Posted: May 15th, 2023

A 65-year-old obese African American male patient presents

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

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An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the 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 cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

The Assignment

Develop a 1- to 2-page case study analysis in which you:

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Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
Explain the process of immunosuppression and the effect it has on body systems.
Scenario: A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.

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Module1_Assignmentrubiccase.pdf

NURS_6501_Module1_Case Study_Assignment_Rubric

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Criteria Ratings Pts

30 pts

25 pts

30 pts

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5 pts

Develop a 1- to 2- page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:Explain why you think the patient presented the symptoms described.

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 the symptoms 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 the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

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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 symptoms, 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 the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.

Identify the genes that may be associated with the development of the disease.

25 to >22.0 pts Excellent The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.

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22 to >19.0 pts Good The response includes an accurate analysis of the genes that may be associated with the development of the disease.

19 to >17.0 pts Fair The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

17 to >0 pts Poor The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

Explain the process of immunosuppression and the effect it has on body systems.

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30 to >27.0 pts Excellent The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

27 to >24.0 pts Good The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

24 to >17.0 pts Fair The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

17 to >0 pts Poor The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

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Written Expression and Formatting –

5 to >4.0 pts Excellent

4 to >3.0 pts Good

3 to >2.0 pts Fair

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2 to >0 pts Poor

Total Points: 100

Criteria Ratings Pts

5 pts

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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.

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.

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.

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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.

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

Written 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.

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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.

Written 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.

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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.

Criteria Ratings Pts

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Case Study Analysis

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Patient Presentation:

A 65-year-old obese African American male patient presents to his healthcare provider with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has a history of chronic inflammatory bowel disease (diverticulitis) and has experienced multiple episodes of similar symptoms over the past 15 years, which have responded to bowel rest and oral antibiotics. Despite recommendations, he has refused to undergo a colonoscopy. His sedentary lifestyle, lack of fiber in his diet, and family history of colon cancer (paternal grandfather) are also notable factors. Finally, after his acute diverticulitis resolves, he agrees to undergo a colonoscopy, which reveals multiple polyps. Pathology confirms the presence of adenocarcinoma of the colon.

Explanation of Symptoms:
The patient's presentation of crampy left lower quadrant pain, constipation, and fevers can be attributed to the underlying chronic inflammatory bowel disease (diverticulitis) and the development of colon cancer. Diverticulitis is characterized by inflammation and infection of small pouches called diverticula that form in the colon wall. The patient's history of recurrent episodes of similar symptoms responding to bowel rest and oral antibiotics indicates a chronic inflammatory process. The presence of multiple polyps detected during colonoscopy suggests the progression to adenocarcinoma, a type of cancer that arises from the glandular cells lining the colon.

Genes Associated with Disease Development:
Several genes have been associated with the development of colon cancer. In this case, the patient's family history of colon cancer, with his paternal grandfather dying from the disease, raises suspicion for inherited factors. Mutations in certain genes increase the risk of colon cancer, such as the APC (adenomatous polyposis coli) gene, which is commonly associated with familial adenomatous polyposis (FAP). FAP is an inherited condition characterized by the development of numerous polyps in the colon, leading to a significantly increased risk of colon cancer. Genetic testing may be warranted to determine if the patient carries mutations in genes associated with hereditary forms of colon cancer.

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Process of Immunosuppression and Its Effect on Body Systems:
Immunosuppression refers to the intentional suppression of the immune system's activity, often done to prevent rejection in organ transplantation or manage autoimmune diseases. Immunosuppressive drugs, such as corticosteroids or immunosuppressants, are commonly used. These medications inhibit immune responses by targeting various components of the immune system, such as T cells, B cells, or inflammatory mediators.

The effect of immunosuppression on the body systems is significant. By dampening immune responses, immunosuppressive drugs reduce the body's ability to fight infections and control inflammation. This puts individuals at a higher risk of developing infections, including opportunistic infections, as well as complications from existing infections. Immunosuppression can also impair wound healing and increase the risk of certain types of cancer, as the immune system plays a crucial role in identifying and eliminating abnormal cells.

In the case of the patient, immunosuppression due to chronic inflammatory bowel disease, as well as the potential use of corticosteroids to manage his symptoms, may have contributed to the progression of the polyps to adenocarcinoma. Immunosuppression weakens the immune surveillance against cancerous cells, allowing them to proliferate and develop into malignancies.

In conclusion, the patient's symptoms can be explained by his underlying chronic inflammatory bowel disease, which led to the development of adenocarcinoma of the colon. Genetic factors, potentially associated with hereditary colon cancer, may have contributed to his increased susceptibility. Furthermore, the immun

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