Case Study Assessment: Nursing Assignment

This nursing assignment covers various topics such as the functions of the endocrine system, pathophysiology of Graves' disease, digestive system, cardiovascular system, nursing interventions, risk factors, and more. It also discusses the effects of age on the respiratory system, the structure of the lymphatic system, stress incontinence, and the relationship between childbirth and stress incontinence.

Running Head: CASE STUDY ASSESSMENT 0
Case Study Assessment: Nursing Assignment
Student Name

CASE STUDY ASSESSMENT 1
Table of Contents
Answer 1....................................................................................................................................1
Answer 2....................................................................................................................................1
Answer 3....................................................................................................................................2
Answer 4....................................................................................................................................2
Answer 5....................................................................................................................................2
Answer 6....................................................................................................................................3
Answer 7....................................................................................................................................3
Answer 8....................................................................................................................................3
Answer 9....................................................................................................................................3
Answer 10..................................................................................................................................4
Answer 11..................................................................................................................................4
Answer 12..................................................................................................................................5
Answer 13..................................................................................................................................6
Answer 14..................................................................................................................................6
Answer 15..................................................................................................................................6
Answer 16..................................................................................................................................7
Answer 17..................................................................................................................................7
Answer 18..................................................................................................................................8
Answer 19..................................................................................................................................8
Answer 20..................................................................................................................................9

CASE STUDY ASSESSMENT 2
Answer 21..................................................................................................................................9
Answer 22................................................................................................................................10
Answer 23................................................................................................................................10
Answer 24................................................................................................................................10
Answer 25................................................................................................................................11
Answer 26................................................................................................................................11
Answer 27................................................................................................................................12
Answer 28................................................................................................................................12
Answer 29................................................................................................................................12
References................................................................................................................................14

CASE STUDY ASSESSMENT 3
Answer 1
Functions of endocrine system
 Corticotrophin hormone secreted by pituitary gland takes part in controlling the
hormone production and its secretion by adrenal glands
 Parathyroid hormone released by parathyroid gland plays an important role in bone
formation and secretion of Calcium and phosphorus
 Glucagon and insulin produced in pancreas takes part in increasing and decreasing the
level of sugar in body
 Aldosterone is the hormone that excreted form Adrenal gland. It takes part in
regulation the balance of salt and water by instructing the kidneys to excrete
potassium (Morley, 2018)
Answer 2
Pathophysiology of Graves ’ disease
Graves’ disease is an autoimmune disease associated with hyperthyroidism. The
autoimmunity is mediated by B and T lymphocytes directed by 4 antigens such as
thyroglobulin, sodium iodide symporter, and thyroid peroxidase and thyroprotein receptor.
The antigen-specific immune response has occurred in this disease. The autoimmune
response is mediated by autoantibodies leads to hyperthyroidism mediated by transfer of
thyroprotein rector protein in blood from the parents to the foetus
The thyroid stimulating antibodies triggers cyclic AMP mediate secretion of TH and
thyroglobulin and stimulation of iodine uptake, synthesis of protein and growth of thyroid
gland. Some of the other molecules also are associated with Graves’ disease like CD4 T

CASE STUDY ASSESSMENT 4
lymphocyte which mediates the Fas expression. There are some genes associated in different
types of autoimmune disorder such as CD40, TSH receptor; CTLA-4, thyroglobulin, and
PTPN22 (Yeung, Habra, & Chiu, 2018)
Answer 3
The digestive system also is known as gastrointestinal tract is extends from mouth to
anus. It breaks the food into nutrients and absorbs the nutrients in to blood and further
excreted the waste material out of the body. Organs of this system produces hormones
associated with removing toxic material from bloodstream.
Answer 4
Cardiovascular system
The minimal changes occurred in the amount of the thyroid hormone result in
cardiovascular abnormalities, insomnia, and increased heart-rate.
Digestive system
Hyperthyroidism attacks on cells of intestinal linings, increases fluid-secretion, leads
to diarrhoea and unnecessary hunger.
Integumentary system
Increased basal metabolic rate results in heat-intolerance, moist skin, and hair loss.
Answer 5
Nursing interventions
 A cool and quiet environment can be provided

