Alterations in Cellular Processes
A comprehensive patient assessment is essential to enable the healthcare provider to understand the underlying patient’s health issues. During the patient assessment, the provider needs to look at the presenting clinical symptoms, such as the presenting complaints, medical history, family history, and social history (Rosti 2017). For the 83-year-old patient living in a skilled nursing facility, the presenting symptoms include generalized oedema of the abdomen and extremities, and the medical history is remarkable for malabsorption syndrome and difficulty eating as a result of lack of dentures. Besides, there has been a diagnosis of protein malnutrition. It is important to explore the scenario in terms of the reasons behind the symptoms and the role of genetics in the development of the disease.
Role of Genetics in Disease
Many diseases and conditions are related to genes in one way or the other. Most disorders are complex, but some mutations may be in a single gene. Genetics plays considerable in the development of different diseases, and protein malnutrition is no exception. For instance, genetics affects the preferences of people for certain foods, and based on the genetic orientation of an individual, he/she may like or dislike some foods (Coulthard 2015). Consequently, this may lead to a situation where the individual gets much of only some types of nutrients and not others. For an individual who dislikes foods rich in protein, the result would be the development of protein malnutrition.
Reasons for the Patient Presenting with the Specific Symptoms
One of the key symptoms the patient presents with is generalized oedema, which can be linked to kwashiorkor. The blood vessels have special proteins that are tasked to hold salts and water. The swelling of the patient’s extremities and abdomen can be attributed to the inadequate availability of the albumin protein that results in the leaking of the fluid into tissues. The malabsorption and poor dentures could point to the problem of the presenting clinical manifestations that seem to contribute to nutritional deficiencies in the patient.
The Physiologic Response to the Stimuli Presented in the Case Study
The occurrence of generalized oedema of the abdomen and extremities is due to protein loss in the blood vessels. This makes the absorption of blood and water difficult. Other responses associated with the presenting stimuli include fatigue and the loss of muscle mass. Benjamin & Lappin (2020) assert that because proteins play a vital role in muscle growth, a lack of it can result in a decline in the growth of these muscles, causing a decline in energy levels.
Cells Involved in the Process
The endothelial cells play a key role in the physiological responses that are associated with the formation of oedema in patients with malnutrition. These cells play critical roles in the absorption of salts and water and are responsible for regulating fluid exchanges from the blood to the adjacent tissues.
How Another Characteristic Can Change the Response
The genetic orientation of an individual is just one of the factors that can cause the development of protein deficiency. Another factor is the age of the person. Children are in a developing stage with high demands for proteins. If the patient was a child, the suspected cause of the protein deficiency could have changed from the lack of dentures to the age of the individual.
References
Benjamin, O., & Lappin, S. L. (2020). Kwashiorkor. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK507876/
Coulthard, G. M. (2015). Oedema in Kwashiorkor is caused by hypoalbuminaemia. Paediatrics and international child health, 35(2), 83-89. https://doi.org/10.1179/2046905514Y.0000000154
Rosti, G. (2017). Role of narrative-based medicine in proper patient assessment. Supportive Care in Cancer, 25(1), 3-6. DOI 10.1007/s00520-017-3637-4
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Question
Scenario: An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized oedema of extremities and abdomen. History obtained from staff reveals the patient has a history of malabsorption syndrome and difficulty eating due to a lack of dentures. The patient has been diagnosed with protein malnutrition.
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 the 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.
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 would another characteristic (e.g., gender, genetics) change your responses?