Organ and the Pathophysiological Processes Essay.

Organ and the Pathophysiological Processes Essay.

 

Introduction

Abdominal pain and vomiting, fatigue, and weight loss are common chief complaints presented by patients in the clinical settings. They can be caused by multiple diseases which necessities the need for appropriate and accurate diagnosis. These should include differential diagnosis due to symptom overlap in diverse conditions. Both physical and laboratory examination are essential in diagnosing patients. Therefore, the purpose of this paper is to address a clinical scenario involving James Alvarez, a 52-year-old patient with abdominal pain and vomiting, fatigue, and weight loss. The paper seeks to diagnose the client, identify the affected organ and describe the pathophysiological processes causing organomegaly as well as develop a comprehensive and holistic plan of care for this patient based on James’ diagnosis.Organ and the Pathophysiological Processes Essay.

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Priority diagnosis

Mr. Alvarez is diagnosed with acute viral hepatitis. This is chosen as a priority diagnosis following the analysis of his chief complain, presenting symptoms as well as physical examination. The client complained of abdominal pain and vomiting, fatigue, and unexplained weight loss. He also notes abdominal swelling which he describes as looking huge regardless of the overall weight loss. Moreover, jaundice is noted from the yellow tinge to the whites of his eyes as well as organomegaly in the right upper quadrant upon examination. Following the above symptomatic and assessment evidence, it is very likely that the patient is suffering from acute viral hepatitis.Organ and the Pathophysiological Processes Essay.

Acute viral hepatitis describes the acute inflammation of the liver resulting from viral infection by one of the five hepatitis viruses, A, B, C, D, E.(Blum, 2019).Other causes include toxins, alcohol use, medications as well as underlying heath conditions. The onset of the swelling can be sudden and may persist a few weeks with none to severe clinical manifestations. The condition is chronic if it lasts more than six months and can lead to liver cancer, liver failure or cirrhosis. However, acute hepatitis resolves within six months and can go away on its own. It is important to note that acute viral hepatitis can be prevented through vaccination against the viruses. This is due to the increased prevalence with more than 500 million cases and over one million deaths occurring every year (Rawat et al., 2019).Organ and the Pathophysiological Processes Essay.

Organ and the pathophysiological processes

Acute viral hepatitis affects the liver causing inflammation. According to Manka, Verheyen, GerkenandCanbay(2016), the pathological features include portal tracts and acini cell infiltration coupled with evidence of liver cell damage. Frank necrosis may or may not occur. The composition of inflammatory filtrate includes lymphoid cells such as plasma cells and a few leucocytes that are segmented.Organ and the Pathophysiological Processes Essay.

The pathophysiology of hepatitis begins with the exposure to the virus which forces the body to activate its defense mechanism to fight the pathogen. As the blood is exposed to the virus, the immune system mounts a response that is cell-mediated by sending the natural killer cells as well as the cytotoxic T cells to the pathogen(Manka, Verheyen, Gerken&Canbay, 2016). This releases cytokines responsible for inflammation. Portal macrophages and Kupffer cells are enlarged and may have in them iron or not together with diastase PAS-positive ceroid pigment. The damage of the liver is caused by shrinkage or swelling. Cell loss areas are marked by the framework of condensed reticulum, Kupffer cells and inflammatory cells. The presence of cholestasis forming as bile plugs in the canaliculi is another characteristic of a damaged liver. Portal inflammation is a relevant feature in acute viral hepatitis and is characterized by infiltration of most portal fields by plasma cell containing lymphocytes. The pathophysiology process of acute viral hepatitis causing liver inflammation in the patient results in organomegaly in the right upper quadrant. The capability of fighting the virus is dependent on the strength of the immune response.

Plan of care

The treatment of acute viral hepatitis depends on the severity. Often, it entails the management of symptoms, resting and maintenance of adequate fluid uptake to remain hydrated. On the other hand, medications are used to treat patients with chronic viral hepatitis in order to eradicate the virus and prevent progressive damage of the liver. The disease is also likely to resolve on its own within several weeks or months. Symptom management involves supportive care usually associated with eradicating nausea, vomiting and abdominal pain. Only necessary drugs are used since the liver is unable to eliminate the medicine at this point and can hence result in accumulation of toxins in the blood thus severing the condition(Ghany& Liang, 2016). To prevent dehydration, intravenous fluids are administered to compensate for the loss caused by vomiting.Organ and the Pathophysiological Processes Essay.

