MN551 Unit 2 Assignment Case Study
Select one of the case studies below for your assignment. In your discussion, be sure to integrate your knowledge of advanced pathophysiology across the lifespan with the clinical implications for the advanced practice nurse
Case Study Assignment Requirements:
- Make sure all of the topics in the case study have been addressed.
- Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
- All reference sources must be within 5 years.
- Do not use sources such as Wikipedia or UpToDate as a reference.
- Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 3: Genetic and Congenital Disorders
Felicity is a very busy 29-year-old woman in a professional career. She has diabetes mellitus and is also pregnant for the first time. Because of her busy schedule, it was over 3 weeks after missing her menstrual cycle when she visited her family doctor to have the pregnancy confirmed. Felicity became very concerned when her physician asked if she had been taking folic acid. It was all Felicity could do to remember to manage her insulin levels, and taking folic acid supplements was something she had not even considered. Her doctor told her to take 600 μg of folic acid daily and advised Felicity to return later for maternal serum marker testing.
- Explain the potential teratogenic effect of folic acid deficiency on the developing fetus. What other risk factor is noteworthy in Felicity’s case?
- What is the benefit of maternal serum marker testing? What other test would be particularly useful to monitor the development of Felicity’s baby in this situation?
- When is the fetus most vulnerable to the effects of teratogens and why?
Before finalizing your work, it is important to:
- Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
- Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
- Utilize spelling and grammar checks to minimize errors.
- Follow the conventions of Standard English (correct grammar, punctuation, etc.).
- Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
- Utilize APA 7th edition format.
- Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Rubric Title: MN551 Unit 2 Assignment Rubric
Case Study 3 Genetic and Congenital Disorders Analysis Example Solution
Pregnancy is a critical issue that requires individuals to manage the health of the mother and the unborn baby. Both have health issues, and some conditions or substances in the mother can be potentially lethal to the baby. According to the CDC, approximately 300,000 babies are born with neural tube defects globally. Van Gool et al. (2018) explain that each woman requires about 400 mcg of folic acid daily, and adequate levels of folic acid in the body help prevent neural tube defects. Folic acid fortified foods are the best interventions. Folic acid and neural tube defects, diabetes and tests in pregnancy, and vulnerability of fetus t teratogens are the focus of this essay.
Teratogenic Effects of Folic Acid Deficiency and other Risks
Folic acid deficiency is a potentially harmful condition to the unborn baby. The most common congenital problem is neural tube defects such as anencephaly and spina bifida (Kallem et al., 2018). They occur when bones in the spinal code have developmental problems when they fail to develop or properly fuse, interfering with the integrity of the spinal cord and the brain. The mechanism is somewhat unclear. However, scientists claim that folic acid stimulates cellular methylation reactions preventing neural tube defects (van Gool et al., 2018). The absence of folic acid leads to slower methylation reactions, leading to incomplete bone formation and fusion hence disorders in the neural tube. However, the mechanism is still unclear, and more research is necessary to determine the mechanism and develop other methods of preventing neural tube defects.
Diabetes complicates pregnancy and can be an issue of concern in Felicity’s case. Reputable bodies such as the CDC and WHO have identified diabetes as a leading cause of congenital anomalies (Kallem et al., 2020). Diabetes leads to various complications in pregnancy, such as macrosomia babies, respiratory distress syndrome, preterm birth, and baby hypoglycemia soon after birth. Besides these complications, diabetes causes congenital disorders such as orofacial defects, heart disorders, limbs, spine, and vertebral malformations. Neural tube defects are significantly higher in diabetic mothers than in the general population.
Maternal Serum Markers and other Tests in Pregnancy
Maternal serum marker testing is a standard test in pregnancy used to detect fetal disorders. Kagan et al. (2022) explain that serum marker tests are vital in detecting neural tube defects such as anencephaly and spina bifida, Down syndrome, Patau syndrome, Edwards syndrome, and other congenital anomalies. The test is vital in decision-making regarding pregnancy and for corrective actions. The first benefit of the test is to prepare the mother for the baby psychologically. The mother learns of the baby’s health status, arrays fears, and prepares to live with a child (Kagan et al., 2022). Giving birth to children with congenital disorders can be challenging, but informing the mother increases preparatory actions for proper coping.
