Analysis of 3 Case Studies in Diploma of Nursing

This report aims to address questions related to 3 case scenarios that encompass separate physiological disorders in Diploma of Nursing. The report covers topics related to the cardiovascular system, respiratory system, endocrine system, and digestive system. It also discusses the immune system and artificially acquired immunity. The report provides answers to questions related to the risk factors, symptoms, and treatment of different physiological disorders.

Running head- DIPLOMA OF NURSING
Analysis of 3 Case Studies
Name of the Student
Name of the University
Author Note

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Executive summary
There are several organ systems in the human body that control the different
physiological processes and metabolism inside the cells. While the circulatory system is
involved in distribution of oxygen through the bloodstream and the respiratory system
helps in exchange of gases, the immune and endocrine system protects the body
against infection and chemically coordinates the action of hormones respectively. The
digestive system on the other hand is involved in providing nutrition and the nervous
system controls all other organs. This report aims to address questions related to 3
case scenarios that encompass separate physiological disorders.

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Table of Contents
Case study 1......................................................................................................................3
Answer 1........................................................................................................................3
Answer 2........................................................................................................................3
Answer 3........................................................................................................................3
Answer 4........................................................................................................................3
Answer 5........................................................................................................................4
Answer 6........................................................................................................................4
Answer 7........................................................................................................................5
Answer 8........................................................................................................................5
Answer 9........................................................................................................................5
Answer 10......................................................................................................................6
Case study 2......................................................................................................................6
Answer 1........................................................................................................................6
Answer 2........................................................................................................................6
Answer 3........................................................................................................................7
Answer 4........................................................................................................................7
Answer 6........................................................................................................................8
Answer 7........................................................................................................................8
Answer 8........................................................................................................................8
Answer 9........................................................................................................................8
Answer 10......................................................................................................................8
Case study 3......................................................................................................................9
Answer 1........................................................................................................................9
Answer 2........................................................................................................................9
Answer 3........................................................................................................................9
Answer 4........................................................................................................................9
Answer 5......................................................................................................................10
Answer 6......................................................................................................................10
Answer 7......................................................................................................................10
Answer 8......................................................................................................................10
Answer 9......................................................................................................................11
Answer 10....................................................................................................................11

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References.......................................................................................................................12
Case study 1
Answer 1
The various structures of the cardiovascular system are given below-
 The Heart
The heart walls are made up of 3 layers, the epicardium, myocardium and the
endocardium.
 The blood vessels- the arteries, veins and capillaries (Miller, 2013).
Answer 2
The major functions of the circulatory system are as follows-
 It helps in circulating oxygenated blood to all parts of the body.
 It brings deoxygenated blood from all body cells and brings them to the lungs for
purification.
 It facilitates transport of nutrients and water to the cells and tissues.
 It expels waste materials such as, carbon dioxide and nitrogenous wastes away
from the cells (Binnington & Obenchain, 2013).
 It helps in maintaining a constant body temperature.
 The white blood cells and antibodies present in blood also provide protection
against several diseases thereby, providing resistance.
Answer 3
The respiratory system consists of the following structures-
Upper respiratory tract- This part of the respiratory system includes the nose, the
mouth, and the portion of the trachea that helps in taking in and giving out air.
Lower respiratory tract- This includes the trachea, the bronchi, the lungs and the
broncheoli. This part of the respiratory system involves the act of breathing. These
organs are present in the thoracic cavity and are protected by means of a ribcage, the
sternum (breast bone) and by muscles that are present between the diaphragm and the
ribs.
Answer 4
The cardiovascular and the respiratory system interact in a complex manner to
perform several physiological functions. These systems help in delivering oxygen to the
tissues and expelling carbon dioxide out of the tissues. The respiratory system supplies
oxygen to the blood to form oxyhemoglobin and removes carbon dioxide from the
bloodstream. The deoxygenated blood that is rich in carbon dioxide and has low oxygen
content is pumped to the lungs through the pulmonary arteries (Chapman, Douglas &
Siva-Jothy, 2013). On expansion, the lungs receive air from the external environment,

