NURS 6501: Advanced Pathophysiology

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Week 1 Discussion

Factors That Influence Disease

Scenario Group A

An infant child was brought to provider by child’s mother with complaints of excessive crying, failure to gain weight, abdominal bloating, salty tasteto skin, congestion, and recent pneumonia. Some comparisons made with 2-year-old sibling during assessment. Diagnosis determined infant to have Cystic Fibrosis. Mother had questions and concerns relating to the disease. 

Defining Cystic Fibrosis

    Basic education on the disease was given to mother beginning with the definition of cystic fibrosis as a life-long disorder affecting all races of people (Cutting, 2015). This disorder is considered a recessive disease, meaning both parents must carry the gene for the disorder to pass it to their offspring (McCance and Huether, 2019).

     According to Cutting (2019), the disease is characterized by accumulation of thick secretions within the respiratory airways. Multiple organs are affected such as the pancreas, liver, intestines, sweat glands, and reproductive organs (Cutting, 2019). Eventual cause of death is usually respiratory failure with the average age of mortality being thirty-seven years of age (Cutting, 2019). Thick secretions cause inflammation of breathing airways triggering hypersensitive reactions (Justin-Vaillant and Zito, 2019) leading to symptoms of congestion and pneumonia. The digestive system is affected due to inability of pancreas to secrete hormones necessary for digestion (Cutting, 2019) which could lead to abdominal bloating causing crying and failure to gain weight. The cells of sweat glands are altered by hypersensitive reactions causing the skin to taste salty (Justin-Vaillantand Zito, 2019).  

Genetic Predisposition

     According to McCance and Huether (2019), chance of occurrence for cystic fibrosis is 1 out of 2,500 births. This genetic disorder tends to affect both sexes equally and is often noted in siblings (McCance and Huether, 2019). The mother asked about chances of this disorder occurring should she have another child. If both parents were found to be genetic carriers of the disorder, there would exist a one-fourth chance of affected offspring (McCance and Huether, 2019). 

References

Cutting, G. R. (2015). Cystic fibrosis genetics: from molecular understanding to clinical application. Nature Reviews Genetics, 16(1), 45–56. https://doi-org.ezp.waldenulibrary.org/10.1038/nrg3849

Justin-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

 

 

Initial Post: Alterations in Cellular Processes
COLLAPSE

Cystic fibrosis (CF) is an autosomal recessive disorder discovered in 1938 (Kinyon, 2019). CF’s symptoms and severity can vary from person to person; common symptoms experienced by people diagnosed with CF include difficulty gaining weight, salty-tasting skin, frequent respiratory infections, and infertility in males (Cystic fibrosis 2020). The initial life expectancy of newborns diagnosed with CF was 46 years of age in 2017, a significant improvement from 2 years of age in the 1950s, due to breakthroughs in technology and medicine (Kinyon, 2019).

Cystic fibrosis is caused by a mutation in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene (Férec & Scotet, 2020). People diagnosed with CF received a copy of the faulty gene from both parents. If a person receives only one copy of the defective gene, they are then classified as carriers. There is a 25 percent probability that parents who are both carriers of the faulty gene will have a child with CF, while there is a 50 percent chance that the child will be just a carrier and a 25 percent chance that the child will be free from the disease (CF Foundation, n.d.). More prevalent in individuals of European descent, CF affects around 30,000 people in the United States. (Férec & Scotet, 2020).

The case presented several symptoms exhibited by the 6-month old patient associated with CF, as evidenced by the mother’s concerns. She indicated that her baby had many episodes of crying after eating, and despite having a good appetite was having trouble gaining weight. Mutation in the CFTR gene interferes with the cystic fibrosis transmembrane conductance regulator (CFTR) protein (National Institutes of Health, 2020). This protein is an ion channel responsible for the movement of chloride ions and water in and out of the cell (National Institutes of Health, 2020). Chloride ions assist in regulating the flow of water in tissues and mucus formation (National Institutes of Health, 2020). Salt-water imbalance can cause the ordinarily slippery mucus that lines various organs and tissues to become thick. This abnormal mucus then disrupts the normal functions of the organs. Thick mucus can cause blockages in the pancreas, negatively affecting the production of digestive enzymes that help absorb nutrients and vitamins, leading to indigestion and malnutrition (Sabharwal, 2016). The underproduction of digestive enzymes can leave food undigested, that can lead to stomach pain, bloating, and constipation in the child (CF Foundation, n.d.). As for the concern of the mother about the baby tasting like salt when kissed, CFTR proteins also function in the sweat glands. The movement of sodium and chloride through the body is affected by the abnormal channels resulting in an increased amount of sodium and chloride to be excreted in sweat (Pool, 2019).

References

CF Foundation. (n.d.). About Cystic Fibrosis. CF Foundation. https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/.

