition differs from osteoarthritis in that the latter occurs when the cartilage between joints breaks down. It is caused by daily wear and tear of the joints.
Why did the APRN order an HLA-B27 lab? How would that lab result assist in understanding what ankylosing spondylitis?
The nurse ordered an HLA-B27 lab because they wanted to determine the level of human leukocyte antigen B2 in the patients (Chen et al., 2017). it is a protein found on the surface of white blood cells and helps fight infections in the body. If the lab result turns positive, it means that the patient has ankylosing spondylitis because detecting the protein is usually associated with autoimmune disorders like ankylosing spondylitis.
Why did the APRN feel a wrist splint would be helpful? What patient characteristics lead to this diagnosis.
The nurse felt that a wrist splint would be vital because it helps support the wrist and ease pain, especially at night (Pyatt, Sinclair & Bibb, 2019). Since the patient reports that he is in the early stages of playing tennis, it would have led to lateral epicondylitis. He may have repeatedly missed hitting the ball, leading to shock in the elbow joint.
What is a seizure and why is status epilepticus so dangerous for patients?
A seizure is a change in the brain’s electrical activity due to an imbalance between brain cells that cause excitement and those that inhibit excitement (McCance & Huether, 2019). It leads to a lack of control of the body, often causing violent shakes. Status epilepticus is dangerous to a patient because it entails a single seizure that lasts more than five minutes. It could also entail multiple attacks within five minutes of each other without the patient returning to normal. It can life-threatening if treatment is delayed.
What is multiple sclerosis and how did it cause the above patient’s symptoms?
Multiple sclerosis is a condition that affects the brain and spinal cord leading to symptoms like low vision, poor coordination of legs and arms, and problems with sensation or balance (McCance & Huether, 2019). It may have caused the patient’s symptoms when her immune system malfunctioned and attacked the myelin sheath. It led to interference with the underlying nerves, leading to slow transmission of messages usually transmitted through the nerves.
What is the underlying pathophysiology of MG?
MG occurs when there is a malfunction of the body’s immune system (McCance & Huether, 2019). The immune system produces autoantibodies that attack specific receptors on the surfaces of muscle cells located at the neuromuscular junction. The autoantibodies bind to the receptors and prevent acetylcholine from binding to them. It thus prevents muscles from responding to nerve signals.
What is Alzheimer’s Disease and how does amyloid beta factor into the development and progression of the Disease?
Alzheimer’s Disease is a chronic neurodegenerative disease that develops over an extended period and leads to the development of dementia. Amyloid-beta can lead to the development of the Disease when the molecules form flexible soluble oligomers (Stakos et al., 2020). Soluble oligomers of the peptide could then lead to the development of the illness gradually.
Explain the differences between primary and secondary spinal cord injury (SCI)?
Primary spinal cord injury occurs immediately after the initial trauma, while the secondary form is an indirect result of an injury (Chin, 2019). Primary SCI includes damage to blood vessels, discoloration, and stretching and tearing of the neurons of axons. On the other hand, secondary SCI entails subarachnoid bleeding, stroke, and traumatic brain injury.
What is spinal shock and how is it different from neurogenic shock?
Spinal shock entails a loss of reflexes after an injury on the spinal cord. The nervous system fails to transmit from the brain to body organs (Chin, 2019). On the other hand, neurogenic shock involves severe damage in the central nervous system, including the brain and cervical and thoracic cords. It interferes with the sympathetic stimulation of blood vessels, leading to a decrease in blood pressure. Neurogenic shock is more harmful than spinal shock because it can lead to severe organ dysfunction and could even lead to death.
Explain the differences between primary and secondary traumatic brain injuries (TBIs)?
Primary TBI mostly entails a fracture on the skull. After an injury, the head’s bones can crack and lead to exposure of the brain matter (Chin, 2019). it thus causes damage to the brain matter. On the other hand, secondary TBI entails a complex process of degeneration and deterioration of cells in the brain. It may start immediately or a few days after an injury. Secondary brain injury patients are more likely to die if they do not seek treatment.
The APRN is called by the ICU staff because the patient’s ICP has risen to 22 mmHg. The APRN recognizes the urgent need to lower the ICP. The APRN institutes measures to decrease the ICP and increase the cerebral perfusion pressure (CPP). What are the factors that determine CPP?
The mean arterial blood pressure (MABP) is one factor that determines CPP. A rise in MABP results in an increase in CPP, and vice versa (Weersink et al., 2015). Intercranial pressure also determines CPP. An increased ICP without a corresponding rise in systemic blood pressure can lead to a drop in CPP.
Why did the patient’s symptoms totally resolve?
The symptoms resolved within an hour because the condition involves a temporary blood clot in the brain. The clot blocks proper blood supply in the brain (McCance & Huether, 2019). However, it goes away after a short time, and the symptoms disappear as well.
How does atrial fibrillation contribute to the development of a CVA?
Atrial fibrillation occurs when rapid and disorganized electrical symbols cause the heart’s two upper chambers to fibrillate, meaning that the muscles do not perform full contractions (McCance & Huether, 2019). Blood is, therefore, not fully pumped out of the chambers, leading to clotting in the heart. An increase in blood clots can lead to CVA.
Describe how osteoarthritis develops and forms and distinguish primary osteoarthritis from secondary arthritis.
Osteoarthritis develops when the protective cartilage on the ends of bones breaks down (McCance & Huether, 2019). It leads to an increase in water content in the cartilage. Collagen fibers of the cartilage thus become susceptible to degeneration, leading to an inflammation on the affected parts. Primary osteoarthritis mainly involves wear and tear of the cartilage and mostly affects older people. On the other hand, secondary arthritis is caused by an injury, obesity, inactivity, genetics, or other factors. It can occur to a person at any age.
What are the underlying causes of fibromyalgia?
Causes of fibromyalgia include abnormal pain messaging in the nervous system, an imbalance of hormones like serotonin, norepinephrine, dopamine, sleep disturbances, and genetics (McCance & Huether, 2019). A person can also contract the condition after an emotional or physical trauma or after suffering an infection. They may alter the response of the nervous system to pain.
The APRN tells the patient that the tender points are no longer used to diagnose FM. She suggests that the patient takes the Widespread Pain Index (WPI) and the Symptom Severity Inventory (SSI). The patient asks the APRN what these tests are for. What is the APRN’s best answer?
The nurse probably replied that the two tests are used to check for fibromyalgia (Morgan & Wooden, 2018). The WPI checks for a history of pain in 19 locations in the body in the past seven days. The SSI analyzes symptoms in four categories that are not related to pain. They include fatigue and cognitive problems, among other possible signs of the condition.