Question

Pathophysiology Paper Purpose: The purpose of the project is to serve as an artifact, showing that students have demonstrated achieving the competency on scientific literacy.

Galen College of Nursing has 6 General Education Competencies:

1. Social Competence
2. Communication
3. Information Technology
4. Critical Thinking
5. Quantitative Literacy
6. Scientific Literacy

This project requires the ability to understand and apply scientific knowledge that you acquire both inside and outside the anatomy and physiology classroom. You will be presented a pathology that is applicable to the systems we have covered. This is a pathology that you may encounter in your nursing career. Your explanations on each sub-topic should include information from sources that go beyond the textbook or classroom.

Criteria

1 Description of the pathology

2 Body System(s) involved

3 Normal anatomy of major body system effected

4 Normal physiology of body system effected

5 Mechanism of pathophysiology

6 Prevention

7 Treatment

8 Clinical Relevance

9 References

• The paper will be double-spaced, and answers should only be on one side of the paper. • The paper will be a minimum of 3 pages long, and should also include an additional citations page at the back. • A minimum of three APA-style references must be included in the paper. There should be an APA format citations page labeled “References” at the end of the presentation. Additionally, sources should be cited directly after any quoted passages in the paper. Reputable resources include peer-reviewed journal articles, interviews with clinicians who deal with these pathologies on a daily basis, personal experiences, class lectures, and other reputable sources. • The student should use a font size of 12. The paper should be written with the text aligned to the left margin. The student is expected to compose ideas in their own words, and only use text from other sources as a minor supplement.

Sample Answer

Pathophysiology of Tuberculosis

Introduction

Pathophysiology is a term derived from pathology and physiology. It refers to the study of processes of physiology and the root cause of physiological disorders that may result in illness, injury, or disease. The study of pathophysiology is useful in explaining the functional transformations that take place within an organism as a result of the pathologic condition or the disease.  Pathology is a field of medicine that describes the observed state or condition of an illness, injury, or an infection.  What pathologists seek to explain is the undesired state or disease or the abnormality.  On the other hand, physiology is a field of medicine that studies the mechanisms or processes that operate in an organism. This paper presents Tuberculosis as a pathologic condition.

Background information

Tuberculosis

Recently, Tuberculosis as a pathologic condition resurfaced as a severe health problem. About 9 million people become infected with Tuberculosis, while 2 million people globally die of tuberculosis yearly (CDCP-World TB, 2007). For instance, according to the CDCP (2006) report, in the US, an estimated 14 000 tuberculosis cases were reported, although this was a 3.2% decrease from a year before, 20 states in the US and particularly Columbia registered the highest rate (CDCP, 2006). Nevertheless, concerns of Tuberculosis and its prevalence is still worrying due to the growing numbers of the homeless and drug abusers, the increased number of immigration from one country to another that increases the incidence, increased international travel, bacterial resistance to medications and infected number of patients with HIV (Goldrick, 2004; p. 69).

Out of a third of the world population, 2 billion people are said to be infected with mycobacteria (Korf et al., 2006, p. 153); therefore, irrespective of the area of care, all nurses are required to understand the pathophysiology of this health problem, preventions, treatment as well as its clinical relevance,. It is true that the hospitalized patients’ vulnerability to Tuberculosis is less recognized; this is due to the constant consideration of this airborne infectious disease as a community disease. A good number of patients who are hospitalized and are in a suboptimal immune state such as the ICU, intensive care units, are more exposed to Tuberculosis than an individual in the community. Thus, when we understand its pathophysiology, causative agents, prevention of Tuberculosis, and its clinical relevance in patients, then it will be better to acknowledge this increasingly common disease.

Body System(s) Involved

When an individual or a patient inhales TB bacilli, these mycobacteria quickly move fast through the nose and mouth into the parts of the smallest and lowest airway, then finally into the terminal lung alveoli and bronchioli. The terminal bronchioli form structures that guide’s air from the upper airways (trachea, mouth, and nose) into tissues of the lung. Alternatively, alveoli are lung tissue parts to provide areas of absorption of inhaled oxygen that is finally used by the body.

Normal anatomy of the significant body system affected

The lung requires a good supply of blood for efficient gas exchange as well as a medium of transporting gases to the rest part of the body. Besides, there is innervation; both the sympathetic and parasympathetic nervous systems that offer essential control level through the airway constriction and dilation.