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and transfer oxygen is via the alveoli to the deoxygenated blood. This is followed by
transfer of carbon dioxide from the blood, back into the lungs. The pure or oxygenated
blood is returned to the heart and is later on distributed to the body parts through the
aorta.
Answer 5
The effects of age on the respiratory system are as follows-
 Reduces the peak airflow and impairs gaseous exchange
 Lung functions such as vital capacity get reduced
 The respiratory muscles become weak
 A decline in the effectiveness of the defense mechanism of the lungs is
observed
The effects of age on the cardiovascular system are as follows-
 A decrease in the amount of RBCs is observed
 The peripheral cells may show constriction or blockage due to blood clot
 The elasticity of the fibrous tissues present in the heart gets reduced
 Buildup of plaques or fatty tissues lead to atherosclerosis
 Arteriosclerosis may also occur where the arterial walls get toughened and
thickened
Answer 6
Angina pectoris- the myocardial cells switch to anerobic metabolism and the
metabolic, electrical and mechanical functions gets impaired. The most common clinical
manifestation is angina pectoris. The myocardial oxygen demand gets increased due to
rapid heart rate and myocardial contraction. This requires more coronary blood flow.
The common signs and symptoms are as follows-
 Retreosternal discomfort in the chest squeezing, heaviness, choking or burning
sensation
 Localized pain in the neck, jaw, shoulders and epigastrium
 Dizziness
 Shortness of breath (Ong et al., 2012)
 Nausea
 fatigue
Emphysema- it refers to the presence of abnormally enlarged air spaces. It leads to
destruction of the alveolar walls. Irritants, such as dusts and tobacco smoke result in
oxidative damage and triggers an inflammatory response (Jankowich & Rounds, 2012).
The cytokines released as a result of inflammation reduce the elasticity of the alveolar
walls and make them rupture.
The common signs and symptoms are as follows-
 mild coughing accompanied by phlegm or mucous production
 Fatigue

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 Poor appetite
 Weight loss
 Wheezing
Answer 7
The risk factors for emphysema are as follows-
 Smoking
 Old age
 Passive exposure to smoke
 Occupational exposure to dust and fumes
 Pollution
The risk factors for angina are as follows-
 Tobacco consumption
 Diabetes
 Hypertension
 Increased triglyceride and blood cholesterol (Benzo et al., 2013)
 Obesity
 Stress
 Sedentary lifestyle
 Old age
 History of heart attack
Answer 8
John’s old age increased the likelihood of suffering from emphysema. His smoking
habit has aggravated his condition. His obese condition raised his risk of suffering from
angina as it is associated with an increase in blood cholesterol levels. In addition, he
reports a history of hypertension that has resulted in damage of the arteries. The history
of heart attack in his father also contributed to development of angina. Immediate
actions will involve-
 Conduction of angioplasty
 Administration of aspirin and beta blockers (Tarkin & Kaski, 2013)
 Administration of statins
 Practicing pulmonary rehabilitation
 Administering bronchodilators and corticosteroids
Answer 9
The other health professionals involved in his care are as follows-
 Cardiologist- specialized doctor who help in treating and preventing heart
disorders
 Physician assistant- delivers range of medical service, obtains medical history,
conducts physical examinations, interprets tests,
 Nurses- coordinates care services, provides emotional support, administers
medications
 Respiratory technologist- monitors the therapeutic procedures

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 Physiotherapist- provides rehabilitation
Answer 10
Artificially acquired immunity involves artificial or intentional exposure of a person
to foreign antigens or to antibodies that are extracted from another individual, in order to
generate immune response. Artificially acquired active immunity is associated with
intentional exposure to antigens, present in a vaccine that stimulates the immune
system to create antibodies, against the specific antigens present in the vaccine. On the
other hand, in artificially acquired passive immunity, the person is administered
intramuscular or intravenous injections of serum or antibodies are transfused (Aickelin,
Dasgupta & Gu, 2014). These help in neutralizing the infectious agents. However, this is
a short-term immunization procedure.
Case study 2
Answer 1
The endocrine system is considered as the organ system that controls chemical
coordination of the human body through the production of chemical messengers or
hormones. The structures are as follows-
 Hypothalamus
 Pituitary gland
 Pineal gland
 Thyroid gland
 Adrenal glands
 Parathyroid gland
 Pancreas
 Gonads
 Thymus
The thyroid gland, adrenals, and gonads are controlled by the master gland, the
pituitary.
Answer 2
The endocrine system controls all physiological processes of the human body.
 They control the motility of the digestive tract.
 Controls the metabolism and absorption of glucose and other minerals present in
the cells.
 It influences the amount of calcium present in the bones and governs calcium
retention that helps in muscle contraction.
 It also controls secondary sexual characters
 Triggers uterine contraction during childbirth (Ross et al., 2016)
 Prevents water loss from body by facilitating re-uptake of water and minerals
 Stimulates thyroid production
 Controls overall body growth (Paz & Vizmeg, 2013)