Serum marker tests also enable the healthcare provider and the parents to take corrective actions. In many instances, healthcare providers perform surgeries on babies before they’re born to correct anomalies such as Spinal Bifida (Kagan et al., 2022). The corrections give babies a better chance at life and significantly improve their quality of life. The serum maker test also allows healthcare providers and patients to make life decisions. For example, these parties may decide to terminate children with severe anomalies such as anencephaly. Such decisions are made when letting the babies survive to term does not change the health or state of the unborn baby. Maternal Serum marker testing is a non-invasive procedure that other contemporary tests should accompany to make a definitive diagnosis (Kagan et al., 2022).
Monitoring the fetus’s weight is integral for all diabetic mothers. According to the CDC, most diabetic women give birth to macrosomia babies, and the situation is worsened by poor glycemic control. HbA1c tests are essential for this client, in addition to routine random and fasting blood sugars for prompt management (Kallem et al., 2020). The intention is to ensure the levels remain within the normal range or below 6.5% as much as possible. Other tests in the first trimester are ultrasounds to determine nuchal translucency and nasal bone determination. An ultrasound is used to detect the fetal structure, location, and abnormalities of the pelvis and the reproductive organs (Kagan et al., 2022). Ultrasounds and serum markers are used to countercheck miscalculated dates.
Vulnerability of Babies to Teratogens
Unborn babies are most vulnerable to teratogens in the first trimester, specifically from 4-8 weeks after concepts. During this period, the body systems usually form; hence it is easy to distort normal development processes. Organogenesis is a crucial stage in which the systems undergo programmed development, and many teratogens in this stage affect the development of organs (CDC, 2020). The heart begins to develop at around 3-4 weeks, and teratogens at this time can prevent its development or leads to congenital disorders such as transposition of great vessels and coarctation of the aorta (CDC, 2020). Teratogens that interfere with the development of vital organs, including the liver, brain, and heart, may not survive and suffer intrauterine fetal death.
Amelia can also result from teratogens for four weeks. Organs like the lungs system and the brain develop but mature progressively. The baby cannot produce enough surfactant until about 26 weeks gestation hence the need (Kaleelullah & Garugula, 2021). Surfactant leads to lung maturity before birth. Preterm delivery requires hastening the process to prevent the baby from developing respiratory distress syndrome from alveoli collapse. Teratogens in the first trimester, especially in organogenesis, can cause many congenital disorders, including failure of organs to develop.
According to the world health organization, many medications used to prevent nausea and vomiting (such as thalidomide) profound in this stage were found to cause the most congenital anomalies. Other drugs, such as Diethylstilbestrol, used to prevent miscarriage, were identified as potentially teratogenic (Kaleelullah & Garugula, 2021). In the second and third trimesters, teratogens find already developed organs and organ systems and can hardly affect the structure. Muacevic et al. (2021) explain that teratogens can potentially affect the integrity of organs and organ systems, prevent further development and maturity, and even cause the malfunction of already formed organs. Thus, the baby is most vulnerable to teratogens in the first trimester, between 4 and 8 weeks. The mother is most vulnerable at this stage hence the need to ensure they have enough stores of vital minerals such as folic acid and Vitamin E. They should also be reviewed to ensure they are not taking potentially teratogenic drugs.
Conclusion
Folic acid deficiency and diabetes are leading risk factors for congenital anomalies. Folic acid supplementation and proper diabetes management are essential interventions in preventing congenital disorders such as neural tube defects and down syndrome.
