Case Analysis: Types of Pain, Medication Consequences, Stress Response Effects, Leukaemia and Risk of Bleeding

This case analysis explores the types of pain experienced by Sarita, the consequences of prescribed analgesic medication, the effects of stress response on her immune and cardiovascular systems, the immune aspects and cellular changes associated with leukaemia, and her risk of bleeding.

Case Analysis

Table of Contents
INTRODUCTION...........................................................................................................................3
PART A...........................................................................................................................................3
Explain the types of pain Sarita is experiencing including pain pathways and the associated
neurotransmitters.........................................................................................................................3
Discuss the positive and negative consequences of prescribed analgesic medication on patient
clinical status and impact of this medication on existing co-morbidities...................................4
PART B............................................................................................................................................5
Analyse the effects of stress response on Sarita's immune and cardiovascular systems in the
ensuing resistance stage..............................................................................................................5
Explain how prolonged stress response could lead to exhaustion phase and irreversible
systematic dysfunction such overwhelming sepsis.....................................................................6
PART C............................................................................................................................................7
Discuss the immune aspects and cellular changes associated with leukaemia...........................7
Outline Sarita's risk of bleeding and the potential sites that need to be assesses of her heart
rate continues to rise....................................................................................................................7
Explain how the prescribed intravascular fluids and pack cell will stabilise Sarita and prevent
further deterioration in her condition..........................................................................................8
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Pathophysiology refers to set of indications that indicates about disordered physiological
procedures which are linked with specific health issue. It includes the analysis of abnormalities
of normal physiological functions carry out in human body by different organs as well as organ
systems (Cugno, Borghi and Marzano, 2017). In respect of this report, it is based on the patient
named Sarita having an age of 22 years with history of glandular fever. This assignment will
focus on kinds of pain which patient feel and relevant consequences of analgesic medication
prescribed for selected person. It will also include the impact of cardiovascular and immune
system of stress along with response of prolonged stress. The changes in cellular and immune
aspects related to leukaemia along with risk of bleeding are given below.
PART A
Explain the types of pain Sarita is experiencing including pain pathways and the associated
neurotransmitters
According to the given case study, it has been analysed that Sarita is an athlete due to
which there are several chances of occurring injuries and pain. It is observed that there are
various types of aches that are face by people which are associated with neurotransmitters.
However, the given patient can be suffered from various types of pain in which some of them are
given below.
Acute pain: This can be described as a condition of occurring ache for a short period of
time which occurs suddenly and caused by tissue or injury. An acute pain is responsible for
beginning with a sharp or intense way before it improves gradually. However, there are number
of causes which may possible in case Sarita including surgery, dental work, labour & childbirth,
cuts, burns and broken bones.
Chronic pain: The term chronic pain can be considered as a situation of long term ache
which is mostly caused due to an injury. It is observed that chronic pain is usually take place due
to past injury or damage which has been left without proper clinical management. Meanwhile,
severe chronic pain can develop problem of depression or anxiety (Chaves Filho and et. al.,
2018). Moreover, it has several symptoms such as tense muscles, lack of energy and limited
mobility in which few of them are present in case of Sarita. For example, chronic pain consist
nerve damage pain, low back ache, arthritis pain, fibromyalgia ache and frequent headaches.

Nociceptive pain: This kind of pain is caused by stimulation of nociceptors that are
consider as pain receptors for tissue injury. Nociceptors are located in skin and internal organs
and they get stimulated via potential harm like burn or cut.
Visceral pain: The visceral pain is generally occur due to injuries or damage of internal
organs including abdomen, pelvis and chest. It can be defined as various factors such as
cramping, squeezing, aching, pressure, appendicitis, gallstones and irritable bowel syndrome.
Glutamate
The glutamate is known as a neurotransmitter which plays an important role in terms of
chronic pain. It has a role in mechanism of chronic pain and most of relevant receptors are
located in peripheral and central nervous system (Yenkoyan and et. al., 2017). However,
glutamate is responsible for transmitting the pain through binding 5-subunit ligand-gated ion
channels present on nociceptive neurons on myelinated pain afferents.
Pathway of pain
The neuropathic pain process begin form damage of nerve or persistent stimulation which
results into rewiring of ache circuits both biochemically & anatomically. Meanwhile, these
circuits are responsible for causing different types of stimulations like spontaneous nerve,
autonomic neural and increased discharge of dorsal forms neurons stimulations. However, the
different stimulations cause neuropathic pain.
Discuss the positive and negative consequences of prescribed analgesic medication on patient
clinical status and impact of this medication on existing co-morbidities
Medication can be refer to as a drug or other sorts of medicines which are used to treat a
particular medical disorder. There are number of medicines available for treating chronic and
severe medical conditions (Bortolato and et. al., 2016). In given case, a 22 year old Sarita who is
suffering from multiple disorders has been prescribed a number of medicines by her health
professionals. However, there could be positive or may be negative impacts of such medication
on patient. Analgesic medications which was prescribed to the patient was Panadeine forte.
This particular medicine is used for treating moderate to severe pain and fever. It contains
paracetamol and codeine. Combination of paracetamol and codeine help to prevent pain
messages to get into the brain. Also it also acts in the brain to minimize the temperature of body
and thus, reduce pain. Panadeine forte will have a positive impact on given patient and will help