CF Foundation. (n.d.). The Digestive Tract. CF Foundation. https://www.cff.org/Life-With-CF/Daily-Life/Fitness-and-Nutrition/Nutrition/Taking-Care-of-Your-Digestive-System/The-Digestive-Tract/.

Cystic fibrosis. (2020, March 14). https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/symptoms-causes/syc-20353700.

Férec, C., & Scotet, V. (2020). Genetics of cystic fibrosis: Basics. Archives De Pédiatrie, 27. https://doi.org/10.1016/s0929-693x(20)30043-9

Kinyon, K. (2019). New Cystic Fibrosis Diagnostic Guidelines: What Does It Mean for Your Practice? The Journal for Nurse Practitioners, 15(4), 274–276. https://doi.org/10.1016/j.nurpra.2019.01.020

National Institutes of Health. (2020, August 17). Cystic fibrosis – Genetics Home Reference – NIH. U.S. National Library of Medicine. https://ghr.nlm.nih.gov/condition/cystic-fibrosis.

Pool, J. (2019, August). Salty Skin and Sweat | Cystic Fibrosis Symptoms. cystic-fibrosis.com. https://cystic-fibrosis.com/symptoms/salty-skin/.

Sabharwal , S. (2016). Gastrointestinal Manifestations of Cystic Fibrosis. . Gastroenterology & Hepatology, 12(1), 43–47. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4865785/.

Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Learning Objectives

Students will:

  • Evaluate cellular processes and alterations within cellular processes
  • Evaluate the impact of the genetic environment on disease

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Discussion: Alterations in Cellular Processes

Photo Credit: Getty Images

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

  • By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

WEEK ONE DISCUSSION
COLLAPSE
Today I am going to discuss the presented case scenario.  In the scenario there is a 27-year-old male found down and unresponsive for unknown amount of time by his roommate.  The male was given naloxone by EMS and became responsive complaining of burning pain to his left greater trochanter and left forearm.  In the ED he was found to have a large amount of necrotic tissue over the greater trochanter and forearm.  His EKG was abnormal with a prolonged PR interval and elevated T waves.  His potassium level was at 6.9 which was elevated.

The Role Genetics Plays in the Disease

 According to the National Institute on Drug Abuse (2019), 99.9 percent of any two people have the same DNA sequences.  The 0.1 percent difference is very important because it accounts for three million differences in almost three billion base pairs of DNA sequences (National Institute on Drug Abuse, 2019).  These differences are what contributes to certain diseases such as addiction (National Institute on Drug Abuse, 2019).  According to the American Psychological Association (2008), genetics can play a role in addiction and at least half of a persons’ susceptibility to drug addiction can be linked to genetic factors.

Why the Patient is Presenting with the Specific Symptoms Described

 The patient overdosed on an opioid drug.  According to Schiller et. al. (2020), when an opiate is used in large amounts the opiate pathway is stimulated.  The over stimulation decreases the respiratory status of the patient (Schiller et al., 2020).  Once the patient’s respiratory status decreased, he became unresponsive and laid on the floor on his left side for a period of time as evidenced by his left greater trochanter and left forearm suffering from necrosis.  According to Simon et al. (2020), the blood flow was decreased, which causes a decrease in circulation, which causes a shift in potassium levels, and this causes cardiac irregularities.

 

 

The Physiologic Response to the Stimulus and Why the Response Occurred

 According to Schiller et al. (2020), overdose of an opioid occurs when the patient over stimulates their opiate pathway.  When the over stimulation occurs the respiratory status decreases (Schiller et al., 2020).  When the opioid enters the body it goes to the synapses, then to the heart and then to the lungs (Schiller et al., 2020).  In the lungs is where the blood is filled with oxygen before going back to the heart again (Schiller et al., 2020).  The heart then pumps the blood to the entire body and attaches opioid receptors (Schiller et al., 2020).  The heart then slows down and the opioid suppresses the neurological signal which causes oxygen levels to fall (Schiller et al., 2020).  The patient then became unresponsive and laid for an unknown period of time on his left side on the floor where he was found.  According to Schiller et al., (2020), the opiates act on opiate receptors in the brain which causes the mu receptor to release dopamine that blocks the signal of pain and decreases the level of consciousness.  With the patient unresponsive laying in the same position on his left side without any signal of pain necrosis set in to the tissue on the left greater trochanter and left forearm.  According to McCance & Huether (2019), when a cell dies it triggers an inflammatory response and plasma and protein is leaked out of the cells.  This process recruits’ leukocytes in host defense and tissue repair (McCance & Huether, 2019).  The patient’s blood supply was decreased to the greater trochanter and left forearm from the pressure of laying on them too long without movement. This caused the nucleus of the cells to swell.  Then the plasma membrane ruptured and caused cellular and nuclear lysis and inflammation to the areas discussed.  The living tissue broke down, releasing chemicals into the bloodstream and tissue damage occurred and became necrotic when the cells died.  