References
Center for Disease Control and Prevention (CDC), (2021). Congenital Anomalies of the Nervous System. Birth Defects Surveillance Toolkit. https://www.cdc.gov/ncbddd/birthdefects/surveillancemanual/index.html
Kagan, K. O., Sonek, J., & Kozlowski, P. (2022). Antenatal screening for chromosomal abnormalities. Archives of Gynecology and Obstetrics, 1-11. https://doi.org/10.1007/s00404-022-06477-5
Kaleelullah, R. A., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
Kallem, V. R., Pandita, A., & Pillai, A. (2020). Infant of diabetic mother: what one needs to know? The Journal of Maternal-Fetal & Neonatal Medicine, 33(3), 482-492. https://doi.org/10.1080/14767058.2018.1494710
Muacevic, A., Adler, J., Kaleelullah, R., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
van Gool, J. D., Hirche, H., Lax, H., & De Schaepdrijver, L. (2018). Folic acid and primary prevention of neural tube defects: A review. Reproductive Toxicology, 80, 73-84. https://doi.org/10.1016/j.reprotox.2018.05.004
MN551 Unit 3 Case Study 4: Disorders of Blood Flow and Blood Pressure Regulation
Select one of the case studies below for your assignment. In your discussion, be sure to apply knowledge of the physiologic alterations in bodily systems in response to disease processes
Case Study Assignment Requirements
- Make sure all of the topics in the case study have been addressed.
- Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
- All reference sources must be within 5 years.
- Do not use sources such as Wikipedia or UpToDate as a reference.
- Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 4: Disorders of Blood Flow and Blood Pressure Regulation
Deborah is 56 years old, smokes a half a pack of cigarettes a day, and is overweight. Her friend wants her to come to a local women’s fitness class she attends once a week. She knows Deborah’s dad had died of an acute myocardial infarction when he was 56, and she fears, seeing Deborah’s lifestyle, the same fate awaits her friend. What she did not know was that Deborah had also been to her doctor for her annual physical where she was told her LDLs were 180 mg/dL, HDLs were 36 mg/dL, and cholesterol was 239 mg/dL.
- What are Deborah’s known risk factors for coronary heart disease?
- Deborah’s doctor referred her to a dietician for strict dietary therapy, hoping the intervention would raise her HDL and lower her LDL and cholesterol levels. Why is diet modification necessary to control and moderate the lipids indicated?
- Deborah’s doctor also gave her pamphlets describing strategies to stop smoking and a list of exercise ideas she might want to try. How is smoking thought to contribute to atherosclerotic plaque formation? Why would exercise have a positive effect on Deborah’s lipid profile?
- Atherosclerosis is thought to be an inflammatory disorder. What is the role of macrophages in the formation of atherosclerotic plaques? What is the significance of elevated serum hs-CRP levels in at-risk individuals?
Before finalizing your work, it is important to:
- Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
- Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
- Utilize spelling and grammar checks to minimize errors.
- Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
- Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
- Utilize APA 7th Edition format.
- Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
MN551 Unit 6 Assignment Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
- Make sure all of the topics in the case study have been addressed.
- Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
- All reference sources must be within 5 years.
- Do not use sources such as Wikipedia or UpToDate as a reference.
- Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
- Why did Marshall’s presentation lead Patricia to think he had influenza and not a cold? Why is it important to medically evaluate and diagnose a potential influenza infection?
- Describe the pathophysiology of the influenza virus. Outline the properties of influenza A antigens that allow them to exert their effects in the host.
- Marshall may be at risk of contracting secondary bacterial pneumonia. Why is this so? Explain why cyanosis may be a feature associated with pneumonia.
Before finalizing your work, it is important to:
- Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
- Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
- Utilize spelling and grammar checks to minimize errors.
- Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
- Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
- Utilize APA 7th Edition format.
- Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Rubric Title: MN551 Unit 6 Assignment Rubric
| Assignment Criteria | Level III | Level II | Level I | Not Present |
| Criteria 1 | Level III Max Points Points: 50 | Level II Max Points Points: 40 | Level I Max Points Points: 30 | Not Present 0 Points |
| Content Quality | One of the assigned Unit 6 case study topics for assignment paper: Acid/Base, Respiratory, Renal, or Gastrointestinal Disorders is chosen.Displays complete understanding of all critical concepts by answering all case study questions thoroughly, utilizing evidence-based practice.Supports opinions and ideas with evidence-based practice details and examples where appropriate. | One of the assigned Unit 6 case study topics for assignment paper: Acid/Base, Respiratory, Renal, or Gastrointestinal Disorders is chosen.Displays understanding of case study critical concepts by answering all case study questions; there may be 1-2 questions with errors/omissions or lack of details.Supports opinions and ideas with evidence-based practice details and examples where appropriate. | One of the assigned Unit 6 case study topics for assignment paper: Acid/Base, Respiratory, Renal, or Gastrointestinal Disorders is chosen.Displays understanding of patient case study critical concepts by answering all case study questions; there may be 3-4 questions with errors/omissions or lack of detail.Opinions and ideas may indicate misconceptions or little understanding of one or more critical concepts. | Does not meet the criteria. |
| Criteria 2 | Level III Max Points Points: 8 | Level II Max Points Points: 6.4 | Level I Max Points Points: 4.8 | Not Present 0 Points |
| Collegiate-level academic writing | Includes no more than three grammatical, spelling, or punctuation errors that do not interfere with the readability.Meets the assignment paper length requirement of at least four full content pages, excluding the cover page and reference page(s). Supports all opinions and ideas with relevant and credible reference sources of information.Provides three or more peer-reviewed or evidence-based practice scholarly references sources. All reference sources are within the past five years. | Includes no more than four grammatical, spelling, or punctuation errors that do not interfere with the readability.Meets the assignment paper length requirement of at least four full content pages, excluding the cover page and reference page(s). Supports many opinions and ideas with relevant and credible sources of information. Provides two peer-reviewed or evidence-based practice scholarly references sources. All reference sources are within the past five years. | Includes five or more grammatical, spelling, and punctuation errors that makes understanding parts of assignment difficult, but does not interfere with readability.Meets the assignment paper length requirement of at least four full content pages, excluding the cover page and reference page(s).Not all references utilized are relevant and/or credible sources of information.Provides one peer-reviewed or evidence-based practice scholarly references source. Reference sources are within the past five years. | Does not meet the criteria. |
| Criteria 3 | Level III Max Points Points: 7 | Level II Max Points Points: 5.6 | Level I Max Points Points: 4.2 | Not Present 0 Points |
| Citations and Formatting | The overall order of information is clear and contributes to the meaning of the assignment. There may be 1-2 sentences, or one paragraph that is out of order, or other minor organization issues.Strong attempt at APA formatting and correctly citing all reference sources. One or two formatting, in-text, or reference citation errors may occur. Quotation marks and citations make authorship clear. | The overall order of information is confusing in places due to 3-4 sentences, or two paragraphs that may be out of order, or other organization issues that interfere with the meaning or intent of the paper.Overall attempt at APA formatting and correctly citing all reference sources. 3-4 formatting, in-text, or reference citation errors may occur. Quotation marks and citations make authorship clear. | The overall order of information is confusing in places due to 5-6 sentences or three paragraphs that may be out of place, or other organization issues that interfere with the meaning or intent of the paper.Attempts to use APA formatting and citing. 5-6 formatting, in-text, or reference citation errors may occur.Quotation marks and citations may be missing or incorrect. Authorship may be unclear in areas. | Does not meet the criteria. |
| Maximum Total Points | 65 | 52 | 39 | 0 |
| Minimum Total Points | 53 points minimum | 40 points minimum | 1 point minimum | 0 |
MN551 Unit 7 Assignment Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Select one of the case studies below for your assignment. In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
- Make sure all of the topics in the case study have been addressed.
- Cite at least three references in your case study paper; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
- All reference sources must be within 5 years.
- Do not use sources such as Wikipedia or UpToDate as a reference.
- Assignments must have at least four full pages of analytic content, double-spaced (the cover and reference pages do not count in the page count, but must be included with the assignment), and follow APA 7th edition format.
