NUR 606 Week 6 Discussion 1 Question-Based Discussion

March 8, 2022
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NUR 606 Week 6 Discussion 1 Question-Based Discussion

NUR 606 Week 6 Discussion 1 Question-Based Discussion

It is understood that thoughtful responses to your topic question(s) will take some time and thought. Please organize your thoughts before creating your initial post. To assist you in your work for this discussion, please use the worksheet linked in each of the team threads to organize your thoughts. Then simply copy and paste the text from the document into your initial post.
Based on your assigned team, create an initial post by answering ALL questions for your assigned case (Team A, B, or C), making sure to address all components of all questions.
By Day 3, post your initial response to your assigned case study as a new discussion thread. Please be sure to number the questions addressed and include all components of each question in your response. Each initial response must have a reference, including at least two scholarly references other than your textbook or course materials. Your post should be limited to 500 to 750 words and comprehensively address the questions posed.
Team A
Week 6 Discussion Team A Worksheet (Word)
1. Describe the three stages of hemostasis.
2. Explain the difference between the terms microcytic and megaloblastic. Identify one condition where each may occur.
3. Compare the general effects of the general states of anemia and polycythemia in terms of hemoglobin level, hematocrit, general appearance, and possible complications. There can be different causes for these conditions. Compare their general presentation, regardless of cause.
4. In patients with leukemia, the mouth and mucosa of the digestive tract are usually inflamed and ulcerated because of anemia, the effects of chemotherapy, and the presence of infections, such as candidiasis. Explain how this situation would affect food and fluid intake, and list some possible subsequent effects on the patient with leukemia.
Team B
Week 6 Discussion Team B Worksheet (Word)
1. State three major functions of plasma proteins, and list the component responsible for each.
2. Explain the difference between petechiae and ecchymoses. Identify one condition where each may occur.
3. Explain how a deep vein thrombosis in a large vein in the leg can result in a life-threatening condition such as a stroke or myocardial infarction.
4. Katie has been diagnosed with leukemia, and she is wondering if it is safe to go to the dentist. Her WBC and platelet counts are still low from chemotherapy. What are the risks associated with invasive procedures while her counts are decreased? How would you explain these to Katie? Include discussion of why bleeding and multiple opportunistic infections are common in patients with leukemia.
1. State three major functions of plasma proteins and list the component responsible for each.
NUR 606 Week 6 Discussion 1 Question-Based DiscussionThe major plasma proteins include albumin, globulin, and fibrinogen. Albumin is important for the maintenance of colloid osmotic pressure of the blood and transportation of drugs, hormones, and fatty acids. Globulins come in three flavors which are alpha, beta, and gamma. Alpha-globulins are high-density lipoproteins that are integral to carrying fats to the cells to be used as energy. low-density lipoproteins are better globulins that help transport fat to the cells for cell membrane synthesis. Gamma globulins are antibodies or immunoglobulins and are produced by the B lymphocytes. Fibrinogen is a glycoprotein coping that is made in the liver and is important for creating fibrin clots to occlude blood vessels if they are broken open and are bleeding (Surinova, Schiess, Hüttenhain, Cerciello, Wollscheid, & Aebersold, 2018).
2. Explain the difference between petechiae and ecchymoses. Identify one condition where each may occur.
Petechiae are tiny round purple spots that occur on the skin and are the result of bleeding underneath the skin from trauma. An example of this is an adolescent tying a sweater around their neck and cutting off circulation. They would appear to have petechiae on their face after the event. Mickey Mouse this is a bruise. Ecchymosis is discoloration of the skin that results from bleeding underneath, also known as a bruise. Bruises can occur from bumping your arm on the table as you walk by it. The main difference between petechiae and ecchymoses is how they manifest, petechiae is scattered tiny dots, while a bruise is a localized area (VanMeter & Hubert, 2018).
3. Explain how a deep vein thrombosis in a large vein in the leg can result in a life-threatening condition such as a stroke or myocardial infarction.
A thrombus forms in a valve pocket of the vein in the leg and is composed of fibrin and red blood cells. According to the CDC, a DVT is not likely to cause a stroke or a myocardial infarction due to the fact it is in a vein and artery. Not sure if this was a trick question. But there is a risk of developing a pulmonary embolism where the cloud will break off and go into the lung (CDC, 2020).
4. Katie has been diagnosed with leukemia and she is wondering if it is safe to go to the dentist. Her WBC and platelet counts are still low from chemotherapy. What are the risks associated with invasive procedures while her counts are decreased? How would you explain these to Katie? Include a discussion of why bleeding and multiple opportunistic infections are common in patients with leukemia.
There is associated with having a dental procedure done with a low WBC and platelet count is the risk of infection and bleeding. if Katie develops an infection from the dental procedure, it would be very difficult to treat the infection due to the state of her immunocompromised condition from chemotherapy. People who have leukemia are subjected to multiple opportunistic infections because they have nonfunctional WBCs so they cannot fight off the infectious agents. The problem with her having low platelets increases her risk for bleeding that would be difficult to stop, spontaneous hemorrhaging, which could have very serious health outcomes (VanMeter & Hubert, 2018). If Katie would like a dental visit it would need to be planned out around her therapy and she may need to take prophylactic antibiotics.
References:
Blood Clots (Deep Vein Thrombosis). (2020, May 28). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/survivors/patients/blood-clots.htm
https://doi.org/10.1080/01612840.2019.167808
Surinova, S., Schiess, R., Hüttenhain, R., Cerciello, F., Wollscheid, B., & Aebersold, R. (2018). On the Development of Plasma Protein Biomarkers. Journal of Proteome Research, 10(1), 5–16. https://doi.org/10.1021/pr1008515
VanMeter, K. C., & Hubert, R. J. (2018). Gould’s pathophysiology for the health professions. (6th ed.). Elsevier Saunders.
Team C
Week 6 Discussion Team C Worksheet (Word)
1. Predict those organs that would be expected to have a large capillary network. What criteria did you use in making this prediction?
2. Explain the difference between leukocytosis and erythrocytosis. Identify one condition where each may occur.
3. Explain how DIC develops, and identify three signs of its development.

