NUR 502 Module 6 Discussion STU

Sample Answer for NUR 502 Module 6 Discussion STU

Musculoskeletal and Neurological function 

Need Help Writing an Essay?

Tell us about your assignment and we will find the best writer for your paper

Write My Essay For Me

 Osteoarthritis is defined by inflammation of the joints as seen in conditions such as Rheumatoid Arthritis (RA) and Juvenile Arthritis (JA). Osteoarthrosis, on the other hand, refers to pathological changes to the joint, such as cartilage loss or joint space narrowing, that often happen as part of the aging process.   

Osteoarthritis 

 Osteoarthritis (OA) tends to be a disease that manifests with age due to wear and tear on the joints. The disease is thought to be precipitated by a reduction in the synthesis of synovial fluid and cartilage as people age (Jeremic et al., 2021). This results in less lubrication for the joint and a narrowing of the joint space leading to more friction and damage to the cartilage. As the cartilage erodes, it is unable to repair itself and causes progressively worse pain, stiffness, and decreased range of motion. The symptoms are usually seen in the hands and then the knees are the next joints to become affected. Joints may become enlarged due to hypertrophy of the joint capsule, and there may also be crepitus in the joint. The joint pain tends to be exacerbated during and after movement and is relieved with rest. 

Rheumatoid Arthritis 

 Rheumatoid arthritis (RA) differs from OA in that it is a systemic autoimmune inflammatory process that can affect other organs in the body. It attacks the synovial membrane, causing synovitis, cartilage erosion, and fibrosis. It often starts with an acute episode, which recovers with time the progresses with periods of exacerbation and remission. Like OA, the most common place for symptoms of RA to start is the hand. Synovitis affects the vasculature, and vascular flow becomes impeded, resulting in loss of shape and alignment of the joint (Dlugasch & Story, 2020). RA manifests with pain and stiffness. However, unlike osteoarthritis, due to its systemic effects, patients with RA may also have fatigue, anorexia, weight loss, depression, renal disease, and other effects. Laboratory testing for RA includes Rheumatoid factor, and cyclic citrullinated peptide antibody (CCP antibody). Antinuclear autoantibodies (ANA) and C-reactive protein (CRP) can also be checked, but they are non-specific for the disease. 

Patient Interventions 

Ms. GJ has a diagnosis of osteoarthritis and has been complaining of pain. I would recommend that she take the anti-inflammatory Celebrex to help with her pain. She is also encouraged to do low-impact exercises like water aerobics, available at the local YMCA. She is also encouraged to take glucosamine and chondroitin as they may provide some benefit. The patient would be educated on the progressive effects of the disease and encouraged to try heat and cold therapy to alleviate pain. 

References 

Dlugasch, L., & Story, L. (2020). Applied Pathophysiology for the Advanced Practice Nurse. Jones and Bartlett Learning. 

Jeremić, D., Gluščević, B., Rajković, S., Jovanović, Ž., & Krivokapić, B. (2021). Osteoarthritis, osteoarthrosis and osteoarthropathy: What is the difference? Srpski medicinski casopis Lekarske komore, 2(1), 25–32. https://doi.org/10.5937/smclk2101015j  

Links to an external site. 

Neurologic Function 

Alzheimer’s disease (AD) is a degenerative brain disease that is the number one cause of dementia in older adults. With AD, the brain atrophies over time, causing a loss of cognitive function. It causes memory loss, behavioral changes, difficulty performing tasks and general cognitive decline. There are no definitive causes for AD but there are various risk factors such as age, female gender, lifestyle, family history and others. 

Types of Dementia 

Alzheimer’s is characterized by progressive disease with gradual changes over time. It is characterized by abnormal deposits of tau protein, which are necessary for microtubule health in the neurons. Vascular Dementia is caused by decreased blood flow to the brain and can be caused by stroke or cardiovascular disease. Vascular dementia tends to have a sudden onset after the cardiovascular event. Similar to AD, Dementia with Lewy bodies (DLB) is a progressive disease that is characterized by abnormal protein deposits in the brain. The manifestations differ in that DLB causes changes in executive function and may cause visual hallucinations. Frontotemporal is a group of disorders that affect the brain’s frontal and/or temporal lobe of the brain. There are three variants: behavioral, semantic, and non-fluent variant. Frontotemporal dementia is progressive and affects the patient’s ability to function normally or even to speak. 