CASE STUDY ASSESSMENT 5
 Propranolol can be administered to control the increased heart rate
 Iodine preparations can be administered to inhibit thyroid hormone release
Answer 6
Risk Factors
1. Genetic factor: this disease can be transferred from parents to children
2. Age: this disorder is prominent in the person older than twenty
3. Smoking (NewMax, 2011).
Answer 7
Isabella’s blood test reports are abnormal which revealed that the level of thyroid
stimulating hormones was lower (0.4 mIU/L than normal), free thyroxine level was 30
pmol/L and free Triiodothyronine level was16 pmol/L.
Answer 8
Heart Rate was higher (tachycardia) and increased respiratory rate of 26 which is
considered abnormal. Her systolic blood pressure was 140 and the Diastolic rate was 70. She
has oxygen saturation level of 100 % and temperature higher (100.4 in Fahrenheit) than
normal.
Answer 9
Health professional
 Endocrinologist: Endocrinologist is a specialist to treat the condition related to
hormonal imbalance. They help the patient to control the hyperthyroidism.

CASE STUDY ASSESSMENT 6
 Anaesthesiologist: Plays an important role to control the sleeplessness and carefully
administer anesthesia to the patient with thyroid disease
 Nutritionist: Nutritionists are specifically trained in providing assistance related to
their diet. They maintain the healthy and balanced diet.
Answer 10
Structure of respiratory system
The structure of respiratory system includes mouth, nose, bronchi, lungs, trachea.
 Bronchi: subdivided in bronchioles situated in both left and right lungs.
 The trachea is a tube-like structure connecting throat to the bronchi.
 Lungs: situated in thorax part of the human body contains bronchioles and pulmonary
alveolus.
Functions of Respiratory system
 Mouth, nose & nasal-cavity: warm, filtration of air
 Trachea: caries air from throat to the lungs. Cilia in Trachea capture dust particles and
excrete them through coughing.
 Bronchi: Allow air from the external environment to the lungs through bronchioles
 Bronchioles: to make sure that the air coming from bronchi is reaching to the each
alveoli
 Alveoli: permits transport of gases O2 and CO2.
Answer 11
Structure of the lymphatic system

CASE STUDY ASSESSMENT 7
 Lymph vessels: these are the site for fluid drainage. Large vessels consist of valves to
stop backflow of blood towards the heart
 Lymph node: small round shape bodies of the lymphatic system transported along the
clusters of lymphatic vessels in armpits, neck, chest, groin, and abdomen.
 Lymph: A colorless liquid body fluid which is distributed by the lymphatic system. It
mainly Contains WBCs (White Blood Cells).
 Lymphoid tissues: contains lymphocytes and dendritic cells
Functions of the lymphatic system
 It is the site for many immunological functions
 Responsible for excretion of interstitial watery liquid from tissues to lymph fluid.
 Absorbs and carries fatty acid and fat molecules in form of chylomicrons from the
digestive system
 Carries WBCs and dendritic cells into lymph nodes where initiation of adaptive
immune response takes place
Answer 12
Effects of age on the respiratory system
 Deduction of Peak airflow and exchange of gases
 Lung functions such as the amount of air that inhaled and exhaled inside the body are
decreases
 Respiratory muscles weaken
 Diaphragm and other muscle support respiration weakens
 Thinning of bones and rib cage shape changes.
 The lungs defense mechanism has been declined with the age (lechtzin, 2018

CASE STUDY ASSESSMENT 8
Answer 13
When the blood transport from the heart out of the body, the plasma containing
protein, waste substances or dead cells and water enter in interstitial spaces where fluids have
been filtered by the lymphatic system. The lymphatic system may return the fluid to the
blood. If any loss of integrity is there in any part occurs results in accumulation of lymph
fluid in interstitial spaces which can further cause edema.
The change in capillary pressure, osmotic pressures, and integrity of muscles of
skeleton system contribute to lymphedema development. The congenital abnormalities occur
in lymphatic system can also cause lymphedema. This disorder can be occurred anywhere
and at any point in the body where lymph drainage takes place (Cruz, 2014).
Answer 14
COPD is the abbreviation for the chronic obstructive pulmonary disease. It is
associated with the inflammation in lungs which leads to obstruction in the transport of air
into and out of both the lungs.
Symptoms
 Shortening of breath
 Wheezing problem
 Weight loss
Answer 15
Risk factors
 Smoking cigarettes and/or tobacco
 Pollution