4. You are taking care of John, a 55-year-old male who has recently been diagnosed with myelodysplastic syndrome. He asks you what this means and if he is going to die. How will you explain the pathophysiology of this condition to John? What can you share with him about prognosis?

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Replies
Select posts from two peers that addressed a case from a different team than you. For example, students from Team A reply to one post from Team B and one post from Team C. Each reply must use at least one scholarly reference other than your textbook.
Thinking about your certification track and anticipated practice area:
• Describe a patient that you might encounter where you could apply the information learned in your peer’s post.
• What “signs” and “symptoms” would you expect this patient to exhibit? Identify at least four, describe the finding, and classify each as subjective or objective data.
NUR 606 Week 6 Discussion 1 Question-Based DiscussionPlease refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
Posting to the Discussion Forum
1. Select the appropriate Thread.
2. Select Reply.
3. Create your post.
4. Select Post to Forum.
Please use this thread to create your reply posts, as indicated in the forum instructions.
1. Describe the three stages of hemostasis.
2. Explain the difference between the terms microcytic and megaloblastic. Identify one condition where each may occur.
3. Compare the general effects of the general states of anemia and polycythemia in terms of hemoglobin level, hematocrit, general appearance, and possible complications. There can be different causes for these conditions. Compare their general presentation, regardless of cause.
4. In patients with leukemia, the mouth and mucosa of the digestive tract are usually inflamed and ulcerated because of anemia, the effects of chemotherapy, and the presence of infections, such as candidiasis. Explain how this situation would affect food and fluid intake, and list some possible subsequent effects on the patient with leukemia.
1. Describe the three stages of hemostasis.
Hemostasis is the process of stopping bleeding. This occurs in three steps. First, in response to injury, the blood vessel vasoconstricts or spasms. This decreases blood flow to the area. Secondly, the thrombocytes adhere to underlying tissue at the site of the injury. Platelet plugs form during this step if the blood vessel is small. Finally, the blood clotting/ coagulation mechanism is activated. A cascade reaction by the different clotting factors occurs here to form a blood clot (Hubert & Van Meter, 2018).
2. Explain the difference between the terms microcytic and megaloblastic. Identify one condition where each may occur.
Microcytosis is when the red blood cell (RBC) size is smaller than the normal range. (Gotter, 2019). A condition where this may occur is in iron-deficiency anemia. Megaloblastic anemia is a form of anemia where the red blood cells are larger than normal and there is a decrease in the number of those cells. This is usually due to acquired deficiency in vitamin B12 or folic acid. Pernicious anemia is a type of megaloblastic anemia (Boston Children’s Hospital, 2017).
3. Compare the general effects of the general states of anemia and polycythemia in terms of hemoglobin level, hematocrit, general appearance, and possible complications. There can be different causes for these conditions. Compare their general presentation, regardless of cause.
In anemia, the hemoglobin and hematocrit levels are low. This can be due to a deficiency of a required nutrient such as iron, bone marrow function is impaired when there is excessive blood loss or a significant destruction of erythrocytes. The general appearance in patients with anemia are fatigue, pallor, dyspnea, and tachycardia, and chest pain (if severe). Possible complications for anemia are oxygen deficit, congestive heart failure if there is a significant reduction in oxygen supply to the heart, and decreased regeneration of epithelial cells may cause inflammation and ulcers in the digestive tract.
Polycythemia is when there is an increased number of erythrocytes. This causes the hemoglobin and hematocrit levels to be high. Patients with polycythemia appear plethoric and cyanotic. These patients are overfilled with blood. There is a bluish-red tone of the skin and mucosa. Patients may also experience pruritus, dyspnea, headaches, and visual disturbances. Possible complications from polycythemia are increased blood pressure, hepatomegaly, thrombosis and infarctions throughout the body, congestive heart failure, and joint pain if the uric acid levels are high (Hubert & Van Meter, 2018).
4. In patients with leukemia, the mouth and mucosa of the digestive tract are usually inflamed and ulcerated because of anemia, the effects of chemotherapy, and the presence of infections, such as candidiasis. Explain how this situation would affect food and fluid intake and list some possible subsequent effects on the patient with leukemia.
Food and fluid intake is limited in patients with leukemia who are experiencing an inflamed and ulcerated digestive tract, effects of chemotherapy, and the presence of infections such as candidiasis. This is because patients do not want to eat and drink if they do not feel well or know it will cause them pain and discomfort. This can lead to dehydration, weight loss, fatigue, fever, kidney stones, as well as an overall impaired ability to get better. The body requires hydration and nutrients to function, and if the body is deprived of that, it cannot do its intended job.

