Posted: January 21st, 2023

NR507 Case Study Pathophysiology Assignments

NR507 Case Study Pathophysiology Assignments

Week 1 Case Study Assignment
Purpose

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The purpose of this assignment is to apply hypersensitivity pathophysiological concepts to explain assessment findings of a patient with Allergic Rhinitis. Students will examine all aspects of the patient’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.
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The purpose of this assignment is to apply hypersensitivity pathophysiological concepts to explain assessment findings of a patient with Allergic Rhinitis. Allergic Rhinitis is a chronic inflammatory disorder of the nasal airways caused by an IgE-mediated hypersensitivity response to allergens such as pollen, dust mites, or animal dander.
The patient's Chief Complaint (CC) is nasal congestion, sneezing, and itchy eyes. The History of Present Illness (HPI) reveals that these symptoms occur seasonally and are worse in the spring and fall. The patient also reports a history of asthma and eczema, indicating a potential atopic predisposition.
The Past Medical History (PMH) and Family History (FH) are significant for a history of allergies, asthma, and eczema in both the patient and their family members. The Social History (SH) reveals that the patient lives in a suburban area and is frequently exposed to allergens such as pollen and grass.
The Review of Systems (ROS) reveals that the patient also experiences fatigue, headache, and insomnia, which are common symptoms associated with allergic rhinitis. The Medications section shows that the patient is currently taking a nasal steroid spray and an antihistamine to manage their symptoms.
By examining all aspects of the patient's assessment, it is clear that the patient is experiencing an IgE-mediated hypersensitivity response to allergens, which is causing inflammation and symptoms of nasal congestion, sneezing, and itchy eyes. The patient's atopic predisposition, exposure to allergens, and history of allergies and asthma support the diagnosis of Allergic Rhinitis. The patient's current treatment plan of a nasal steroid spray and antihistamine is appropriate for managing the symptoms of allergic rhinitis.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

NR507 Case Study Pathophysiology Assignments

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Analyze the case to arrive at the type of hypersensitivity reaction that the patient is exhibiting. (CO1)
Explain the pathophysiology of the identified hypersensitivity reaction. (CO1)
Identify all subjective and objective information provided in the case. (CO3)
Explain, using pathophysiology, the rationale for each subjective and objective finding. (CO1, CO3)
Identify two types of medications that are strongly recommended for the treatment of allergic rhinitis according to the clinical practice guidelines on the management of allergic rhinitis. (CO2, CO5)
Explain the mechanism of action of the two medication classifications and include how the symptoms of allergic rhinitis are alleviated when taken. (CO2, CO5)
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Week 1 Case Study template

Pathophysiology & Clinical Findings of the Disease

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Identify the correct hypersensitivity reaction:

Explain the pathophysiology associated with the chosen hypersensitivity reaction:

Identify at least three subjective findings from the case:

Identify at least three objective findings from the case:

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Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each:

Describe the mechanism of action for each of the medication classes identified above:

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Identify two treatment options that are NOT recommended (I.e., recommended against):

References

[Must be on a separate page and in APA format]

Requirements:

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Content Criteria:

Read the case study listed below.
Refer to the rubric for grading requirements.
Utilizing the Week 1 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal. NR507 Case Study Pathophysiology Assignments
You must use the Clinical Practice Guideline (CPG) for the management of allergic rhinitis to answer the treatment recommendation questions. The guideline can be found at the following web address: https://journals.sagepub.com/doi/10.1177/0194599814561600Links to an external site. .You may also use a medication administration reference such as Epocrates to provide medication names.
Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.

Case Study Scenario

A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that “seems to never go away”. She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose) and inflamed nares.