CASE STUDY ASSESSMENT 9
 Genetic condition
 Age
 Exposure to fumes comes from burning fuels
 Occupational exposure to the chemicals
Answer 16
Assessment
1. Pain Assessment can be done to check the pain level in the joints of the patient
2. Sputum Test: included volume of sputum, if any bacterial infections
3. Measuring fever by using a thermometer
Immediate nursing intervention
Antibiotics should be administered as prescribed by the physician (Koutoukidin,
Stainton, & Hughson, 2016) and pain should be decreased immediately, painkillers can be
used.
Answer 17
Health professionals
1. The general physician or primary care physician: to deal with fever and other
complications
2. Emergency care physician: to provide immediate assistance and recovery. They also
deal with influenza.
3. Respiratory therapist: experts in pulmonary medicine and trained to deal with the
patient having pulmonary problems. Mr Papas admitted with the breathing difficulty
and a respiratory therapist may help in this case.

CASE STUDY ASSESSMENT 10
Answer 18
Artificial Acquired immunity
Artificially acquired immunity includes an exposure of a person to foreign antigen or
antibody which belongs to someone else, to generate an immunity.
Artificially acquired active immunity is the protection produced where the person is
exposed to antigens in a vaccine intentionally so that the active immune response can be
produced. Artificially acquired passive immunity is the injecting an injection containing
antibodies belongs to some else.
Answer 19
 Kidneys: An adult kidney is nearly 12 cm long and 6 cm wide. There is a medial
indentation in kidneys called renal hilum. At the hilum, various other structures
located such as ureters, blood vessels, and nerves. Each kidney is enclosed with
fibrous capsule and provides a glistening appearance to the kidney. (Marieb, 2009).
 Ureters: long, thin tube-like structure with smooth muscles. It is 25-30 cm long.
 Urethra: it is narrow and nearly 4 centimeters long extends from the neck of the
bladder to external urethral orifice vaginal areas. It is shorter than male urethra which
17.5 to 29
Answer 20
Functions of the urinary system
Kidney:

CASE STUDY ASSESSMENT 11
 Functions of the urinary system
 Blood volume regulation
 Production of red blood cells
 Vitamin D synthesis
 Eliminate the waste material and foreign substances out of the body
Bladder: store urine in to excrete it out of the body
Urethra: acts as a passage for the urine
Uterus: to prevent the backflow of urine.
Answer 21
Structure of the female reproductive system
 Ovaries: a small glands pair with the shape of an almond. Located on left and right
part of the pelvic cavity
 Fallopian tube: a pair of the muscular tube. Extend from the uterus to edge of ovaries.
FT ends in the infundibulum
 Uterus: the uterus is muscular hollow and pear-shaped. It connects with fallopian
tube and vagina.
 Vagina: elastic, muscular tube-like structure which connects cervix to exteriors part of
the body
 Vulva: surrounds external ends of urethral openings. It includes mons pubis, clitoris
and labia minor and majora.
Answer 22
Stress incontinence

CASE STUDY ASSESSMENT 12
Stress incontinence (SI) is the unintentional urine loss. It happens when any physical
movement such as sneezing, running, coughing and lifting heavy weight create pressure on
bladder. It is common in females than males.
Answer 23
Relationship between childbirth and Stress Incontinence
SI is common in women give births. During the pregnancy uterus expands due to the
pressure has been occurs on bladder. The pressure is exerted because of continued growth of
the baby. This results in easier excretion of urine out of the bladder due to sneezing,
coughing, or exercising. In some women’s the injured tissues does not repaired fully. In this
case the stress incontinence is common.
Stress incontinence is the unintentional urine loss. It happens when any physical
movement such as sneezing, running, coughing and lifting heavy weight create pressure on
the bladder. It is common in females than males
Answer 24
Causes of Urinary Tract Infection
1. Bacterial: The infection occurs in bladder usually caused by bacteria Escheria Coli.
This type of bacteria found in GI tract
2. Sexual intercourse: It may cause cystitis. Which is due to the short distance between
urethra and anus and openings of the urethra to the bladder?
3. Birth control: switching birth control results in hormone shift which may cause
changes in normal bacteria in the vagina.