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Answer 3
Thyroid hormone production is controlled by a complex feedback look that
involves release of thyrotropin-releasing hormone (TRH) from the hypothalamus, which
in turn stimulates the pituitary gland to release TSH. Binding of TSH to thyroid gland
receptors results in release of thyroid hormones. T4 is secreted in greater amounts
compared to T3. The elevated hormone levels act on the hypothalamus and result in
decreased TRH secretion. In hyperthyroidism, serum T3 levels increase that leads to
toxicosis (Cooper & Biondi, 2012). This condition causes hyperthyroidism or Grave’s
disease.
Risk factors involve-
 Family history of hyperthyroidism
 Smoking
 Stress
 Administration of sex steroids
Answer 4
It can be deduced from the low TSH levels and the T4 and T3 levels that Isabella is
suffering from hyperthyroidism. The common signs and symptoms of Grave’s disease
are consistent with those that are presented by her. They are as follows-
 Anxiety and irritability
 Frequent bowel movements
 Weight loss despite following a normal eating habit (Menconi, Marcocci & Marinò,
2014)
 Fine tremor of hands
 Irregular heartbeats that results in palpitations
These symptoms appear due to over activity of the thyroid glands that lead to an
elevated level of T4 and T3 and a reduction in TSH.
Answer 5
The digestive system contains a series of hollow organs, which bring about
consumption, digestion and absorption of food. The organs are as follows-
 Mouth
 Pharynx
 Oesophagus
 Stomach (Chapman, 2013)
 Liver
 Pancreas
 Small intestine
 Large intestine
 Anus
Answer 6
The major functions of the digestive system includes the following-

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 Ingestion of food
 Propulsion of food by peristaltic action of the muscles
 Breakdown of food that involves the process of food churning, and chemical
digestion, thereby providing nutrition.
 It is also involved in metabolizing saccharides, lipids, proteins and amino acids
by the action of several digestive enzymes. Metabolism helps in converting the
consumed food into energy that helps to carry out different physiological
processes.
Answer 7
The principle function of the immune system is to ward off foreign particles such
as pathogens in order to protect the human body from infection. It protects the host from
a range of harmful environmental agents such as, microbes and chemicals to provide
resistance and preserve the integrity of the body. Natural immunity protects our bodies
from infection by several natural barriers like skin, saliva, mucous and chemical
secretions, thereby preventing the entry of pathogens (Abbas, Lichtman & Pillai, 2014).
On the other hand, acquired immunity gets developed in the body over a prolonged
period of time and helps in neutralizing the action of harmful antigens, once the
pathogens have invaded the body.
Answer 8
Autoimmune diseases occur when an immune response is generated against
self-antigens in place of the foreign ones. The immune system attacks and destroys the
tissues of the body. This leads to hypersensitivity or autoimmune disease. One such
disease is rheumatoid arthritis (Wahren-Herlenius & Dörner, 2013).
Pathophysiology- Smoking, trauma or infection sets off an autoimmune reaction
that causes synovial hypertrophy and chronic inflammation of the joints. This results in
release of cytokines, interleukins and other growth factors. The inflammation,
progresses with time and results in destruction of the bone, and cartilage.
Answer 9
An analysis of her T4, T3 and TSH levels and the symptoms indicate that she is
suffering from hyperthyroidism. She will be examined for puffiness around the eyes and
swelling of the thyroid gland (Bartalena et al., 2015). This will be followed by
administration of medications such as beta blocker drugs (atenolol, propanolol) to
counteract the action of thyroid hormone. In addition, she will also be prescribed
antithyroid durgs like propylthiouracil and methimazole in addition to administration of
radioactive iodine (Bartalena, 2013).
Answer 10
Health professionals who will be involved are mentioned below-
 Endocrinologists- diagnose and treat the endocrine disorder
 ENT surgeon- conducts surgery if required
 Nursing care coordinators- administers the medicine and provides emotional
support