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Case Study Questions

Pathophysiology & Clinical Findings of the Disease

Identify the correct hypersensitivity reaction.
Explain the pathophysiology associated with the chosen hypersensitivity reaction.
Identify at least three subjective findings from the case.
Identify at least three objective findings from the case.
Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

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Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each.
Describe the mechanism of action for each of the medication classes identified above.
Identify two treatment options that are NOT recommended (I.e., recommended against).
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Pathophysiology & Clinical Findings of the Disease:

The correct hypersensitivity reaction for this patient is likely Type 1 (IgE-mediated) hypersensitivity, also known as allergic rhinitis.
In an IgE-mediated hypersensitivity reaction, the immune system produces IgE antibodies in response to an allergen. These antibodies bind to mast cells and basophils, causing the release of inflammatory mediators such as histamine. This leads to the characteristic symptoms of allergic rhinitis, such as nasal congestion, sneezing, and rhinorrhea.
Subjective findings: nasal congestion, rhinorrhea, sneezing.
Objective findings: eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners, allergic crease, and inflamed nares.
Management of the Disease:

Medication classes:
Antihistamines: example drug name is cetirizine
Intranasal corticosteroids: example drug name is fluticasone
Mechanism of action:
Antihistamines block the action of histamine, thereby reducing symptoms such as nasal congestion and sneezing.
Intranasal corticosteroids reduce inflammation in the nasal passages, thereby reducing nasal congestion and other symptoms.
Treatment options NOT recommended:
oral decongestants: are not recommended as they can cause rebound congestion if used for a prolonged period of time.
Oral corticosteroids: Long-term use of oral corticosteroids can cause significant side effects, so they are not recommended as a first-line treatment for allergic rhinitis.
It's important to note that it is crucial to identify and remove the allergen causing the reaction, in this case, it might be the dog or cat, and in addition, it's important to note that while these are the recommended treatment options, it is important to check the patient's medical history and current medications to avoid any drug-drug interactions or adverse effects.
NR507 Week 1 Case Study
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Pathophysiology & Clinical Findings of the Disease
The student:

– Identifies the correct hypersensitivity reaction.

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– Explains the pathophysiology associated with the chosen hypersensitivity reaction.

– Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).

– Identifies at least three subjective findings from the case.

– Identifies at least three objective findings from the case.

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(5 Required Elements)

45 pts
All 5 required elements are present

41 pts
1 required element is missing.

37 pts
2 required elements are missing

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23 pts
3-4 required elements are missing.

0 pts
All 5 required elements are missing.

45 pts
This criterion is linked to a Learning Outcome Management of the Disease
The student:

– Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.

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– Identifies two strongly recommended medication classes for the treatment of the condition and provides an example (drug name) for each.

– Describes the mechanism of action for each of the medications identified.

– Identifies two treatment options that are NOT recommended (I.e., recommended against). NR507 Case Study Pathophysiology Assignments

45 pts
All 4 elements are present

41 pts
1 required element is missing

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37 pts
2 required elements are missing

23 pts
3 required elements are missing

0 pts
All 4 required elements are missing

45 pts
This criterion is linked to a Learning Outcome Organization, spelling, grammar & APA format
The student:

– Uses the week 1 case study template for case study responses.

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– Provides correct in-text citations for responses which match the reference page.

– Has minimal spelling, grammar & APA format errors.

10 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format.

9 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format.

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8 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format.

5 pts
Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format.

0 pts
Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.

10 pts
This criterion is linked to a Learning Outcome Late penalty deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0 pts
Manual Deductions

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0 pts
Manual Deductions

0 pts
Total Points: 100
Week 2 case Study Assignment (NR507 Case Study Pathophysiology Assignments)
Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

Explain the pathophysiology of heart failure by analyzing a patient’s symptoms. (CO1)
Differentiate between systolic and diastolic heart failure. (CO1)
Explain the significance of physical exam and diagnostic findings in the diagnosis of heart failure. (CO4)
Requirements:

Read the case study below.
In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
Provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question using appropriate resources, before Sun., 11:59 pm MT.
Case Scenario:

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A 72-year-old male presents to the primary care office with shortness of breath, leg swelling, and fatigue. He reports that he stopped engaging in his daily walk with friends three weeks ago because of shortness of breath that became worse with activity. He decided to come to the office today because he is now propping up on at least 3 pillows at night to sleep. He tells the NP that he sometimes sleeps better in his recliner chair. PMH includes hypertension, hyperlipidemia and Type 2 diabetes.