Explicit and Implicit memory 

Explicit memory or declarative memory can be described as conscious thought which requires processing through the hippocampus. This type of memory is recalling facts and events, such as knowing your birthday or your mother’s name. Implicit memory, on the other hand, is non-declarative and is done subconsciously. It does not need to be processed through the hippocampus but is instead a reflex pathway. This includes things like walking or riding a bicycle. 

Diagnosis Criteria for Alzheimer’s Disease 

There are multiple causes for dementia, and it is important that the correct diagnosis be made to tailor treatment to the patient. The provider needs to first conduct a thorough history and physical to determine what medications the patient is taking and determine if there are any other causes for mental changes. Next, a cognitive test needs to be conducted, which includes memory, problem-solving, attention, etc.  Blood and urine tests need to be conducted to rule out infection as a cause for any changes seen. A psychiatric evaluation is needed to rule out mental health conditions as a contributing factor. If there is no clear differential, a lumbar puncture needs to be done to analyze the CSF for causative abnormal proteins.  The patient can then have an MRI, CT, or PET scan to confirm the diagnosis.   

Patient Recommendation 

Ms.  HM appears to be having early signs of Alzheimer’s dementia. After a full work-up, if the diagnosis is confirmed, she will be started on Memantine, any medications with sedative effects will be re-evaluated to verify necessity. Ms. HM will be referred to a social worker early to assess needs at home, such as a home health aide.  Her family will be involved in her care plan and will need to have a discussion about advanced directives and to ensure that Ms. HM is in a safe environment. 

References 

Armstrong, R. A. (2019). Risk factors for alzheimer’s disease. Folia Neuropathologica, 57(2), 87–105. https://doi.org/10.5114/fn.2019.85929  

Links to an external site. 

Dlugasch, L., & Story, L. (2020). Applied Pathophysiology for the Advanced Practice Nurse. Jones and Bartlett Learning. 

How Is Alzheimer’s Disease Diagnosed? (n.d.). National Institute on aging. Retrieved February 14, 2024, from https://www.nia.nih.gov/health/alzheimers-symptoms-and-diagnosis/how-alzheimers-disease-diagnosed  

Sample Answer 2 for NUR 502 Module 6 Discussion STU

Module 6 Discussion 

Musculoskeletal Function 

Osteoarthritis vs Osteoarthrosis 

Osteoarthritis (OA) is a degenerative joint disease characterized by the breakdown of cartilage in the joints, leading to pain, stiffness, and decreased mobility. Osteoarthrosis (OA) and other degenerative joint alterations (such as degenerative disc disease) fall under the umbrella term of osteoarthrosis. The breadth of degenerative joint changes is what distinguishes osteoarthrosis from OA; the former primarily pertains to cartilage deterioration in the joints, while the latter covers a more generalized set of symptoms (Allen et al., 2022). The basic symptoms of osteoarthritis are present in G.J.’s case: long-term bilateral knee soreness that is worse with weight gain and certain weather conditions; stiffness that improves with movement; and so on. She is 71 years old, overweight, has a family history of joint problems, has had chronic lower back pain for a long time, and her symptoms have become worse as her weight has risen. All of these things increase the likelihood that she may develop osteoarthritis. 

Differences 

Although both rheumatoid arthritis (RA) and osteoarthritis (OA) impact the joints over time, the symptoms, diagnostic criteria, and joints impacted by each are unique. Osteoarthritis (OA) is mostly a degenerative joint disease that causes pain, stiffness, and decreased mobility due to cartilage degradation and bone abnormalities. It often manifests in the spine, hips, and knees, which carry the brunt of human weight. Osteoarthritis (OA) manifests itself clinically via a slow but steady increase in joint discomfort, stiffness that becomes worse when you sit still and better when you walk about, increased joint size as a result of bone spur production, and reduced mobility (Allen et al., 2022). Physical exam, imaging techniques (such as X-rays), and symptom assessment are the approaches used to diagnose OA. Joint discomfort, swelling, and deformity may develop as a result of inflammation of the synovium in autoimmune diseases like RA. The hands, wrists, and feet are common sites of symmetrical impact on smaller joints. Systemic symptoms such as fever and exhaustion, symmetric joint involvement, rheumatoid nodules, and morning stiffness that lasts more than an hour are clinical signs of rheumatoid arthritis. Radiation arthritis (RA) testing includes imaging scans, blood tests for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies, and evaluation of clinical criteria such as joint involvement and symptom duration. 

