“Alterations of Musculoskeletal Function in Children

NURS – 6501N: Advanced Pathophysiology

DISCUSSION # 1

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Factors That Influence Disease

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.

To Prepare

· Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.

· Select a disorder from the following list:

· Adrenal insufficiency (Addison’s disease)

· Atherosclerosis

· Cholelithiasis (gallstones)

· Colon cancer

· Cystic fibrosis

· Hemophilia

· Nephrolithiasis (kidney stones)

· Osteoporosis

· Parkinson’s disease

· Tuberculosis

· Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.

· Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.

Post a brief description of a patient scenario involving the disorder and the factor you selected. Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

· Chapter 1, “Cellular Biology”

This chapter reviews cellular biology to establish a foundation for exploring the pathophysiology of disease. It also covers the structure and function of cellular components, cell-to-cell adhesions, cellular communication, cellular metabolism, membrane transport, the cell cycle, and tissues.

· Chapter 2, “Genes and Genetic Diseases”

This chapter explores genetic disorders and factors that impact genetic disorders. It also examines how mutations and chromosomal abnormalities lead to transmission of genetic disorders.

· Chapter 4, “Altered Cellular and Tissue Biology”

This chapter examines disorders related to cell adaptation, injury, and death. It also explores disorders associated with altered cellular and tissue function as a result of aging.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

· Chapter 2, “Genetic Disease”

This chapter reviews the clinical manifestations, pathophysiology, and genetic principles of genetic diseases. It also explores different types of genetic diseases and the mechanisms involved.

· Chapter 5, “Neoplasia”

This chapter explores various disorders associated with neoplasia. It also covers causes and effects of common cancers and tumors resulting from neoplasia.

Required Media

Laureate Education, Inc. (Executive Producer). (2012d). Introduction to advanced pathophysiology. Baltimore, MD: Author.

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pathophysiology for the advanced practice nurse.

DISCUSSION # 2 (This has 2 Parts)

Discussion A: Maladaptive Responses to Immune Disorders

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?

To Prepare

· Review Chapter 6 and Chapter 8 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.

· Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).

· Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.

· Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders.

Post a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder.

Discussion B: Arthritis

While arthritis impacts nearly 50 million adults in the United States, it is not a disease that is limited to adulthood. Consider the case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was always swollen and that she often wanted to be carried instead of walking on her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder was discovered. Arthritis in children is not uncommon. According to the CDC (2011), an estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition. Due to the prevalence of the disorder in both children and adults, you must understand the pathophysiology and symptoms of arthritis in order to properly diagnose and prescribe treatment.

To Prepare

· Review Chapter 37 in the Huether and McCance text and Chapter 24 in the McPhee and Hammer text. Identify the pathophysiology of osteoarthritis and rheumatoid arthritis. Consider the similarities and differences of the disorders.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of and treatment for the disorders.

Post a description of the pathophysiology of osteoarthritis and rheumatoid arthritis, including the similarities and differences between the disorders. Then explain how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of treatment for the disorders. 

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

· Chapter 6, “Innate Immunity: Inflammation and Wound Healing”

This chapter examines how the body responds to injury and infection by exploring the first, second, and third lines of defense. It also covers wound healing and alterations of the wound healing process.

· Chapter 7, “Adaptive Immunity”

This chapter examines the third line of defense, adaptive immunity. It also covers the roles of antigens and immunogens, the humoral immune response, cell-mediated immunity, and the production of B and T lymphocytes in the immune response.

· Chapter 8, “Infection and Defects in Mechanism of Defense”

This chapter covers the epidemiology, clinical presentation, and treatment of disorders resulting from infection, deficiencies in immunity, and hypersensitivity. It also examines the pathophysiology of an important immune disorder—HIV/AIDS.

· Chapter 9, “Stress and Disease”

This chapter evaluates the impact of stress on various body systems and the immune system. It also examines coping mechanisms and disorders related to stress.

· Chapter 10, “Biology of Cancer”

This chapter explores the developmental process of cancer and factors that impact the onset of cancer at the cellular level. It also describes various treatment options.

· Chapter 11, “Cancer Epidemiology”

This chapter reviews genetic, environmental, behavioral, and diet-related risk factors for cancer. It also examines types of cancers that result from risk factors.

· Chapter 12, “Cancer in Children and Adolescents”

This chapter focuses on the presentation and prognosis of childhood cancers. It examines the impact of genetic and environmental factors on these cancers.

· Chapter 38, “Structure and Function of the Musculoskeletal System”

This chapter covers the structure and function of bones, joints, and skeletal muscle. It also explores effects of aging on the musculoskeletal system.

· Chapter 39, “Alterations of Musculoskeletal Function”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of bone, joints, and skeletal muscle disorders. Additionally, it explores musculoskeletal tumors, osteoarthritis, and rheumatoid arthritis.

· Chapter 40, “Alterations of Musculoskeletal Function in Children”

This chapter includes musculoskeletal disorders that affect children, such as congenital defects, bone infection, juvenile idiopathic arthritis, muscular dystrophy, musculoskeletal tumors, and nonaccidental trauma.

· Chapter 41, “Structure, Function, and Disorders of the Integument”

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