9DIPLOMA OF NURSING
 Counselors- helps the patient to cope with mood disorders such as, anxiety and
depression
 Dietician- formulates a balance diet keeping in mind the association of iodine with
thyroid glands.
Case study 3
Answer 1
The nervous system has three functions-
 Sensory- it collects information from the sensory receptors and sends them to the
central nervous system brain and spinal cord via the afferent neurons.
 Integration- it processes sensory information by evaluating and comparing them
and finally using them.
 Motor- it sends the information processed by the interneurons from the central
nervous system to the effector muscles or glands via the efferent neurons.
Thus, the basic function is to transmit nerve signals from one cell to another.
Answer 2
Multiple sclerosis is a demyelinating and inflammatory disease of the CNS, which
occurs due to lesions and destruction of the oligodendrocytes. The axon also gets
destroyed in some patients. It is also characterized by periventricular infiltration of
macrophages and lymphocytes. The lesions break the blood-brain barrier and the IgG
levels get elevated in the CSF. Damage to the mitochondria is thought to contribute to
the neurodegeneration (Witte et al., 2014).
Answer 3
 Urine urgency is observed because MS disrupts the nerve fibers that controls
micturition
 Inflammation of the optic nerve leads to loss of peripheral vision or blurred vision
 Demyelination of the neurons result in cognitive problems that ultimately
contribute to poor memory
 Loss of neurons lead to changes in sensation that ultimately account for
numbness
 It also affects parts of the brain that controls motor coordination thereby leading
to poor gait and balance (Lalmohamed et al., 2012)
Answer 4
The urinary system is involved in removing waste products from the body. The
structures are as follows-
 Kidneys
 Ureter
 Urinary bladder
 Urethra

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Answer 5
The 5 senses help in perceiving the external stimuli.
 Eyes- help in detecting light and allow vision
 Nose- help in smelling scents and is a part of the respiratory system
 Ears- detect sound vibrations and help in hearing. They also help in maintaining
balance.
 Tongue- helps in chewing and swallowing food and helps in perceiving food
tastes
 Skin- helps in perspiration, communicating through touch, and sensing pressure,
pain and temperature changes
Answer 6
Multiple sclerosis affects the sense organs of the body in the following ways-
 Inflammation of the optic nerve, optic neuritis leads to vision loss, colour
blindness and blurring (Kister et al., 2013)
 Greater lesions affect the sense of taste and worsens taste perception
 MS also leads to a reduction in the volume of olfactory bulb and gray matter. This
affects sense of smell.
 It also damages the nerve fibers innervating the fingers and legs. This gives rise
to a tingling sensation and numbness.
 Inflammation or scarring of the auditory nerve results in hearing problems and
balance coordination.
Answer 7
Edentulous- it refers to missing tooth or denture in mammals. This generally occurs
due to tooth loss. Complete loss of teeth is called partial edentulism and loss of all teeth
is complete edentulism. Inflammation of soft tissues and bone remodeling events hold
clinical significance for edentulous people (Joo et al., 2013).
Dentate- it refers to the condition of having tooth like projections or margins. Any
species that has dentition, which refers to the development and arrangement of tooth, is
referred to as a dentate. Animals having similar type of teeth are homodont and those
having morphologically different teeth are called heterdont.
Answer 8
Oral health diseases involve dental cavities, gum disease, oral cancer, injury
trauma, mouth sores and infectious diseases. The tooth ache that she reports may be a
result of decay of teeth, absessed teeth, a damaged filling, tooth fracture or infected
gums. These may lead to bacterial infection of the nerves present in the tooth. This
increases sensitivity to hot and cold foods and causes tooth ache. The ache can also be
an indication of cracked tooth or receding gums.

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Answer 9
On assessing the symptoms presented by Daisy it can be stated that she is suffering
from progressive relapsing multiple sclerosis. Therefore the immediate actions would
be-
 Use of interferon therapies like avonex, extavia and rebif (Cohen et al., 2012)
 Administration of glatiramer acetate or copaxone, and mitoxantrone.
 Administering baclofen would reduce spasticity (Criste et al., 2014)
 Intravenous injection of methylprednisolone may reduce severity of optic neuritis
(Popescu & Lucchinetti, 2012)
Answer 10
Health professionals involved are-
 Primary care providers- doctors who keep a track of the blood pressure, glucose
level, cholesterol and immunization status and prescribe medicines
 Radiologist- reads the imaging studies and diagnoses the condition
 Physical therapist- helps her regain strength and mobility
 Occupational therapist- they also help in mobility
 Psychologist- they will counsel the patient

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