NURS_6501_Module1_Case Study_Assignment_Rubric.

WEEK #2 TOPIC This week look at the objectives, resources, and assignment Assignment this week:  Scenario 3: A 34-year-old Hispanic-American male with end-stage renal disease received kidney transplant from a cadaver donor, as no one in his family was a good match.NURS_6501_Module1_Case Study_Assignment_Rubric. His post-operative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and had returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued, and began to run temperatures up to 101˚F. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection.NURS_6501_Module1_Case Study_Assignment_Rubric.

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Develop a 1- to 2-page case study analysis in which you: -Explain why you think the patient presented the symptoms described. -Identify the genes that may be associated with the development of the disease. -Explain the process of immunosuppression and the effect it has on body systems. Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting. NURS_6501_Module1_Case Study_Assignment_Rubric.    This week you examine compensatory mechanisms and physiological responses to disorders. You also explore the impact of patient factors on the pathophysiology of disorders and resulting compensatory mechanisms.   Objectives are:   By the end of the week, you will be able to:   • Compare maladaptive and physiological responses of immune disorders • Evaluate the impact of patient factors on the pathophysiology of immune disorders • Analyze the pathophysiology of disorders • Assess adaptive responses to alterations • Evaluate clinical considerations of disorders • Understand and apply key terms, concepts, and principles related to adaptive and compensatory mechanisms   Rubric Detail   Name: NURS_6501_Module1_Case Study_Assignment_Rubric 
   Excellent Good Fair Poor Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following: Explain why you think the patient presented the symptoms described. 28 (28%) – 30 (30%) The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. 25 (25%) – 27 (27%) The response describes the patient symptoms.NURS_6501_Module1_Case Study_Assignment_Rubric. The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. 23 (23%) – 24 (24%) The response describes the patient symptoms in a manner that is vague or inaccurate. The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research. 0 (0%) – 22 (22%) The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.NURS_6501_Module1_Case Study_Assignment_Rubric. Identify the genes that may be associated with the development of the disease. 23 (23%) – 25 (25%) The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease. 20 (20%) – 22 (22%) The response includes an accurate analysis of the genes that may be associated with the development of the disease. 18 (18%) – 19 (19%) The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease. 0 (0%) – 17 (17%) The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing. Explain the process of immunosuppression and the effect it has on body systems. 28 (28%) – 30 (30%) The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems. 25 (25%) – 27 (27%) The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems. 23 (23%) – 24 (24%) The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems. 0 (0%) – 17 (17%) The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance.NURS_6501_Module1_Case Study_Assignment_Rubric. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. NURS_6501_Module1_Case Study_Assignment_Rubric.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6501_Module1_Case Study_Assignment_Rubric

Rahimi et al. (2017) highlight kidney transplantations as the most preferred surgical management of renal disorders today. Apart from being well established, surgical transplants have very high rates of success and minimal complications. However, there are also instances when patients may develop surgical complications or experience rejection. Knowledge of the pathophysiology of rejection is key to identifying the clinical signs and symptoms of rejection and intervening appropriately. NURS_6501_Module1_Case Study_Assignment_Rubric.

Why the Patient Presented With the Symptoms Described

The patient presented with the described symptoms due to rejection.  Acute rejection usually occurs in the initial six months following transplantation and African Americans are at the highest risk of allograft failure (Taber, Egede & Baliga, 2017). Race is a significant factor that influences patient and graft survival in recipients of kidney transplants. Among Hispanic Americans, an increase in the immunologic response to an allograft causes an increase in graft loss. Cytokines, alloimmune responses, and growth factors that cause inflammatory allograft changes when a recipient’s immune system recognizes an allograft as a foreign antigen activate the microvascular endothelial cells (ECs) and destabilization (Bijkerk et al., 2017). The events associated with rejection cause perpetual EC damage and angiogenesis. Collectively, these events result in ischemia, microvasculature loss, cell death, interstitial fibrosis, and ultimately, graft dysfunction. NURS_6501_Module1_Case Study_Assignment_Rubric.

Genes Associated With Development of the Disease

The LIMS 1genes in recipients are associated with transplant rejection. When the recipient and donor are incompatible, there is allosensitization against the new genes such that, the recessive gene inheritance causes allograft rejection (Wu et al., 2015).   NURS_6501_Module1_Case Study_Assignment_Rubric.

Process of Immunosuppression and Effect to Body Systems

When a person undergoes a transplant, the body detects the transplanted kidney as a foreign body and acts in defense causing destruction and dysfunction. As highlighted by Nasr, Sigdel & Sarwal (2016), to assist the body to suppress this response, healthcare providers administer immunosuppressant, which helps to prevent rejection and minimize the resultant complications.NURS_6501_Module1_Case Study_Assignment_Rubric.

Conclusion

Knowledge on the pathophysiology of rejection is key to identifying the clinical signs and symptoms of rejection and intervening appropriately.  The LIMS 1genes are associated with transplant rejection , which occurs when cytokines, alloimmune responses, and growth factors that cause inflammatory allograft changes in a recipient’s immune system recognizes an allograft as a foreign antigen. Collectively, these events result in ischemia, microvasculature loss, cell death, interstitial fibrosis, and ultimately, graft dysfunction. NURS_6501_Module1_Case Study_Assignment_Rubric.