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ANSWERED! 67-year-old female presents with chief complaint

67-year-old female presents with chief complaint of shortness of breath fatigue weakness unintentional weight loss and mild numbness in her feet

Scenario 3: 67-year-old female presents with chief complaint of shortness of breath fatigue weakness unintentional weight loss and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.

Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO2 95% on room air.

Physical exam revealed pale, anxious female appearing older than stated years.

HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.

Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B12 levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.

Module 7 Assignment: Case Study Analysis

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in 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 the elements that may be factors in the diagnosis, and you explain the implications to patient health.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • The factors that affect fertility (STDs). The response includes accurate, clear, and detailed explanations of the processes related to women\’s and men\’s health, infections, and hematologic disorders and is supported by evidence and/or research, as appropriate, to support the explanation.
  • Why inflammatory markers rise in STD/PID. The response includes an accurate, complete, detailed, and specific analysis of the concepts and principles of pathophysiology across the life span and is supported by evidence and/or research, as appropriate, to support the explanation.
  • Why prostatitis and infection happens. Also explain the causes of systemic reaction. The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation.
  • Why a patient would need a splenectomy after a diagnosis of ITP. The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.
  • Anemia and the different kinds of anemia (i.e., micro and macrocytic). The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation.
  • 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.

GRADING RUBRIC:

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 the factors that affect fertility (STDs)–

Excellent 23 (23%) – 25 (25%)

Good 20 (20%) – 22 (22%)

Fair 18 (18%) – 19 (19%)

Poor 0 (0%) – 17 (17%)

Explain why inflammatory markers rise in STD/PID–

Excellent 18 (18%) – 20 (20%)

Good 16 (16%) – 17 (17%)

Fair 14 (14%) – 15 (15%)

Poor 0 (0%) – 13 (13%)

Explain why prostatitis and infection happen. Also explain the causes of systemic reaction.–

Excellent 18 (18%) – 20 (20%)

Good 16 (16%) – 17 (17%)

Fair 14 (14%) – 15 (15%)

Poor 0 (0%) – 13 (13%)

Explain why a patient would need a splenectomy after a diagnosis of ITP.–

Excellent 5 (5%) – 10 (10%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Explain anemia and the different kinds of anemia (i.e., micro and macrocytic).–

Excellent 5 (5%) – 10 (10%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Written Expression and Formatting – 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.–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Written Expression and Formatting – English Writing Standards:

Correct grammar, mechanics, and proper punctuation–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

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.–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3 (3%) – 3 (3%)

Poor 0 (0%) – 2 (2%)

Total Points: 100

EXPERT ANSWER AND EXPLANATION

Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

 Factors Affecting Fertility 

Fertility in women can be affected by various factors. One of the factors is iron deficiency anemia. A study done by Turner, Parsi, and Badireddy (2020) found that pernicious anemia can cause secondary infertility in both men and women. The 67-year-old female in the case risks being infertile because the symptoms she reports are signs of anemia. Another cause of infertility is age. Women who are above 40 years may have low quality and quantity eggs, making it difficult for them to conceive (McCance & Huether, 2019). The woman in the case is 67 years old. Thus, she may be infertile because, in her age, she has poor quality and few eggs. Sexually transmitted diseases (STDs) may also cause infertility. In this case, the patient experiences anemia caused by maybe, as a result of STD, such as gonorrhea.

Why Inflammatory Makers Rise in STD/PID

The body often responds to diseases or injuries through a process known as inflammation. The inflammation makers may increase in the pelvic area when the location is infected or injured (Low & Broutet, 2017). The patient presented in this case is likely to have contracted gonorrhea, which in turn caused anemia. Thus, the inflammatory makers, such as ESR, CA-125, and CRP, may increase in her pelvic region in a move to respond to an infection caused by gonorrhea.

Why Prostatitis and Infection Happens

Prostatitis is a bacterial infection that affects the prostate gland. The disease can occur without showing any signs of infections. If untreated for long, a patient with prostatitis risks suffering from prostate cancer. Some of the bacteria can cause prostatitis to include Proteus, Escherichia coli, and mirabilis. According to McCance and Huether (2019), prostatitis may occur when infected urine leaks and enters the prostate gland. A severe prostatitis infection may cause a systematic reaction known as sepsis. The patient in the case is a woman. Women do not have prostate glands; thus, the patient is less likely to contract the disease.

The Need for Splenectomy 

Splenectomy is a therapy used to treat patients with immune thrombocytopenia (ITP). One of the ITP is pernicious anemia. Stauder, Valent, and Theurl (2019) defines pernicious anemia as a disease caused by vitamin B-12 deficiency. The disease affects people with fewer vitamin B12 in the body. Weakness, tingling, numbness, and personality changes are some of the symptoms of pernicious anemia. Patients with pernicious anemia require splenectomy to help prevent them from losing destroyed platelets (Kessler, 2019). The 67-year-old female patient requires splenectomy because she has pernicious anemia.

Anemia and Types of Anemia

Anemia occurs when one has insufficient red blood cells in their blood. Anemia has been grouped into two categories, including micro and macro anemia. According to (), microcytic anemia is a kind of anemia disease characterized by small particles of red blood cells, namely microcytes (Nagalia, 2019). Anemia caused by iron-deficiency is one of the anemic diseases found under micro anemia. The macrocyte anemia is caused by a situation where the red blood cells are larger than normal. The disease can be caused by liver dysfunction, myelodysplastic syndrome, and alcoholism (Kessler, 2019). The type of amenia the patient in the case has is micro anemia because it caused by iron deficiency and STD.

References

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true

Turner, J., Parsi, M., & Badireddy, M. (2020). Anemia. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499994/

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