Treatment Alternatives 

For G.J., a comprehensive treatment approach for osteoarthritis should aim to alleviate pain, improve function, and slow disease progression. Physical therapy for muscle strengthening and joint stability, weight reduction for reduced joint stress, and low-impact activities like swimming or cycling for improved mobility without aggravating pain are all examples of non-pharmacological treatments. Orthotic inserts and knee braces are two examples of assistive devices that help lessen the load on the joints. Transcutaneous electrical nerve stimulation (TENS), cold or heat treatment, and other similar techniques may also alleviate symptoms (Abramoff & Caldera, 2020). Acetaminophen is a potential first-line analgesic pharmacological option because of its minimal risk of gastrointestinal side effects; this is particularly relevant given G.J.’s resistance to nonsteroidal anti-inflammatory drugs (NSAIDs). For targeted pain treatment, you may want to think about using capsaicin cream or topical NSAIDs. When dealing with chronic pain, it is best to take opioid analgesics like tramadol with caution and for short periods of time. 

However, they should only be administered with caution and closely monitored because of the hazards of tolerance and dependency. Localized joint inflammation and discomfort may be temporarily alleviated by intra-articular corticosteroid injections. Glucosamine and chondroitin sulfate are examples of disease-modifying osteoarthritis medications (DMOADs), which have conflicting data about their effectiveness in slowing the course of the disease. In extreme circumstances when functional damage is substantial, surgical treatments such as joint replacement may be explored (Abramoff & Caldera, 2020). To track the development of symptoms, make necessary adjustments to treatments, and encourage self-management techniques for long-term joint health, patient education and frequent follow-up are essential parts of therapy. 

Handling Patient Concerns 

I would start by explaining to G.J. the dangers of osteoporosis and how her age and family history are among the risk factors for the disease. When it comes to preventing osteoporosis, I think it is crucial to make certain changes to your lifestyle. For example, you should avoid smoking and drink too much alcohol. Make sure to do weight-bearing exercises regularly. Make sure to get enough calcium and vitamin D via food and supplements. In order to evaluate her present bone health and direct future treatment, I would also go over the importance of bone density testing, such as a dual-energy X-ray absorption (DEXA) scan, as recommended by Abramoff & Caldera (2020). Osteoporosis prevention and treatment suggestions, including the use of prescription drugs such as bisphosphonates or selective estrogen receptor modulators (SERMs), would be based on her unique risk profile. In order to lessen the likelihood of fractures, I would also advise her on fall prevention measures, such as making sure her house has enough lighting and getting rid of any obstacles that may cause her to trip. 

References 

Abramoff, B., & Caldera, F. E. (2020). Osteoarthritis: pathology, diagnosis, and treatment options. Medical Clinics, 104(2), 293-311. 

Allen, K. D., Thoma, L. M., & Golightly, Y. M. (2022). Epidemiology of osteoarthritis. Osteoarthritis and cartilage, 30(2), 184-195. 

Neurological Function 

Risk Factors for Alzheimer’s Disease 

Age, having a family history of the illness, having the apolipoprotein E (APOE) ε4 allele, having a history of brain trauma, and specific lifestyle factors including not being active enough, eating poorly, smoking, and being overweight are the most prevalent risk factors for Alzheimer’s disease. There is evidence that certain medical disorders, such as diabetes, high blood pressure, and cardiovascular disease, may raise the likelihood of acquiring Alzheimer’s disease. Inflammation, oxidative stress, and vascular function are just a few areas of brain health that these risk factors affect, which in turn contributes to the development and progression of Alzheimer’s disease (Zhang et al., 2021). The specific etiology of the illness is yet unknown. If these risk factors can be identified and managed early on, it may be possible to lessen or postpone the development of Alzheimer’s disease. 

