How to critique nursing MSN570 Week 8 Case Studies solved

Choose a condition from the following case studies: (Week 8 Case Study Details).
Part 2: Select two different students/topics and discuss the condition encompassing clinical experiences and critique the post.
MSN570 Week 8 Case Studies
A 30-year-old female presents with muscle weakness and fatigue. Abnormal electromyography testing and a positive acetylcholine receptor antibodies test is reported. Her final diagnosis is Myasthenia Gravis.

Describe the normal synaptic transmission at the Neuromuscular Junction (NMJ).
Why is the ACh level increased?
Explain why the patient with myasthenia gravis cannot generate consistent action potentials in the muscle fiber.
Treatment for the patient involves pyridostigmine—what does this drug do and how would it benefit our patient?

An 80-year-old male presents with resolving decubitus, that is now oozing and red. The wound team has been involved. His daughter wants information regarding his skin condition.

Describe the phases of wound healing.
What is resolution, regeneration and replacement?
What is the significance of the oozing and discoloration?
What factors impede the healing process and why?

A 65-year-old male presents with a painful left finger, he is unable to bend it and it is significantly swollen. He has a history of osteoarthritis.

OA is a disease of articular cartilage and subchondral bone in diarthrodial joints. Explain this.
What is the role of osteophytes in OA?
How do NSAIDS affect OA?
How does weight loss affect OA?

A 6-year-old male fell out of a tree and broke his left ulna.

What is the significance of a growth plate?
How is bone formed?
What is the role of the following bone formation: hormones (GH + sex hormones), Ca2+, stress; low Ca2+ increases PTH.
Compare and contrast the various types of fractures.

solution to MSN570 Week 8 Case Studies

80- Year-Old with Resolving Decubitus

Describe the phases of wound healing

Optimal wound healing involves four continuous and overlapping phases. The first phase is hemostasis which begins at the onset of injury and functions to stop the bleeding (Rodrigues et al., 2019). The body is observed to activate the emergency repair system and blood clotting system that form a dam to block bleeding. The inflammatory phase follows to destroy bacteria and remove debris that prepares the wound bed for the growth of new tissue. During the proliferative phase, shiny deep red granulation tissue fills the wound bed. New blood vessels and connective tissue are formed to enable the gripping of wound edges and pulling them together to close the wound (Rodrigues et al., 2019). The last phase is remodeling which involves the thickening of collagen and reorganization of collagen to increase the tensile strength of the healing tissue.

What is resolution, regeneration and replacement?

During the healing, resolution is the process whereby a tissue or organ is totally restored to normal structure and function (Eming et al., 2017). Regeneration is a process where damaged parenchymal cells are replaced by new cells of the same type (Eming et al., 2017). When resolution and regeneration are not possible during healing, tissues are repaired by laying down connective tissue, a process called replacement.

What is the significance of the oozing and discoloration?

During wound healing, the affected area may appear swollen, red, and clear fluid oozing may be observed as more blood vessels are formed (Rodrigues et al., 2019). This process is significant because it helps clean the wound and discoloration means the wound is healing as melanin moves to the injured area.

What factors impede the healing process and why?

Factors affecting wound healing can be local or systemic. Local factors directly influence the characteristics of the wound and include oxygenation, infection, foreign body, or venous sufficiency (Wernick et al., 2021). Systemic factors may include things like age, sex hormones, stress, medications, and nutrition. For example, the elderly are less likely to heal faster than young adults because of delayed re-epithelialization and collagen synthesis.

References

Eming, S. A., Wynn, T. A., & Martin, P. (2017). Inflammation and metabolism in tissue repair and regeneration. Science (New York, N.Y.), 356(6342), 1026–1030. https://doi.org/10.1126/science.aam7928

Rodrigues, M., Kosaric, N., Bonham, C. A., & Gurtner, G. C. (2019). Wound healing: A cellular perspective. Physiological Reviews, 99(1), 665-706.

https://doi.org/10.1152/physrev.00067.2017

Wernick B, Nahirniak P, Stawicki SP. (2021). Impaired wound healing. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK482254/