NURS 6501 Module 2 Assignment Case Study AnalysisNURS 6501 Module 2 Assignment Case Study AnalysisTh

NURS 6501 Module 2 Assignment Case Study Analysis

NURS 6501 Module 2 Assignment Case Study Analysis

This week we will have another scenario to base our assignment on it is listed below:

A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations.

On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF).

• Using the above mentioned scenario you are to complete a knowledge check. Per the instructions: You will complete a 10- to 20-question Knowledge Check to gauge your understanding of this module’s content.
• This Knowledge Check will give you an opportunity to review a given scenario or situation to help you to determine cause and effect of a given disorder from a pathophysiology perspective. Please note that this is a formative practice for you to help you better prepare for your Midterm and Final Exams.

Please reach out if you have any questions.

NURS 6501 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 for NURS 6501 Module 2 Assignment Case Study Analysis

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

Alterations Within Cellular Process Example Paper

A 16-year-old boy comes to the clinic with the chief complaint of a sore throat for three days. Denies fever or chills. PMH negative for recurrent colds, influenza, ear infections, or pneumonia. NKDA or food allergies. Physical exam reveals temp of 99.6 F, pulse 78, and regular respirations of 18. HEENT normal with the exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy.

Rapid strep test performed in office was positive. His HCP wrote a prescription for amoxicillin 500 mg PO q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips and difficulty breathing with audible wheezing. 911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction.

In the aforementioned case study, the patient presented with acute pharyngitis. Pharyngitis refers to the inflammation of mucus membranes of the oropharynx. Manifestations of uncomplicated pharyngitis include fever, painful cervical adenopathy, tonsillar exudates, and pharyngeal erythema (Wolford et al., 2022). It is predominantly caused by viral or bacterial infectious processes. A positive rapid strep test, in his case, favors a bacterial etiology.

According to Wolford et al. (2022), Group A beta-hemolytic streptococci is the most common cause of bacterial acute pharyngitis and accounts for up to 36% of the cases. Subsequently, the boy has been prescribed antibiotics, principally amoxicillin which is recommended for bacterial eradication in patients with strep pharyngitis. Upon taking the first capsule, the patient develops an immediate hypersensitivity reaction.

Genetics

The patient in the case study above is allergic to penicillin. Type 1 hypersensitivity reactions include atopic diseases, which run in families. Drug hypersensitivity reactions can be allergic or non-allergic. However, these reactions usually occur as a result of cumulative interaction and interplay of various environmental and genetic factors.

For instance, more than half of children born in atopic families develop an allergic disease as opposed to one in five children with no family history of allergies (Amo et al., 2019). Additionally, various genes act diversely in different families to predispose to drug hypersensitivity reactions. For instance,   the PHF11 gene on chromosome 13q14 has been linked consistently with drug hypersensitivity reactions.

Specific Symptoms, Why, and Physiologic Response

The patient presented with swelling of lips and tongue, difficulty breathing, and audible wheezing. Swelling of the lips and tongue are characteristics of allergic angioedema. According to Justiz Vaillant et al. (2022), allergic angioedema is a type 1 hypersensitivity reaction and can be triggered by foods such as nuts and medications such as penicillin.

In this scenario, the patient has an exaggerated immune response in response to amoxicillin. Severe angioedema may progress to anaphylaxis. The difficulty in breathing and audible wheezing are a result of histamine-mediated bronchoconstriction. If not treated, the patients usually develop anaphylactic shock, which is life-threatening and may lead to death.

Involved Cells and the Process

According to McCance and Huether (2019), type 1 hypersensitivity reactions are IgE- mediated and involve the release of large amounts of histamines and later leukotrienes by mast cells. Immune cells that are involved in this allergic reaction are T helper cells of types 1, 2, and 17. T helper 1 cells produce IL-2 and interferon-gamma and enhance a cell-mediated immune response, while T helper 2 cells produce IL-4 and IL-13, which enhance the production of antigen-specific-IgE.

Meanwhile, T helper 17 cells produce IL-17, IL-21, and IL-22. The drug is presented to these T cells via dendritic cells. Finally, the antigen binds to TCR receptors on the T cells and activates these immune cells (McCance & Huether, 2019).

Gender and other characteristics such as age, genetics, geography, and race influence the distribution of allergic diseases such as hypersensitivity reactions. For instance, most of these reactions are highly prevalent in childhood. In the United States, Puerto Ricans have the topmost prevalence, followed by blacks, whites, Asians, and ultimately Mexicans.