her to reduce her temperature. Regardless of fever it will also give relief to the patient to
overcome from pain caused by general aches.
Unlike other medicines, Panadeine forte can also have some serious side effects.
Sometimes it may be minor or temporary or other times it could be serious and severe.
However, it is necessary for Sarita to take prescribed medicine according to the dosage suggested
by her health professionals otherwise it may cause side effects or may lead to some serious
negative consequences. Side effects of this medicine include Nausea, constipation, vomiting,
dizziness or light headedness (Maes and Carvalho, 2018). Some of these side effects may occur
if it has been taken in a wrong way or in the form of drugs. As it contains Codeine who has its
own specific negative results such as blurred vision, dry mouth, decreased heart rate, tiredness,
dizziness and sometimes it may cause difficulty for patient to concentrate properly and create
confusions.
PART B
Analyse the effects of stress response on Sarita's immune and cardiovascular systems in the
ensuing resistance stage
The immune system may be affected by many different types of disease. In case of Sarita,
she is suffering from the glandular fever and after some investigation she is being diagnosed with
leukaemia and later on it is observe that she is also suffering from upper respiratory tract
infection. The effect of stress response on immune system occur effect when the immune system
produces antibodies to fight the virus. But after the infection, the virus will live in dormant stage
in the throat and can come in active stage when it is come in contact with other virus. Due to the
leukaemia, the effect of stress response on immune by making the immune weaker as it reaches
into the blood.
This disease also affect the other parts of the body like spleen, liver, etc. the leukaemia
patient can bleed easily due to the effect of white blood cells fight off infection as the leukaemia
viruses keeps them away off from working properly (Kohler and et. al., 2016). The patient is a
athlete since childhood. So due to the regular and frequently exercises, the risk of cardiovascular
disease is increases. The exercise increase the cardiac output which results with high blood
pressure and increases the risk of heart disease. In the glandular fever it reduces the production
of all three types of cells which are responsible for developing the secondary infection. As the

red blood cells are reduced and the white blood cells are start developing other infections. These
stress are effecting the patient for more than weeks. Due to her routine medical history she is
suffering from lethargy, bruising, anorexia, pains which making the immune system and
cardiovascular system weaker of patient. From these , the secondary infection are also develop
with in the body of patient.
Explain how prolonged stress response could lead to exhaustion phase and irreversible
systematic dysfunction such overwhelming sepsis
The exhaustion phase is when the body is no longer available to recover from the stress. The
sepsis occur when an infection pass the tissue which induces the dis functioning of any organ or
system. This stress response occur at the time of emergency reaction system at the exhaustion
phase. This stress responses release substances when the body reaches the exhaustion phase. It
start releasing some chemicals which indicate the severity of disease. This sepsis can lead to
dysfunction of organs or system like the indication of any threat. In the case of patient, the
sepsis occur with in her body indicating the severe disease as the blood start to be discharging
from nose and some other symptoms are also start appearing (Gupta, Gupta and Dwivedi, 2017).
Due to the improper malfunction of organs and system and over the weeks she also start eating
less, this will make her weaker immune system. Recently, she has been diagnosed with
leukaemia but from her clinical assessment reveal that she has lower white blood cells and also
have the lower platelets which also can impact on the body and can cause other disease.
At the exhaustion stage the body focus on the stressor and the heart start working harder.
These stress hormones affect the respiratory and cardiovascular system. When the stress
responses occur, breathe become faster to absorbs oxygen to rich the blood throughout the body.
These stress hormones are to be resolve as they cause the exhaustion phase if they are live in the
body in dormant stage and after sometimes it produces the sepsis which may affect the immune
system adversely. Basically, the sepsis is the alarm which is produce by body to indicate the
medication of the disease. But if the medication could not give on time then it can also lead to
the death. So the stress should not be prolonged for many weeks and leads to the exhaustion
phase.