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
- When testing for hypothyroidism, why is the free T4 level an important measurement? What would the TSH and T4 test results indicate in someone with primary hypothyroidism?
- Using your knowledge of the function of thyroid hormone in the body, explain why Bertha’s respiratory rate was decreased? Why might pleural effusion be present in someone with hypothyroidism?
- What factors in Bertha’s history leave her susceptible to myxedematous coma? What are the physiologic aspects involved in myxedematous coma?
Before finalizing your work, it is important to:
- Review Case Study Assignment Requirements (described above) and the Case Study Assignment Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
- Make sure to review your chosen case study carefully to make sure you have effectively answered all questions asked.
- Utilize spelling and grammar checks to minimize errors.
- Follow the conventions of Standard American English (correct grammar, punctuation, etc.).
- Make sure your assignment is original, insightful, and utilizes your logic and critical thinking skills; that your assignment is well-organized, with superior content, style, and mechanics.
- Utilize APA 7th Edition format.
- Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.
Rubric Title: MN551 Unit 7 Assignment Rubric
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism Sample Approach
Importance of Measuring T4 Levels in Hypothyroidism
The endocrine system is vital in the body because it produces hormones that regulate many processes in the body. Pathologies in the endocrine glands lead to pathologies in other organs and organ systems. The majority of the body processes require hormones to proceed. They include heat regulation, reproduction, metabolism, breathing, and muscle and bone function. The thyroid gland is one of the major glands in the endocrine system and produces T4 (thyroxine) and T3 (Triiodothyronine) hormones. T4 amounts are about 90% more than T3 amounts; hence T4 levels are the most measured. T3 is the more active hormone of the two, and Body tissues convert T4 into T3. T3 and T4 have various functions, including digestion, muscle activity, bone integrity, body weight, cholesterol levels, and heart rate (Armstrong et al., 2019).
TSH and T4 Levels in Primary Hypothyroidism
T3 is the active hormone that stimulates the production of certain hormones and proteins helpful in metabolism. Armstrong et al. (2019) note that the proteins bind these hormones in their transfer, and free lab measures can help calculate each hormone’s total and free levels. Thyroid-stimulating hormone (TSH) stimulates the production of thyroid hormones. TSH deficiency or destruction of the thyroid cells leads to low thyroid stimulation or less production of T3 and T4. In hypothyroidism, there are two primary underlying mechanisms which include the destruction of thyroid tissue or pituitary gland or the hypothalamus malfunctions leading to the low levels of TSH hence low stimulation of the thyroid gland (Armstrong et al., 2019). Due to the shortage, the body binds the free T3 and T4 for use, and the levels drop drastically. Thus, the levels of T4 are usually low in hypothyroidism. Measuring the levels of T4 is therefore paramount when testing for hypothyroidism.
Primary hypothyroidism is decreased T3 and T4 levels resulting from pathologies within the thyroid tissue. These pathologies include infections or autoimmune diseases such as Hashimoto’s thyroiditis (Hegedüs et al., 2019). The thyroid gland fails to function appropriately, hence low T3 and T4. The body produces more thyroid-stimulating hormones to stimulate and increase the production of T3 and T4, thus high levels of TSH (Armstrong, 2019). TSH stimulates the thyroid, but due to the underlying pathology, the T4 levels remain low. T3 levels will thus be normal or low. T4 levels will be low in primary hypothyroidism, while the TSH levels will be high.
Effects of Hypothyroidism on the Respiratory Rate
Destruction of the thyroid by her autoimmune disease leads to low production of thyroid hormones. Insufficient level of thyroid hormones in blood and tissues begins a cascade of pathologies in multiple organs. Kakimoto et al. (2021) note that goiter is common in hypothyroidism and can cause acute respiratory failure. Decreased T3 and T4 levels significantly affect metabolism and availability of energy. Breathing muscles weaken in myxedema /severe hypoxia hence hypoventilation. The chest fails to contract and relax normally, and the respiratory effort is severely reduced, hence Bertha’s shallow and slow breathing. Decreased thyroid hormones also negatively affect the functioning of neurotransmitters in breathing. The central respiratory center may thus fail to respond to hypercapnia and hypoxia triggers and therefore does not signal the breathing muscles to improve the respiratory effort, worsening breathing and causing further shallow and slow breathing (Hwang, 2020). The resulting hypoxia causes further compromise in an endless loop when medical interventions are not delivered.