Normal physiology of the significant body system affected

From a physiological point of view, inhaled TB bacilli quickly move fast through the nose and mouth into the parts of the smallest and lowest airway, then finally into the terminal lung alveoli and bronchiole

Mechanism of Pathophysiology

Immediately the TB bacilli are inhaled, there is a settlement of the infectious droplets into parts of the airways. However, most of these infectious mycobacterial are trapped onto the airways upper parts by the secreted mucus from the goblet cells. This produced mucus traps these foreign substances as supported by the cilia found on the cells surface that continuously beat the entrapped mucus particles upward for their elimination (Frieden et al., 2003; p. 889).

The mucus particles protect the body through initial physical defense hence preventing the lung and particularly the entire body from tuberculosis exposure (Jensen et al., 2005; p. 13). However, the remaining bacteria within the droplets that have bypassed the system of mucociliary reach the alveoli; however, the alveolar macrophages quickly engulfed them (Frieden et al., 2003, p. 891; Korf et al., 2006, p. 155). The macrophages are part of the inborn immune system that provides the body with an opportunity to destroy the mycobacteria as well as prevent its infection. Funny enough, the mycobacteria slowly continue to multiply even when the macrophages already ingest them through cell division (Korf et al., 2006, p. 159). As a result, the mycobacteria reach the terminal lung alveoli and bronchiole that guide’s it from the upper airways (trachea, mouth, and nose) into tissues of the lung. This physiological process results in a condition known as Tuberculosis.

Alternatively, the constriction and dilation of the airways in the lung are attained via nervous control between the sympathetic and parasympathetic nervous systems. In this case, the lung requires sympathetic nervous system to stimulate bronchodilation while it requires a parasympathetic system to cause bronchoconstriction (Jensen et al., 2005; p. 89). As such, reflex actions like coughing as well as the lungs ability in regulating levels of carbon dioxide and oxygen are also caused by control of the autonomic nervous system. Besides, the lung is consisting of the sensory nerve fibers that emerge from the vagus nerve to fifth thoracic ganglia; this joins the plexus of the pulmonary region at the root of lung forming at the hilum nerve entrance.

The supplied blood carries deoxygenated blood to the lungs from the body where erythrocytes cells are capable of picking up oxygen that they transport to the body tissues. Within the lung is the pulmonary artery that emerges from the trunk of the pulmonary and plays the role of carrying arterial and deoxygenated blood to the alveoli — the artery branches into many bronchi, which is progressively smaller in size. Also, there are the venules and one arteriole that supplies and drains one lobule of pulmonary. These (alveoli) branches into a network of pulmonary capillary. The system of the pulmonary capillary is made up of minute vessels whose walls are thin, thus creating the membrane for respiration. Immediately the blood is oxygenated; it is moved out of the alveoli through various pulmonary veins, thus leaving the lungs via the hilum.

Prevention

There are a few measures that can be used to prevent the active TB from spreading; these ranges from avoiding infected by not allowing them to be social places like the workplace, schools as well as avoid sleeping in full rooms with infected persons to minimize the spreading risk. Besides, when handling TB patients, one need to wear a mask, cover mouth, as well as stay in well-ventilated rooms to limit its spread.

Treatment

TB is cured using antibiotics with the right medication that is correctly administered. The length and antibiotic used relies on the potential resistance to the antibiotics, the overall health of the patient, age of the patient as well as whether the TB is active or latent.\

Clinical Relevance

The processes of cellular occurrence of TB develop in a different way for every TB patient; this depends on the immune system of the patient as well as their status. However, this involves various stages including latency, primary disease, primary progressive disease, and another pulmonary disease all with various medical manifestations.

Conclusion

The reemergence of TB has caused a significant concern in public health globally emerging as one of infectious disease. Thus, the pathophysiological understanding of this airborne infection from the primary virus to active infection is essential. This is useful in critical care as well as the creation of awareness of its causes, prevention, treatment as well as clinical relevance in evaluating a patient’s condition of the disease and how to manage it.

References

Centers for Disease Control and Prevention (2006). Trends in tuberculosis incidence, United States. MMWR Morb Mortal Wkly Rep. 2007; 56(11):245-250.

Centers for Disease Control and Prevention-World TB day, (2007). MMWR Morb Mortal Wkly Rep; 56(11):245.

Frieden, T.R., Sterling, T.R., Munsiff, S.S., Watt, C.J., Dye, C. (2003). Tuberculosis. Lancet; 362: 887-899

Jensen, P., Lambert, L.A., Iademarco, M.F., Ridzon, R. (2005). Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings; 54(RR-17):1-141.

Korf, J., Pynaert, G., Tournoy, K. (2006). Macrophage reprogramming by mycolic acid promotes a tolerogenic response in experimental asthma. Am J Respir Crit Care Med; 174(2):152-160