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.
To prepare:
- 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.
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.
Read a selection of your colleagues’ responses.
The role genetics plats in this disease:
After further research, I've learned that malabsorption syndrome is an autosomal recessive inheritance and can be caused by genetic diseases. Having such genetic diseases can affect how our bodies absorb the nutrients we put inside of it. It can result in the intestinal tract not absorbing or transporting nutrients, such as protein throughout the body as it should. Genetics can also affect a person's preference such as preferences for specific foods and in this case, this patient may have a malabsorption to protein due to him not liking food sources that provide protein for our bodies.
Why the patient is presenting with the specific symptoms prescribed:
The 83-year-old male patient is presenting with some common symptoms associated with this disease. One of these symptoms being the generalized edema of the extremities and abdomen which can be considered, Kwashiorkor. This is a condition seen in patients with nutritional deficiencies or extreme malnutrition, which in our scenario, our patient has protein malnutrition. With Kwashiorkor, the patient will usually present with bilateral edema in the lower extremities, which is a symptom this 83-year-old resident had. "Edema results from a loss of fluid balance between hydrostatic and oncotic pressures across capillary blood vessel walls" (Benjamin, O. 2021, July 22). The patient not having dentures can ultimately result in protein malnutrition, ultimately any form of malnutrition due to not being able to eat specific foods. The patient has a history of malabsorption and being diagnosed with protein malnutrition indicates his body does not properly absorb protein as it should.
The physiologic response to stimulus presented in the scenario and why you think this response occurred:
"Low protein levels in the blood caused by malnutrition, kidney and liver disease can cause edema. The proteins help to hold salt and water inside the blood vessels, so fluid does not leak out into the tissues" (Edema. Harvard Health. 2018, December 18). Protein is what helps hold salt and water in the blood vessels, and with this patient having protein malnutrition, his blood vessels were not able to hold the salt and water, resulting in swelling of the lower extremities.
The cells that are involved in this process:
The patient presented with generalized edema in the lower extremities and abdomen. Increased permeability allows leukocytes to migrate into surrounding tissue and accumulate which is known as margination. Endothelial cells in vessel walls react to mediators and retract which allow leukocytes to migrate into interstitial space, causing the edema.
How another characteristic would change your response:
With this diagnosis, gender would not play a role. Protein malnutrition is an autosomal recessive inheritance and with these, ""males and females are equally likely to be affected by autosomal recessive diseases" (McCance, K. L., & Huether, S. E. 2019). The age of the patient can significantly impact the outcome of this disease. For instance, in children, the demand for protein is very important hence, putting younger children more at risk for this type of disease.
Resources
Benjamin, O. (2021, July 22). Kwashiorkor. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK507876/.
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children. Elsevier.
Edema. Harvard Health. (2018, December 18). https://www.health.harvard.edu/a_to_z/edema-a-to-z#:~:text=Low%20protein%20levels%20in%20the,leak%20out%20into%20the%20tissues.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Your assessment of the patient involved in Scenario #3 is very thorough and well put together.
In long-term care facilities (LTCF), unfortunately, it is common to see many residents with poor oral health."Many LTCF residents experience poor oral health due to reduced access to professional dental service" (VanArsdall, 2016). Poor oral health can lead to complications such as weight loss and nutritional deficiencies. With the patient having a history of malabsorption syndrome and difficulty eating, his body is unable to absorb the necessary nutrients in the small intestine, which in return has led to protein malnutrition (McCance & Huether, 2019). Treatment goals would include nutritional therapy and dietary supplementation once the patient is stabilized. Albumin levels would need to be drawn to determine the extent of hypoalbuminemia. Typically, residents with low levels of albumin are started on liquid protein supplements such as Pro-Stat. The patient’s edema should start to resolve as the fluid balance stabilizes and protein levels return to normal.
References
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
VanArsdall, P. S. (2016, May 13). Improving the oral health of Long-Term Care Facility residents Decisions in Dentistry. https://decisionsindentistry.com/article/improving-oral-health-long-term-care-facility-residents/.