PART C
Discuss the immune aspects and cellular changes associated with leukaemia
Leukaemia is a term for cancer in blood cells which mostly begin with bone marrow and
eventually result in large number of abnormal blood cells. Such blood cells are generally known
as leukaemia cells. Symptoms of leukaemia include bruising or bleeding, feeling tired, high fever
and an increased risk of infections. In given case, Sarita may have chances of developing such
medical condition as she has adapted all such symptoms.
Patients suffering from leukaemia can bleed or bruise and often heals slowly. Thus, this is
a sign of a weak immune system (Bhattacharya and Drevets, 2016). Immune system is termed as
defence system of the body as it fight against number of infections, bacteria and other pathogenic
agents tries to enter in human body. Diseases or cancers like leukaemia effect or weakens the
immune system of an individual by expanding into the bone marrow. As bone marrow is the
main source of making blood cells to fight with infections. Leukaemia prevents bone marrow to
make blood cells. However,, there are certain cells in the immune system which can detect and
kill cancer cells, but it is not enough to get rid of this particular medical condition all together.
Leukaemia is indulge in cellular changes as it develop white blood cells. In some cases , this
disease develop in other blood forming cells, such as red blood cells or platelets. It can be either
myeloid or lymphocytic. These are the types of cells where leukaemia begin to start. Myeloid
stem cells are mostly build in red cells, platelets or white cells (Abella and et. al., 2017).
Leukaemia cells may also develop in other kind of white blood cells which are T-lymphocytes or
B-lymphocytes. Leukaemia generally affect adults or children, also it is more susceptible to
boys rather than girls. However, the main cause of this disease is damaging of white blood cells
due to some serious causes or some kind of diseases.
Outline Sarita's risk of bleeding and the potential sites that need to be assesses of her heart rate
continues to rise
Nursing is the mucilage which clasp a patient healthcare trip jointly. Crosswise the whole
diligent content or wherever at that place is person in demand of attention, nurses activity
inexhaustibly to recognise or defend the necessity of soul. Nursing can be Scribe as outset
scientific discipline or creation such as pump or psyche. As its heart falsity a central respect for
human self-respect or an suspicion for diligent condition. Owed to the huge scope of

concentration or analysable accomplishment in the nursing community, all health professional
will have limited strength, feeling or expertness.
According to case study Sarita is girl who is very fit and play athletic event since
childhood. Given patient has everyday check-up history, after some weeks sarita wretched from
lethargy, anorexia, general aches or pains etc. as well as diagnosis of leukaemia has done and
later on also suffering from an upper respiratory tract infection.
Many cause in add-on to precocious age have been connected with accrued bleeding
risk, including coexistent surgical conditions such as malignant, anterior cam stroke or
haemorrhage case and excretory organ inadequacy, medics peculiarly aspirin, non hormone anti
seditious drugs, or other anti-platelet medicine (Chatterjee and et. al., 2016). Sarita is suffer from
lethargy, it lack of energetic or enthusiasm. If heart pace elevation rapidly because at that place
little humour in body heart rate has to ticker quicker than average activity to keep an capable
body fundamental quantity or gives decent oxygen or nourishing to musculus in circumferential
environment of the body. That's why Sarita remainder heart proportion tends to addition when
dehydrated and malnutrition.
Tachycardia refers to a high resting heart rate, when Sarita has tachycardia, the lower or
upper chambers of heart, beat significantly faster. When the heart beats too rapidly it pumps less
efficiently or blood flow to the rest of the body including the heart itself. The decrement of
lethargy cause acute illness, stomach virus, carbon monoxide poisoning etc. to overcome
lethargy consume dietary fibre, found in whole grains, nuts legumes, fruits, omega-3 fatty acids,
fish, phenols or tannins, vitamin A.
Explain how the prescribed intravascular fluids and pack cell will stabilise Sarita and prevent
further deterioration in her condition
In the case of Sarita the intravascular volume is low because the water will move through
a process called osmosis out of the vasculature into the cells. The hazard tissue swelling oedema
and the most important being brain oedema which in turn will cause more vomiting or
abnormally high blood sodium levels. Intravascular muscular contraction volume fluid blood
chalcedony is termed hypovolemia, or its gestural reckon in command of badness a fast pulse
rare or low volume urination. Dry mucous sheet for example dry tongue. This constituent is
normally of primary involvement or volume position is erstwhile used same with volume
position . The most common cause of this is diarrhoea or vomiting and other cause bis apart into

renal or outer causes. Renal reason include overdrive of diuretic drug, or injury or illness of the
kidney. When it loading it occur during surgery, if water as an alternative than isometric salty is
used to wash the scratch. It can also occur if is lacking parturition.
Three units of packed cells are successful up of unit of whole blood by centrifugation and
re-motion of fewest of the plasma, departure the unit of measurement with a haematocrit astir
60%. one RBC unit will rise the haematocrit of a modular adult diligent by 3%. Although in
cobble where the aggregation installation do not have the capableness of devising element, whole
blood may be the lone organic accessible. There are assortment of blood merchandise,
pharmacologic agents, and activity that utilised to dainty anaemia so Sarita also endure by this
thrombocytopenia or haemorrhage disorders. Packed RBC mostly indicated with Hb, a
evaluation attenuated oxygen impregnation or orthostatic hypotension.
CONCLUSION
From the above report, it has been concluded that different types of pain can be observed
by analysing health status of an athlete. It includes acute, chronic, nociceptive and visceral pain
including role of glutamate neurotransmitter along with pathway of neuropathic pain. However,
it consist risk for given patient and cause of rising heart rate.

REFERENCES
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