Physical Exam:

BP 106/74 mmHg, Heart rate 110 beats per minute (bpm)

HEENT: Unremarkable

Lungs: Fine inspiratory crackles bilateral bases

Cardiac: S1 and S2 regular, rate and rhythm; presence of 3rd heart sound; jugular venous distention. Bilateral pretibial and ankle 2+pitting edema noted

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ECG: Sinus rhythm at 110 bpm

Echocardiogram: decreased wall motion of the anterior wall of the heart and an ejection fraction of 25%

Diagnosis: Heart failure, secondary to silent MI

Discussion Questions:

Differentiate between systolic and diastolic heart failure.
State whether the patient is in systolic or diastolic heart failure.
Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.
Week 3 Case Study Assignment
Purpose

The purpose of this assignment is to apply hypersensitivity pathophysiological concepts to explain assessment findings of a patient with respiratory disease. . Students will examine all aspects of the patient’s assessment including: Chief Complaint (CC), History of Present Illness (HPI), Past Medical History (PMH), Family History (FH), Social History (SH), Review of Systems (ROS), and Medications and then answer the questions that follow on the provided Comprehensive Case Study template.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

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Examine the case scenario and analyze the spirometry results to determine the most likely respiratory diagnosis. (CO1)
Explain the pathophysiology of the respiratory disease. (CO1)
Differentiate between subjective and objective findings which support the chosen diagnosis. (CO4)
Apply evidence-based practice guidelines to classify the severity of the respiratory disorder and employ an appropriate treatment plan. (CO1, CO5)
Requirements:

Content Criteria:

Read the case study listed below.
Refer to the rubric for grading requirements.
Utilizing the Week 3 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/Links to an external site.. At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used. NR507 Case Study Pathophysiology Assignments
Case Study Scenario

Chief Complaint

A.C., is a 61-year old male with complaints of shortness of breath.

History of Present Illness

A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.

Past Medical History

Hypertension
Hyperlipidemia
Atherosclerotic coronary artery disease
Smoker
Family History

Father deceased of acute coronary syndrome at age 65
Mother deceased of breast cancer at age 58.
One sister, alive, who is a 5 year breast cancer survivor.
One son and one daughter with no significant medical history.
Social History

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35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention.
Denies alcohol or recreational drug use
Real estate agent
Allergies

No Known Drug Allergies
Medications

Rosuvastatin 20 mg once daily by mouth
Carvedilol 25 mg twice daily by mouth
Hydrochlorothiazide 12.5 mg once daily by mouth
Aspirin 81mg daily by mouth
Review of Systems

Constitutional: Denies fever, chills or weight loss. + Fatigue.
HEENT: Denies nasal congestion, rhinorrhea or sore throat.
Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
Heart: Denies chest pain, chest pressure or palpitations.
Lymph: Denies lymph node swelling.
General Physical Exam

Constitutional: Alert and oriented male in no apparent distress.
Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93%
Wt. 180 lbs., Ht. 5’9″
HEENT

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Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
Ears: Tympanic membranes intact.
Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry.
Neck/Lymph Nodes

Neck supple without JVD.
No lymphadenopathy, masses or carotid bruits.
Lungs

Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
Heart

S1 and S2 regular rate and rhythm, no rubs or murmurs.
Integumentary System

Skin cool, pale and dry. Nail beds pink without clubbing.
Chest X-Ray

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Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.
Spirometry

Week 3 Template

Pathophysiology & Clinical Findings of the Disease

Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?

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Explain the pathophysiology associated with the chosen pulmonary disease.

Identify at least three subjective findings from the case which support the chosen diagnosis.

Identify at least three objective findings from the case which support the chosen diagnosis

Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

Classify the patient’s disease severity. Is this considered stable or unstable?

Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.

Describe the mechanism of action for each of the medication classes identified above.

Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.

References

[Must be on a separate page and in APA format. NR507 Case Study Pathophysiology Assignments

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