NURS 6501 Assignment: Advanced Pathophysiology Week 3 Knowledge Check

Scenario 1: Myocardial Infarction

Question 1: Which cholesterol is considered the “good” cholesterol and what does it do?

Cholesterol plays various significant roles in supporting the normal functioning of cells, including contributing to the structural makeup of the membrane and modulating its fluidity. Although cholesterol is essential for human life, it is possible to group it as “good” or “bad”. High-density lipoprotein (HDL) is “good” cholesterol because it carries cholesterol to the liver, leading to its breakdown and subsequent removal from the bloodstream (Huff et al., 2019). This factor contributes to decreased risk of various diseases, including cardiovascular conditions and obesity.

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Scenario 2: Myocardial Infarction

Question 2: How does inflammation contribute to the development of atherosclerosis?

Inflammation is a profound determinant of all phases of atherosclerosis, considering its contribution to the accumulation of macrophages and plague development. On the other hand, the accumulation of macrophages in adipose tissue is a vital characteristic of obesity and a risk factor for chronic inflammation. As a result, inflammation results in the severity of atherosclerosis and the development of complex lesions that are susceptible to rupture, leading to adverse events.

Scenario 3: Pleural Friction Rub

Question 3: Because of the result of a pleural friction rub, what does the APRN recognize?

A pleural friction rub is an extraneous sound heard upon the auscultation of the heart, lung, and other organs, primarily using a stethoscope as a profound part of the examination (Adderley & Sharma, 2022). This sound manifests in patients with pneumonia, malignant pleural disease, pleurisy emanating from viral infection or pancreatitis, and pulmonary embolism. After confirming a pleural friction rub, the APRN should distinguish it from a pericardial friction rub, which is a sign of pericarditis.

Scenario 4: Deep Venomous Thrombosis (DVT)

Question 4: Given the history of the patient explain what contributed to the development of deep venomous thrombosis (DVT)

As described by the patient, deep venomous thrombosis (DVT) manifests through various symptoms, including leg swelling, pain, soreness, change in skin color on the leg, and cramping (Badireddy & Mudipalli, 2021). The patient has a history of obesity which increases her susceptibility to DVT. Besides a history of obesity, other risk factors for DVT include old age (≥70 years), prolonged immobility, lengthy admission to intensive care units (ICUs), and the presence of chronic conditions like active cancer, acute respiratory failure, and congestive heart failure (CHF).

Scenario 5: Chronic Obstructive Pulmonary Disease (COPD)

Question 5: There is a clear relationship between emphysema and COPD. Explain the pathology of emphysema and the relationship to COPD

Pathologically, it is possible to define emphysema as the atypical, irreversible enlargement of air spaces that leads to reduced gaseous exchange, progressive air trapping, and alterations in airway dynamics. Further, emphysema leads to a decline in the alveolar surface area available for gas exchange (McCance & Huether, 2019). Emphysema relates to COPD in the sense that chronic obstructive pulmonary disease results in irreversible damage to the airways and tiny air sacs in the lungs, leading to breathing difficulties.

References

Adderley, N., & Sharma, S. (2022). Pleural friction rub. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537118/#

Badireddy, M., & Mudipalli, V. R. (2021). Deep venous thrombosis (DVT) prophylaxis. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534865/

Huff, T., Boyd, B., & Jialal, I. (2019, March 13). Physiology, cholesterol. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470561/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for

disease in adults and children (8th ed.). Mosby/Elsevier