Read the following case study and discuss the questions: 

Mr. Enson comes to the clinic reporting abdominal pain and watery diarrhea.

“Sometimes, it’s pretty severe,” he says. “It’s been that way for 2 days. The scary part is that I have a lot of blood in my stool now. It’s not like before. This is way more intense.”

Mr. Enson has a history of Crohn disease, which is now exacerbated by extensive inflammation. His history indicates that he has been taking antiinflammatory agents for several years despite complaining of nausea and heartburn from the drugs.

“I’ve already tried the steroid route,” he says. “I don’t want to ever do that again. I prefer the sulfasalazine. The trouble is that it doesn’t seem to be helping anymore. What can we try next?”

He has already been in drug trials for a new immune system suppressor, with no significant clinical change. Dr. Holly, Mr. Enson’s physician, suspects a resection may be necessary.

Dr. Holly examines his abdomen for tenderness, requests a white blood cell count, and assesses his pain. She also orders a computed tomography (CT) scan of his large intestine.

Mr. Enson’s white-cell count is high, which Dr. Holly had expected, and the CT scan reveals significant new damage to Mr. Enson’s gastrointestinal tract. She schedules him for a surgical procedure to close the fistulas, drain several abscesses, and remove a section of Mr. Enson’s colon.

1.      At one time, Mr. Enson assumed he had ulcerative colitis (UC) because both his brother and sister have it. What is the difference between UC and Crohn disease? How can a medical practitioner distinguish between the two?

2.      In preparing her patient for his surgery, Dr. Holly explains that Mr. Enson will undergo surgical resection of the most severely damaged segment of his colon. She will then create an artificial anus on Mr. Enson’s abdominal wall by incising the colon and bringing it out to the surface. She explains, “There are actually two procedural options for your resection, but I am confident this choice is the better of the two for your condition.” What are the two surgical options, and which one has she chosen?

3.      If Dr. Holly had chosen to remove a portion of Mr. Enson’s small intestine, then he would have been at increased risk for what syndrome?

Post your answers in discussion form, approximately 250 words and respond to one other student.  

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

Photo Credit: yodiyim / Adobe Stock  https://class.content.laureate.net/ad53d124acd1e3138e04f9296f98b5fa.jpeg

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your 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.

By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

 CASE: 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 has to sleep on two pillows in order to get enough air.