In this case, Mr. Alvarez plan of care will begin with hospitalization. This will allow further monitoring and initialization of treatment. He will receive intravenous fluids as a way of compensating for lost amounts during vomiting. He will also receive pain killers to relieve the abdominal pain and be placed on a bed rest to promote supportive symptom management care. Since the patient suffers from acute viral hepatitis, he will not receive further medical treatment because the illness is expected to go away on its own. However, careful monitoring will be done to ensure that the illness does not progress to chronic levels.

Follow up: Acute viral hepatitis has no indicated therapy or emergency department treatment. As such, it is recommended that the patient receives supportive care as the illness is expected to resolve within six months. However, careful monitoring of the patient will be necessary to determine the need for medication use to prevent liver damage and development of chronic hepatitis. The patient will be expected to visit the hospital after every four weeks after discharge to determine his progress since the illness can completely go away from four to eight weeks. Moreover, he can visit the hospital whenever the symptoms severe or in the event of complications.Organ and the Pathophysiological Processes Essay.

Population-based component plan of care: This refers to the engagement of the population in prevention and management of the disease. It can be achieved through undertaking of vaccinations which help in the prevention of the infection and spread of illness. Maintenance of population hygiene will help prevent the infection as some of the viruses are spread through human feces. As such, the population can ensure that the environment in which Mr. Alvarez lives is clean enough to prevent the spread of the pathogens. They should also offer supportive care in the form of uncontaminated food and water to the patient. The population should also ensure that food prepared meets the hygiene standards by washing their hands with running soap and water. Patient education is also essential to help understand the illness and promote community prevention and treatment through health awareness.Organ and the Pathophysiological Processes Essay.

Conclusion

Acute viral hepatitis is a public health concern across the world. The illness is caused by one of the five viruses A, B, C, D and E.  As evident in the case scenario involving Mr. James Alvarez, the major symptoms include vomiting, nausea, fatigue, abdominal pain, weight loss and organomegaly of the right upper quadrant. This occurs due to the inflammation of liver following the infiltration of most portal fields by plasma cell containing lymphocytes as the body endeavors to fight the viral pathogens through an immune response. The treatment of acute viral hepatitis is dependent on the stage of illness. However, treatment of the acute condition involves symptom management as it is bound to go away within six months. An effective treatment care plan should involve both the nurse practitioner and the population to ensure prevention and treatment. In addition, the administration of medication should consider the capability of the liver to eliminate toxins to prevent accumulation that could severe the health condition of the patient.Organ and the Pathophysiological Processes Essay.

The purpose of this paper is to address the following clinical scenario with the use of your textbook, external credible literature, and/or reliable electronic sources. Use the guide below to draft your paper and review the rubric to ensure you have met the assignment criteria. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s).Organ and the Pathophysiological Processes Essay.

James Alvarez is a 52 y.o., recently divorced, Latino male; new patient who arrives at the community health clinic for an appointment with a primary care Nurse Practitioner. His chief complaint of abdominal pain and vomiting, fatigue, and weight loss. He notes that although he has experienced overall weight loss, his stomach “looks huge.” As his history is taken, he notes no alcohol use.  In speaking with him, the Nurse Practitioner notices a yellow tinge to the whites of his eyes. During examination, the Nurse Practitioner notes organomegaly in the right upper quadrant. Organ and the Pathophysiological Processes Essay.

Please use the following headings/subheadings as a guide to draft your paper:

  1. Introduction (including purpose statement)
  2. What would be your priority diagnosis for Mr. Alvarez?
  3. Identify the organ and describe the pathophysiological processes, which may have caused the organomegaly.
  4. Develop a comprehensive and holistic plan of care for this patient based on James’ diagnosis.
  5. Conclusion
    1. Within your description, place in bold font the key pathophysiological concepts (terms).
    1. Include recommendations for follow-up with the Nurse Practitioner.
    2. Incorporate a population-based component to Mr. Alvarez’ plan of care.