Hypothyroidism and the Risk for Pleural Effusion
Hypothyroidism symptoms are subtle and insidious, progressing slowly over the years and include goiter from enlargement of the thyroid due to growth of new tissues after stimulation by FSH. Low T3 levels increase the membrane’s permeability in the pleural cavity, causing fluid to leak into the pleural cavity. The hormone deficiency is hence rapid and reversible capillary permeability. Fluid thus accumulates in the pleura after leakage from the lung tissue, a process that takes time (Yuan et al., 2019). The deficient levels of thyroid homes in hypothyroidism can expose an individual to increases capillary and membrane permeability hence accumulation of fluid in the pleural, leading to pleural effusion (Yuan et al., 2019). In some instances, the pericardium (fluid leakage) leads to pericardial effusion, affecting vascular endothelial growth factors, and signs and symptoms such as pleural and pericardial effusion develop slowly over time (Hwang et al., 2020).
Bertha’s History and Susceptibility to Myxedematous Coma
Myxedema is a rare, life-threatening condition resulting from long-term undiagnosed hypothyroidism. Santos et al. (2022) note that the disease is a lethal emergency and the most severe complication of hypothyroidism. Drugs trigger the condition, stress, or infections, and symptoms include intense cold intolerance and feeling exhausted, lethargy, and unconsciousness. A myxedematous coma is a severe form of hypothyroidism that is potentially lethal with mental alteration hence Bertha’s incomprehensible sounds, extreme cold (Bertha has blankets around her), puffy face, and hanging eyelids (Santos et al., 2022). The condition requires emergency medical attention to its critical nature. Bertha has had a long-term illness, hypothyroidism, which is the precursor of the disease. She developed pneumonia last winter, and infections are a risk factor for myxedematous coma. She is old, and the condition is more prevalent in older women with pre-existing hypothyroidism (Santos et al., 2022). Shoveling snow is a hard job that could trigger the body due to the high heat and energy demand, leading to myxedema coma. Working in the cold is dangerous for hypothyroidism and is potentially lethal due to decreased core temperature, which is challenging to raise. The Winter season and exposure to cold aggravate the condition (Santos et al., 2022). These factors in her history could trigger a severe myxedema coma episode.
Physiologic Aspects Involved in Myxedematous Coma
Patients with myxedematous coma are not in an actual coma but experience mental alteration, typically older women with altered consciousness. The mechanism underlying the problem is similar to hypothyroidism, but in a myxedematous coma, the body’s mechanism fails and is unable to maintain homeostasis. It is thus considered the most severe complication of hypothyroidism. The body fails to raise its core temperatures hence cold stress. Decreased metabolism leads to low energy availability for vital organs, consequently reduced brain activity, and thus confusion and altered consciousness (Wartofsky & Klubo-Gwiezdzinska, 2019). The primary physiologic aspects are a decreased level of consciousness, defective thermoregulation, and cardiovascular collapse. Cardiovascular collapse causes low blood pressure and tissue hypoperfusion worsening the condition.
Bertha’s condition is a medical emergency that requires medical attention. The medical team should be swift to raise the low hormone levels and provide supportive care such as ventilatory support. Myxedema coma is potentially fatal, as seen, and prompt action is required. Individuals should work towards preventing the complication through infection prevention, early detection and management, follow-up, and avoiding working in the cold.
References
Armstrong, M., Asuka, E., & Fingeret, A. (2019). Physiology, thyroid function.
