Scenario:76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now must sleep on two pillows in order to get enough air.

 

 

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

  • The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Use APA format, reference classroom textbooks, peer-reviewed journals reflecting research done in last 5 years.

 

READ INSTRUCTION CAREFULLY

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

  • Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
  • Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
  • Chapter 35: Structure and Function of the Pulmonary System; Summary Review
  • Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

 

Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062

 

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Scenario:

 

  • A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever.
  • The patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every Friday morning and prednisone 5 mg po qam.
  • He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats.
  • He says he has had more fatigue than usual and reports some chest pain associated with coughing.
  • He admits to having occasional episodes of hemoptysis.
  • He works as a grain inspector at a large farm cooperative.
  • After an extensive workup, the patient was diagnosed with Invasive aspergillosis.

 

 

 

The Assignment

 

 

 

Develop a 1- to 2-page case study analysis in which you:

  • Explain why you think the patient presented the symptoms described. (Occupational, exposures/environmental)
  • Identify the genes that may be associated with the development of the disease. (The underlying RA and treatment will be the genetic piece with associated immunocompromised state.)
  • Explain the process of immunosuppression and the effect it has on body systems. Be sure to cite your points to support your explanations.
  • A paragraph or two will substantively develop the questions asked. Use APA format, reference classroom textbooks, peer-reviewed journals reflecting research done in last 5 years.

 

INFORMATION

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

  • Chapter 1: Cellular Biology; Summary Review
  • Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents(pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
  • Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases,
  • Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
  • Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
  • Chapter 7: Innate Immunity: Inflammation and Wound Healing
  • Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
  • Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
  • Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
  • Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
  • Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
  • Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

​Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls.

 

 

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Client Name: Ana

Client age: 24

Gender: F

Presenting Problem

Client states, “I recently lost my job and feel hopeless. I can’t sleep and don’t feel like eating.” Client also reports she has lost 10 pounds during the last two months. Client states that she is a solo parent and is worried about becoming homeless. Client states, “I worry all the time. I can’t get my brain to shut off. My husband is in the military and currently serving in an overseas combat zone for the next eight months. I worry about him all the time.”

Behavioral Observations

Client arrived 30 minutes early for her appointment. Client stated that she had never been in counseling before. Client depressed and anxious, as evidenced by shaking hands and tearfulness as she filled out her intake paperwork. Ana made little eye contact as she described what brought her into treatment. Client speech was halting. Client affect flat. Client appeared willing to commit to eight sessions of treatment authorized by her insurance company.

General Background

Client is a 24-year-old first-generation immigrant from Guatemala. Ana was furloughed from her job as a loan officer at local bank three months ago. Client reported that she was from a wealthy family in Guatemala, but does not want to ask for help. Client speaks fluent Spanish.

Education

Client has completed one year of college with a major in business. Client states that she left college after her son was born as she found it difficult to manage a baby, college, and a full-time job.

Family Background

Client is the middle of four siblings. Client has two older brothers and one younger sister. Client’s parents have been married for 27 years. Client states that she has had a “close” relationship with her family, although she states that her father is a “heavy drinker.” Client states that all her brothers and sisters have graduated from college and have professional careers. Client states that her father is a banker and her mother is an educator. Client states that she has not seen her family for 1 year. Client has a 1-year-old son and states that she is sometimes “overwhelmed” by raising him alone.

Major Stressors

Lack of family and supportive friends

Financial problems due to job loss

Husband deployed overseas

Raising a baby by herself

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