References

Amo, G., Martí, M., García-Menaya, J. M., Cordobés, C., Cornejo-García, J. A., Blanca-López, N., Canto, G., Doña, I., Blanca, M., Torres, M. J., Agúndez, J. A. G., & García-Martín, E. (2019). Identification of novel biomarkers for drug hypersensitivity after sequencing of the promoter area in 16 genes of the Vitamin D pathway and the high-affinity IgE receptor. Frontiers in Genetics, 10, 582. https://doi.org/10.3389/fgene.2019.00582

Justiz Vaillant, A. A., Vashisht, R., & Zito, P. M. (2022). Immediate hypersensitivity reactions. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513315/

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biological basis for disease in adults and children. Elsevier.

Wolford, R. W., Goyal, A., Syed, S. Y. B., & Schaefer, T. J. (2022). Pharyngitis. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519550/

NURS 6501 Module 2 Assignment Case Study Analysis Learning Resources

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.

•  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.

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

?Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls.
Note: This article was presented in the Week 1 resources. If you read it previously you are encouraged to review it this week.

Required Media (click to expand/reduce)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology  | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes.

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly [LK1] (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

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

To Register to View the Content

1. Go to https://evolve.elsevier.com/
2. 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.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. 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.

NURS 6501 Week 4: Alterations in the Cardiovascular and Respiratory Systems

INTRODUCTION

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

LEARNING OBJECTIVES

Students will:

• Analyze processes related to cardiovascular and respiratory disorders
• Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
• Analyze racial/ethnic variables that may impact physiological functioning
• Evaluate the impact of patient characteristics on disorders and altered physiology

CASE STUDY ANALYSIS

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

An understanding of the symptoms of alterations in cardiovascular and respiratory systems 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 “Announcements” section of the classroom for your assignment from your Instructor.

The Assignment

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

• The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
• Any racial/ethnic variables that may impact physiological functioning.
• How these processes interact to affect the patient.
• BY DAY 7 OF WEEK 4
• Submit your Case Study Analysis Assignment by Day 7 of Week 4
• 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/templatesLinks to an external site.). All papers submitted must use this formatting.

Week 4 Case Study Assignment

Adma Grace Wilson-Romans

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Hello Class,

Week 4 Case Study Assignment:

A 55-year-old high school teacher begins experiencing a cough after a parent-teachers conference. Initially it was a mild cough and the teacher thought nothing of it since he had a history of asthma. As he was driving home, the cough became more intense, and he began experiencing chest tightness. He used his rescue inhaler as usual but did not get any relief. Minutes later he began experiencing chest pain, unlike the tightness that he experienced with his asthma.

He began to sweat profusely, experience light-headedness and difficulty breathing. He attempted to pull into a park but passed out and struck the curve causing his vehicle to come to a stop. A passerby saw the incident and called 9-1-1. On the scene, the paramedic found the man unconscious. His EKG revealed ST segment elevation in the anterior leads (V3 and V4), his pulse was shallow, and respirations were 10 breaths/min. Upon arrival to the ER, a troponin level was 13ng/l and his CK level was 265 U/L.

LEARNING RESOURCES

Required Readings

• 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

Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.

Required Media

• Alterations in the Cardiovascular and Respiratory Systems – Week 4 (15m) Transcript Attached

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/Links to an external site.

NURS_6501_Module2_Case Study_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following: Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.

30 to >27.0 pts

Excellent

The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.

27 to >24.0 pts

Good

The response describes the patient symptoms. … The response includes accurate reasons, with explanation for both the cardiovascular and cardiopulmonary pathophysiologic processes supported by evidence and/or research, as appropriate, to support the explanation.

24 to >22.0 pts

Fair

The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes reasons for the cardiovascular and/or cardiopulmonary pathophysiologic processes, with explanations that are vague or based on inappropriate evidence/research.

22 to >0 pts

Poor

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 either the cardiovascular or cardiopulmonary pathophysiologic processes, or the explanations are vague or based on inappropriate or no evidence/research.

30 pts
This criterion is linked to a Learning Outcome Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

30 to >27.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

27 to >24.0 pts

Good

The response includes an accurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

24 to >22.0 pts

Fair

The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

22 to >0 pts

Poor

The response includes a vague or inaccurate explanation of how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.

