Discussion: Alterations in Cellular Processes
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
- By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Scenario: An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition
By Day 3 of Week 1
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your response.
Expert Answer and Explanation
Assessment of Protein Malnutrition Disease
Prior to administering treatment, clinicians have to assess patients, and this assessment is necessary because it informs the caregiver on the best form of intervention for a particular patient scenario. During patient examination, an interventionist assesses the patient’s health background, and clinical manifestations. When working with a patient with a potential protein malnutrition, for example, a caregiver would examine patient factors such as the problem with their denture as well as their age because these are some of the factors that can exacerbate this condition. Thus, this study explores genetics’ role in the development of the protein malnutrition, and determine the reasons for the presenting clinical symptoms.
How Genetics Affect Protein Malnutrition
People’s risk of developing protein malnutrition differs, and genetics plays a role in the causation of this difference. Depending on one’s gene composition, one may prefer certain foods, and dislike others. Different foods provide different nutrients to the body, and when one does not eat foods rich in protein, their risk of developing kwashiorkor increases (Coulthard, 2015). Therefore, genetics causes kwashiorkor by causing an individual to dislike protein-rich foods such as milk.
Reasons for the Patient’s Symptoms
One can attribute the clinical manifestations present in the 83-year patient to the physiological changes linked to the protein malnutrition disease. The patient has a generalized edema of extremities, and this is one of the symptoms associated with the deficiency of the protein, albumen in the body. This protein plays a crucial role in helping hold the blood salts and water, and the lack of this protein may cause water to leak into the fluid tissues. Eventually, this causes the size of the patient’s extremities and abdomen to expand (Mozanzadeh et al, 2018).
Physiological Response to Stimuli
Based on the case study, the 83-year old experiences physiological changes which stem from the lack of the adequate protein in the patient’s body. The edema is one of these responses. The patient has issues with their dentures, and this explains why they experiences difficulty eating. There is a connection between the formation of these dentures and the malnutrition of the protein considering that nutrients play a bigger role in the strengthening of the dentures and the teeth. Based on the patient medical background, they have a mal-absorption syndrome, and this can be a trigger of the protein deficiency (Ellison, 2019).
Cells which are involved in Physiological Response
Cells play significant roles in the absorption of the nutrients and water, and within one’s body, some cells contribute to the formation of the edema. The endothelial cells are responsible for the formation of the edema given their role in the absorption of the salts and water. This is because they help facilitate the exchange of the fluids and salts to and from the blood to the tissues.
Effect of additional Factor
Gender is an additional factor that can alter the pathophysiology of kwashiorkor. Nutrition status may differ across gender, and female seem to be at higher risk of experiencing malnutrition. This is the reason why cases of the kwashiorkor and edema are more prone in women compared to men (Kismul et al., 2014).
In conclusion, edema is a clinical manifestation linked to the malnutrition of the protein, and genetics affects an individual’s risk of developing this malnutrition. This is because the protein controls the absorption of the salts and fluid, and the buildup of this fluid due to the lack of protein may cause the edema to grow. However, gender also plays a role in the development of the kwashiorkor.
Coulthard M. G. (2015). Oedema in kwashiorkor is caused by hypoalbuminaemia. Paediatrics and international child health, 35(2), 83–89. Doi: https://doi.org/10.1179/2046905514Y.0000000154.
Ellison, D.H. (2019). Clinical Pharmacology in Diuretic Use. Clinical Journal of American Society of Nephrology, 14 (8), 1248-1257. Doi: https://doi.org/10.2215/CJN.09630818.
Kismul, H., Van den Broeck, J., & Lunde, T. M. (2014). Diet and kwashiorkor: a prospective study from rural DR Congo. PeerJ, 2.Doi: https://doi.org/10.7717/peerj.350.
Mozanzadeh, M.T.., Yaghoubi, M., Marammazi, J.G., Safari, O., & Gisbert, E. (2018). Effects of Dietary Protein on Essential Amino Acid Deficiencies on Growth, Body Compassion, and Digestive Enzyme Activities of Silvery-Black Porgy (Sparidentex hasta). Int Aquat Res, 10, 45-55. Doi: https://doi.org/10.1007/s40071-017-0187-9.