In regards to APA format, please use the following as a guide:

  • Include a cover page and running head (this is not part of the 4-5 page limit)
  • Include transitions in your paper (i.e. headings or subheadings)
  • Use in-text references throughout the paper
  • Use double space, 12 point Times New Roman font
  • Spelling, grammar, and organization are appropriate
  • Include a reference list (this is not part of the 4-5 page limit)
  • Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. ANA)Organ and the Pathophysiological Processes Essay.

Assignment 3 Rubric

Competency 20 Points 12 Points 6 Points 0 Points Points Earned
Nursing Application and Analysis of Content with Connection to  Expert Nurse Level Knowledge Base Establishes very high level of nursing knowledge application and analysis to assignment that equates to the expert practice nurse knowledge base. Briefly describes application to nursing knowledge or that knowledge is not of an expert nurse but more than a novice nurse base knowledge. Level of nursing knowledge is of a novice nurse with little application or support to expert nurse practice. Does not include established nursing knowledge base and/or does not apply this to current clinical practice. /20
Teaching Considerations Evidence of intentional inclusion of patient and family teaching considerations which is sensitive to diversity, demographics and education level as necessary for the assignment. These are well supported in the literature and demonstrate clear positive impact on compliance with  excellent patient outcomes. Moderate attempt to demonstrate patient and family inclusion in teaching approaches.  Some consideration given to sensitive factors which would positively impact patient receptivity and implementation for impact on patient outcomes. Little demonstration of awareness and inclusion of patient and family sensitive teaching considerations. Impact on outcomes is not clearly addressed but can be inferred. No attempt to demonstrate sensitive approach to patient and family teaching considerations. Impact on outcomes is not addressed. /20
Critical thinking Pathophysiology content and integration with current best practice standards (supported by the scholarly literature) are used to construct critical examination and application of concepts and content. Connection between pathophysiology knowledge and current best practices is stated but now well supported with scholarly sources and/or weakly used to construct examination and application of concepts and constructs. Integration of pathophysiology and current best practice standards are anecdotal and not supported by the literature or are outdated based on current best practice standards. Little attempt to apply knowledge in examination and application to concepts and constructs. No attempt to integrate pathophysiology and current best practice standards in examination and application to constructs and concepts with no support from relevant, scholarly literature. /20
Scholarly, evidence based, current standards of practice, Sources: 3-5+ Current, relevant and authoritative scholarly sources are used to support content. Demonstrates current, evidence-based standards of practice. Minimum of 3-5+ sources. Moderate inclusion of current, relevant and authoritative scholarly sources are used to support content. Demonstrates occasional current, evidence-based standards of practice. Little attempt to include current, relevant and authoritative scholarly sources are used to support content. Or, information is purely anecdotal or not  current, evidence-based practice knowledge. No attempt to use current, relevant and authoritative scholarly sources to support content. Does not demonstrate current, evidence-based standards of practice. /20
Competency 5 Points 3 Points 1 Point 0 Point Points Earned
Organization Organization excellent, ideas clear and arranged logically, transitions smooth, no flaws in logic. Organization good; ideas usually clear and arranged in acceptable sequence; transitions usually smooth, good support Organization minimally effective; problems in approach, sequence, support and transitions Organization does not meet requirements /5
Grammar Grammar, punctuation, mechanics, and usage correct and idiomatic, consistent with Standard American English Grammar, punctuation, mechanics, and usage good mostly consistent with Standard American English; errors do not interfere with meaning or understanding Grammar, punctuation, mechanics and usage distracting  and often interfere with meaning or understanding Grammar, punctuation, mechanics, and usage interfere with understanding /5
APA Format Demonstrates competent use of mechanics and APA Minimal APA errors Many APA errors Complete lack of understanding /5
References References are relevant, scholarly, authoritative and contemporary Adequate references Minimal use of appropriate references Poor use and/or selection of references not relevant /5
Total /100

Organ and the Pathophysiological Processes Essay.