30 pts
This criterion is linked to a Learning Outcome Explain any racial/ethnic variables that may impact physiological functioning.

25 to >22.0 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.

22 to >19.0 pts

Good

The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning supported by evidence and/or research, as appropriate, to support the explanation.

19 to >17.0 pts

Fair

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations based on inappropriate evidence/research.

17 to >0 pts

Poor

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.

25 pts
This criterion is linked to a Learning OutcomeWritten 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.

5 to >4.0 pts

Excellent

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.

4 to >3.0 pts

Good

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.

3 to >2.0 pts

Fair

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.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. … No purpose statement, introduction, or conclusion were provided.

5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts
This criterion is linked to a Learning OutcomeWritten 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.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1 or 2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3 or 4) APA format errors.

2 to >0 pts

Poor

Contains many (? 5) APA format errors.

5 pts
Total Points: 100

PreviousNext

NURS 6501 Module 3: Knowledge Check Quiz

Question 14 pts

Scenario 1: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain is described as burning, non-radiating, and worse after meals. Denies N&V, weight loss, or obvious bleeding. She admits to frequent belching with bloating.

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain

Family Hx-non contributary

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and has 6-7 cups of coffee per day. She denies illicit drug use, vaping, or unprotected sexual encounters.

A breath test in the office revealed + urease.

The healthcare provider suspects the client has peptic ulcer disease.

Questions:

1. Explain what contributed to the development of this patient’s history of PUD?

The patient’s peptic ulcer disease is most likely multifactorial. One of the confirmed risk factors in this patient is Helicobacter pylori infection. H. pylori infection has been confirmed by a positive breath test for urease. This gram-negative flagellated spiral bacterium is an established cause of peptic ulcer disease, among other illnesses such as acute and chronic gastritis. Another risk factor in the above patient is tobacco smoking. The patient has 35 packs per year of smoking, and this is a significant risk for PUD. Thirdly, the patient’s elderly age, above 64 years, is another risk for peptic ulcer disease.

The patient also takes alcohol, especially 1-2 glasses of wine daily, and this contributes to the development of PUD. The patient’s use of nonsteroidal anti-inflammatory drugs, especially ibuprofen, is a risk factor for PUD development in this patient.  The patient’s coffee consumption cannot be associated with her PUD. According to a review article by Nehling (2022), there has been no substantial evidence linking coffee consumption or use of any caffeinated drinks with acid-related gastrointestinal diseases such as peptic ulcer disease

McCance, K. L., & Huether, S. E. (2022). Pathophysiology: The biologic basis for disease in adults and children (9th ed.). Mosby.

Nehlig, A. (2022). Effects of coffee on the Gastrointestinal tract: A narrative review and literature update. Nutrients, 14(2), 399. https://doi.org/10.3390/nu14020399

Question 24 pts

Scenario 1: Peptic Ulcer

A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain is described as burning, non-radiating, and worse after meals. Denies N&V, weight loss, or obvious bleeding. She admits to frequent belching with bloating.

PMH:  seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,

Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain

Family Hx-non contributory

Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and has 6-7 cups of coffee per day. She denies illicit drug use, vaping, or unprotected sexual encounters.

A breath test in the office revealed + urease.

The healthcare provider suspects the client has peptic ulcer disease.

Question:

1. What is the pathophysiology of PUD/ formation of peptic ulcers? 

This patient’s peptic ulcer disease is multifactorial. The pathophysiology of PUD in the above patient was orchestrated by an imbalance between muco-protective and destructive factors. The above factors led to the weakening of muco-protective defense mechanisms in the stomach and duodenum. When these barriers are eroded by the aforementioned factors, the mucosa is exposed to gastric acid, which leads to PUD.

Muco-protective factors include gastric mucus, stable blood flow, intact epithelial cell lining, and prostaglandin production. Acids and toxins destroy these barriers. Helicobacter pylori release toxins that irritate the already defenseless mucosa to cause an inflammatory response. NSAIDs decrease prostaglandin production by inhibiting cyclooxygenase production.

Thus, the use of these medications increases acid production and decreases gastric mucus production. Stress such as physiological and psychological stress can increase acid production. All these factors lead to mucosa erosion. The outcome is epigastric pain, vomiting, nausea, hematemesis, and sometimes melena stool

McCance, K. L., & Huether, S. E. (2022

Solution: