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Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

 

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Discussion Part Three

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and

appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P

= 116, R = 22, T = 98.6 , BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R =

16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal,as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus.

 

Explain the murmur from a mechanistic view of the hearts physiological functioning?

 

What is the epidemiology of a patent ductus arteriosus?

 

How is a patent ductus arteriosus treated?

 

Week 4: Alterations in Renal Function – Discussion Part One

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1

 

Mrs. Orndorf is a 28-year-old woman married for 3 years who has just returned from an outdoor camping trip with her husband, with symptoms of dysuria with a burning sensation, urgency to urinate, and frequent urination. She said, “I have had similar symptoms three times over the last 2 years. Pubic and low back discomfort awoke me two nights ago and that is why I am here.” On physical examination, her temperature was 98.6° F, blood pressure was 114/64 mm Hg, pulse was 68 beats per minute, and the respiratory rate was 12 breaths per minute. Other than a tender abdominal pelvic area, the examination was unremarkable.

 

• What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

 

• According to the first item in your differential, what are the risk factors for this disorder?

 

• What are some treatments for this disorder?

 

 

 

 

Week 4

 

 

Week 4: Alterations in Renal Function – Discussion Part Two

 

Discussion

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology , developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

A 56-year-old female comes into the clinic complaining of intermittent severe pain that radiates from the flank to the groin and sometimes to theinner thigh. Upon further questioning she tell you that she has an urge to always go to the restroom and that she sometime sweats and feels nauseous. A urinalysis provides traces of blood, a few white blood cells and no bacteria.

 

• What is your differential diagnosis? Discuss in detail the pathophysiology of each item in your differential and how it might fit in describing this case.

 

• The x-ray comes back and there is nothing abnormal except a slightly dilated ureter. Does this change your differential or narrow it?

 

• How would you treat the pain in this case?

 

 

 

 

 

Week 4: Alterations in Renal Function – Discussion Part Three

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

A 60-year-old patient comes into your office with a history of hypertension and a myocardial infarction 13 years ago. You notice that both of her ankles are swollen and that her skin seems shiny. She first noticed her ankle swelling 9 months ago and it has gotten progressively worse. She has a smell of ammonia on her. She also has a 2 year history of diabetes.

 

• What are at least five systemic effects of chronic kidney disease?

 

• How would you modify the diet and what is the rationale to the changes of the diet that you make?

 

Week 5

 

Week 5: Alterations in Endocrine Function – Discussion Part One

 

This week’s graded topics relate to the following Course Outcomes (COs).

 

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

 

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

 

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

 

4 Distinguish risk factors associated with selected disease states. (PO 1)

 

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

 

6 Distinguish risk factors associated with selected disease states. (PO 1)

 

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

 

Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:

 

Sodium (Na+) 156 mEq/L

 

Potassium (K+) 4.0 mEq/L

 

Chloride (Cl–) 115 mEq/L

 

Arterial blood gases (ABGs) pH- 7.30; Pco2-40; Po2-70; HCO3-20

 

Normal values

 

Sodium (Na+) 136-146 mEq/L

 

Potassium (K+) 3.5-5.1 mEq/L

 

Chloride (Cl–) 98-106 mEq/L

 

Arterial blood gases (ABGs) pH- 7.35-7.45

 

Pco2- 35-45 mmHg

 

Po2-80-100 mmHg

 

HCO3–22-28 mEq/L

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