References:
Gotter, A. (2019). Everything You Need to Know About Microcytic Anemia. Healthline. https://www.healthline.com/health/microcytic-anemia
Hubert, R. J., & VanMeter, K. C. (2018). Pathophysiology Online for Gould’s Pathophysiology for the Health Professions (6th ed.). Elsevier.
Megaloblastic Anemia | Boston Children’s Hospital. (2017). Megaloblastic Anemia. https://www.childrenshospital.org/conditions-and-treatments/conditions/m/megaloblastic-anemia
Week 6 Team C
1. Predict those organs that would be expected to have a large capillary network. What criteria did you use in making this prediction?
Organs that I think that have a large capillary network include the skeletal muscle system and the kidneys. Both of these organs have tiny capillaries that are required to carry blood to and from and to exchange oxygen within these systems.
2. Explain the difference between leukocytosis and erythrocytosis. Identify one condition where each may occur.
Leukocytosis- is an increase in WBCs in the circulation that is often associated with inflammation or infection. This can be seen in bacterial infections such as pneumonia.
NUR 606 Week 6 Discussion 1 Question-Based DiscussionErythrocytosis- is an increase in the body’s production of RBCs. This can occur in response to prolonged hypoxia and increased erythropoietin secretion. Primary polycythemia is a condition in which there is an increased erythrocyte production caused by cells within the bone marrow.
(Hubert, R. J., & VanMeter, K. C. (2018))
3. Explain how DIC develops, and identify three signs of its development.
DIC- Disseminated Intravascular Coagulation
DIC occurs as a complication of many problems and the clotting process is activated in the microcirculation throughout the body. What happens is that clotting factors and fibrinolysis components are consumed which then leads to hemorrhage, then to hypovolemia or shock.
Signs/Symptoms- thrombocytopenia, low plasma fibrinogen levels, and there is a prolonged bleeding time that can be seen in labs also.
4. You are taking care of John, a 55-year-old male who has recently been diagnosed with myelodysplastic syndrome. He asks you what this means and if he is going to die. How will you explain the pathophysiology of this condition to John? What can you share with him about prognosis?
Myelodysplastic syndrome is a group of cancers in which immature blood cells in the bone marrow do not mature enough, they do not become healthy blood cells. What happens is the blood stem cells (immature cells) do not become mature red blood cells, white blood cells, or platelets in the bone marrow. These immature blood cells, called blasts, do not function and either die in the bone marrow or soon after they’re released into the blood. Leaving less room for healthy white blood cells, red blood cells, and platelets to form in the bone marrow. When there are fewer healthy blood cells, infection, anemia, or bleeding more easily can occur (National Cancer Institute. (2021)). Treatment options for Mr. John would be transfusion therapies, chelation therapy to reduce iron levels, and supportive therapies to decrease complications. The prognosis for MDS depends on the age of the patient, any past history with chemo or radiation, and responses that we see with treatment (Hubert, R. J., & VanMeter, K. C. (2018)).
References
Hubert, R. J., & VanMeter, K. C. (2018). Gould’s Pathophysiology for the Health Professions (6th ed.). Elsevier.
National Cancer Institute. (2021, September 20). Myelodysplastic syndromes treatment (pdq®)–patient version. https://www.cancer.gov/types/myeloproliferative/patient/myelodysplastic-treatment-pdq

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