Hegedüs, L., Bianco, A. C., Jonklaas, J., Pearce, S. H., Weetman, A. P., & Perros, P. (2022). Primary hypothyroidism and quality of life. Nature Reviews Endocrinology, 18(4), 230-242. https://doi.org/10.1038/s41574-021-00625-8
Hwang, J. W. (2020). A case of profound hypothyroidism presenting with hypertensive emergency and a large amount of pericardial effusion. The American Journal of Case Reports, 21, e923299-1. https://doi.org/10.12659/AJCR.923299
Kakimoto, S., Harada, Y., & Shimizu, T. (2021). Acute upper airway obstruction by a goiter due to Hashimoto’s thyroiditis. BMJ Case Reports, 14(9). https://doi.org/10.1136/bcr-2021-245198
Santos, A., Doukas, S., Enete, C., Santharaman, A., Rommel, E., & Roy, R. (2022). Abstract# 1185196: Myxedema Coma: A Forgotten Lethal Endocrine Emergency. Endocrine Practice, 28(5), S159. https://doi.org/10.1016/j.eprac.2022.03.371
Wartofsky, L., & Klubo-Gwiezdzinska, J. (2019). Myxedema coma. In the Thyroid and Its Diseases (pp. 281-292 https://doi.org/10.1007/978-3-319-72102-6_20
Yuan, G., Yan, Q., & He, M. (2019). A Case of Pleural Effusion Caused by Hypothyroidism. Journal of Biosciences and Medicines, 8(1), 1-4. https://doi.org/10.4236/jbm.2020.81001
MN551 Unit 9 Narrative, PowerPoint Assignment Assignment
For this assignment, you will be developing and presenting an Educational, Narrative PowerPoint. In the presentation of your chosen topic, be sure to examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan (MN551-3).
Narrative, PowerPoint Assignment Requirements
- Make sure all of the content topics of the assignment have been addressed.
- Cite at least three references in your PowerPoint; this may include peer-reviewed journal articles, textbooks, or evidence-based practice websites to support the content.
- All reference sources must be within 5 years.
- Do not use sources such as Wikipedia or UpToDate as a reference.
Design and develop a 8- to 12-slide PowerPoint presentation using voice/narrative feature on each slide (the title and reference slides do not count in the slide count, but must be included in the assignment), that will be used to educate the community about one of the following topics:
- Type II Diabetes
- Atherosclerosis
- Hypertension
- Depression
- Urinary Tract Infection
Narrative, PowerPoint Contents to include, but not be limited to:
- Risk factors and causes
- Possible consequences
- Prevention Strategies
- Treatment Modalities
PowerPoint Format:
- Follow APA 7th edition format for PowerPoint presentations.
- Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
- Slide content should include brief points that identify the areas that will be addressed in the narration.
- In-text citations should be included with any brief points that were researched from outside sources, and the narration should fully explain the points.
- Reference all sources on a separate reference slide at the end of the presentation and cite each source in the body of the presentation using 7th edition APA format.
- Identify the sources of any pictures you use, being sure to cite them correctly in 7th edition APA style, using in-text citations.
Narration Guidelines:
- Maintain a professional tone by summarizing observations and evaluations for each slide.
- Ensure that your presentation is highly ordered, logical, and unified.
- Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
Before finalizing your work, it is important to:
- Review Narrative PowerPoint Assignment Requirements (described above) and the Narrative PowerPoint Grading Rubric (under the Course Resources), to ensure you have completed all required elements of the assignment.
- Make sure to review your chosen topic carefully to make sure you have answered all content effectively.
- Utilize spelling and grammar checks to minimize errors.
- Follow the conventions of Standard English (correct grammar, punctuation, etc.).
- Make sure your presentation is original, insightful, and utilizes your logic and critical thinking skills; that your presentation is well-organized, with superior content, style, and mechanics.
- Utilize APA 7th edition format.
- Be diligent about APA formatting including paraphrasing and direct quotations, utilizing appropriate in-text citations, and referencing your sources.