Similarities and Differences 

The many forms of dementia, such as Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, and frontotemporal dementia, are characterized by different symptoms and pathologies. The most prevalent kind of dementia, Alzheimer’s disease is marked by a gradual deterioration in cognitive abilities, changes in behavior, and loss of memory. Cognitive impairment, including memory loss, confusion, and trouble with thinking and problem-solving, may be caused by reduced blood flow to the brain, which is often caused by strokes or small artery disease (Zhang et al., 2021). This condition is known as vascular dementia. Symptoms of visual hallucinations, cognitive fluctuations, and motor issues including tremors and stiffness are shared by Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies. Before major memory loss happens, people with frontotemporal dementia see changes in their personality, conduct, and language abilities due to the disease’s impact on the frontal and temporal lobes of the brain. There may be some symptom overlap between dementia categories, however, treatment techniques and prognoses are affected by differences in underlying causes and pathological characteristics. 

Explicit and Implicit Memory 

Memories that are intentionally and consciously recalled from one’s history are called explicit memories or declarative memories. Tasks like recall and recognition are often used to evaluate this kind of memory, which is associated with the hippocampus and other regions in the medial temporal lobe. Implicit memory, on the other hand, is the ability to automatically retrieve knowledge without consciously recalling it; it is also called non-declarative memory (Ahmadian, 2020). Procedure learning, priming effects, and conditioned responses are common ways that people exhibit implicit memory, which is a shared memory across different parts of the brain (basal ganglia, cerebellum, etc.). Implicit memory functions below the level of conscious awareness and is shown by task performance without explicit recollection of past experiences, in contrast to explicit memory, which depends on deliberate effort and maybe recounted orally.  
Diagnosis Criteria 

Diagnostic criteria for Alzheimer’s disease were developed by the National Institute on Aging and the Alzheimer’s Association (NIA-AA) to provide researchers and doctors with uniform recommendations. To help in the diagnosis of Alzheimer’s disease throughout its range, from preclinical stages to dementia, these criteria were last revised in 2011. They integrate clinical, cognitive, and biomarker data. The standards stress the need to identify cognitive impairment by means of an all-encompassing examination, which includes testing of language, memory, executive function, and visuospatial ability (Dubois et al., 2021). The criteria also acknowledge the use of biomarkers in confirming the pathology of Alzheimer’s disease, such as amyloid-beta and tau proteins in CSF or detected by neuroimaging. The goal of these diagnostic criteria is to make it easier to spot Alzheimer’s disease early on, which will lead to better treatment options. 

Best Therapeutic Approach 

A holistic care plan that takes into account C.J.’s cognitive impairments helps her with everyday functioning, and improves her quality of life would be the best therapy strategy. To help her with her memory issues, she may need to engage in cognitive stimulation activities or use memory aides like calendars, lists, or reminders. Furthermore, it is essential to provide C.J. and her family with assistance and information so that they can comprehend and manage the difficulties of living with Alzheimer’s disease. Memantine and acetylcholinesterase inhibitors are pharmacological treatments that may be investigated for the management of cognitive symptoms and the slowing of disease development; however, the effectiveness of these therapies differs from person to person (Dubois et al., 2021). To provide C.J. with the comprehensive care she requires, addressing her emotional, cognitive, and functional requirements in the long run, a multidisciplinary team consisting of neurologists, geriatricians, psychologists, and occupational therapists may be formed. To ensure the best possible results and keep C.J. healthy in the long run, it is crucial to closely evaluate her reaction and make modifications to her treatment plan as needed. 

References 

Ahmadian, M. J. (2020). Explicit and implicit instruction of refusal strategies: Does working memory capacity play a role? Language Teaching Research, 24(2), 163-188. 

Dubois, B., Villain, N., Frisoni, G. B., Rabinovici, G. D., Sabbagh, M., Cappa, S., … & Feldman, H. H. (2021). Clinical diagnosis of Alzheimer’s disease: recommendations of the International Working Group. The Lancet Neurology, 20(6), 484-496. 

Zhang, X. X., Tian, Y., Wang, Z. T., Ma, Y. H., Tan, L., & Yu, J. T. (2021). The epidemiology of Alzheimer’s disease modifiable risk factors and prevention. The journal of prevention of Alzheimer’s disease, 8, 313-321.