CASE STUDY ASSESSMENT 13
Answer 25
Pathophysiology of pyelonephritis
Pyelonephritis is caused by the presence of E. coli in kidneys. It is of two types: active
and chronic. Acute pyelonephritis is results of primary infections caused by the bacteria and
chronic state is occurred due to the untreated infection. Chronic pyelonephritis (CP) normally
causes a defect in the urinary tract. And can spread in other organs like kidney tissue. The
inflammation response triggered by the bacteria results in edema. AP includes tissues
inflammation, cell necrosis, and abscess formation. It also causes pus formation anywhere in
the kidney. Fibrosis and scars may develop due to the inflammation and further spread in the
intestinal area. In CP the infection also infects the transferred in uterus form bladder due to
the unclosed papillae in the kidney. Inflammation and fibrosis also cause pelvis and calices
deformity. Continues infection may lead to the impaired kidney functioning.
Answer 26
Heart rate is: 88 (normal)
Respiratory rate is: 24 (abnormal)
Blood pressure:
 Systolic pressure is 110
 Diastolic pressure is 60
Body temperature is 38 which considered high
Pulse Oximetry is 100 % on room temperature

CASE STUDY ASSESSMENT 14
Answer 27
 Specific Gravity (SG): 1020 (Abnormal)
 PH: 5 (Lower than normal which indicates an environment that conducive to kidney
stone).
 Protein-large (high amount of protein)
 Blood-large (high amount of blood excreted with urine)
 Leucocytes- moderate (white blood cells amount is moderate in urine, associated with
infection)
 Nitrites- positive (Nitrates converted to nitrites by bacteria, a positive sign of bacterial
infection)
Answer 28
Nursing interventions
1. Encourage the patients to consume a high amount of liquid to promote the renal blood
flow and to excrete the bacteria out of the body.
2. Coffee, colas, tea and alcohol consumption should be avoided
3. Use of antispasmodic agents that may help to relieve the irritation in the bladder.
Analgesic and heat can be administered to relieve the pain
Answer 29
1. Urologist: to provide relief form urinary tract infection
2. Urogynecologist: Specialised in females urinary system and pelvic conditions in
females
3. Dietician or nutritionist: to maintain the nutrition intake by providing a healthy diet to
the patient

CASE STUDY ASSESSMENT 15

CASE STUDY ASSESSMENT 16
References
Morley, J. E. (2018). Endocrine function. Retrieved from:
https://www.msdmanuals.com/home/hormonal-and-metabolic-disorders/biology-of-the-
endocrine-system/endocrine-function
Yeung, S. J., Habra, M. A., & Chiu, A. C. (2018). Grave’s disease. Retrieved from:
https://www.medscape.org/viewarticle/727357
NewsMax (2011). Risk factors and complications of Graves’ disease. Retrieved from:
https://www.newsmax.com/fastfeatures/complications-graves-disease-symptoms/
2011/06/29/id/401941/
Lechtzin, Noah (2018). Effects of aging on the respiratory system. Retrieved from:
https://www.msdmanuals.com/home/lung-and-airway-disorders/biology-of-the-lungs-
and-airways/effects-of-aging-on-the-respiratory-system
Cruz, B. (2014). Lymphedema: Pathophysiology, Diagnosis & Management. Master of
Science in Nursing (MSN) student scholar. 9. Retrieved from:
https://digitalcommons.otterbein.edu/cgi/viewcontent.cgi?
article=1003&context=stu_msn
Koutoukidin, G., Stainton, K., & Hughson, J. (2016). Tabbners Nursing Care: Theory and
practice. (7th ed.). Australia: Elsevier Health Science.
Marieb, E. N. (2013). Essentials of human anatomy & physiology. (9th ed.). San Francisco:
Pearson Education.

CASE STUDY ASSESSMENT 17