 Next the Naloxone was administered by the EMS.  According to the National Institute on Drug Abuse (2018), Naloxone is an opioid antagonist and it binds to the opioid receptors.  It reverses the effects of opioids and blocks them (National Institute on Drug Abuse, 2018).  Normal respirations then occur in the patient and they become responsive. They then start to feel pain again as well.  Once at the ED the patient was found to have an elevated serum potassium level and an EKG with a prolonged PR interval and elevated T waves.  According to Simon et al., (2020), dehydration leads to hypotension and decreased tissue perfusion.  Metabolic acidosis occurs next with decreased circulation of blood flow (Simon et al., 2020).  Next a shift in the potassium occurs, an intracellular shift, and this causes an elevated potassium level (Simon et al., 2020).  According to Yates & Manini (2012), an elevated potassium level causes a prolonged PR interval because opioids decrease sympathomimetic tone and rhythm disturbances occur due to a blockade of potassium.  With the peaked T waves an ion disturbance takes place because the potassium channels are being blocked (Yates & Manini, 2012).

The Cells That Are Involved in This Process

 In this scenario the blood cells are involved because of the decrease in blood circulation.  The skeletal muscle cells are involved because the patient was down for a long period of time in the same position.  The nerve cells are involved because the feeling of pain was decreased because the pain receptors were blocked.  The skin cells are involved because of the necrosis that occurred.  So many cells were involved in this overdose and the repercussions from the overdose.

How Another Characteristic Would Change My Response

 I am not sure any characteristic would change my response.  Characteristics such as gender, genetics, physical appearance or age would not affect my response.  Whether male or female, old or young, tall or short, with an opioid overdose as in this scenario used, the results would be the same.  If the scenario spoke of healing time, then my response would be different for an example.  The scenario given to me, is going to be the same outcome no matter the characteristics.  All bodies will respond the same way as in the scenario.

References

American Psychological Association. (2008). Genes matter in addiction. https://www.apa.org/monitor/2008/06/genes-addict

McCance, K.L., & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8thed.). St. Louis, MO: Mosby/Elsevier

National Institute on Drug Abuse. (2018). Opioid overdose reversal with Naloxone (Narcan, Evzio). https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-reversal-naloxone-narcan-evzio

National Institute on Drug Abuse. (2019). Genetics and epigenetics of addiction drug facts. https://www.drugabuse.gov/publications/drugfacts/genetics-epigenetics-addiction

Schiller, E. Y., Goyal, A., Cao, F., & Mechanic, O.J. (2020). Opioid overdose. In StatPearls. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470415/

Simon, L.V., Hashmi, M.F., & Farrell, M.W. (2020). Hyperkalemia. In StatPearls. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470284/

Yates, C., & Manini, A. (2012).Utility of the electrocardiogram in drug overdose and poisoning: Theoretical considerations and clinical implications. https://www/ncbi.nlm.nih.gov/pmc/articles/PMC3406273/

What’s Coming Up in Week 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology.

 

Week 2: Altered Physiology

With a place squarely in the spotlight for patients diagnosed with all manner of disease, APRNs must demonstrate not only support and compassion, but expertise to guide patients’ understanding of diagnoses and treatment plans.

This expertise goes beyond an understanding of disease and sciences, such as cellular pathophysiology. APRNs must become experts in their patients, understanding their medical backgrounds, pertinent characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the immune system and the resultant disease processes. You consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

  • Evaluate cellular processes and alterations within cellular processes
  • Analyze alterations in the immune system that result in disease processes
  • Identify racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

Photo Credit: Getty Images/Hero Images

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

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.
By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College 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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M1Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M1Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Module 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

To participate in this Assignment:

Module 1 Assignment

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 2, you will analyze processes related to cardiovascular and respiratory disorders. To do this, you will analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 3 Knowledge Check: Cardiovascular and Respiratory Disorders

In the Week 3 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 2. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

 

Week 3: Concepts of Cardiovascular and Respiratory Disorders

The circulatory system and the respiratory system are powerful partners in health. While they work closely together in good health, a disease or disorder that manifests in one can have a significant impact on both, hampering the pair’s ability to collaborate.

Cardiovascular and respiratory disease and disorders are among the most common reasons for hospital visits, and among the leading causes of fatality. Heart disease and pneumonias are among the most familiar, but a wide variety of issues can impact physiological functioning of one or both systems.

This week, you examine fundamental concepts of cardiovascular and respiratory disorders. You explore common diseases and disorders that impact these systems, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Cardiovascular and Respiratory Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • myocardial infarction
  • endocarditis
  • myocarditis
  • valvular disorders
  • lipid panels
  • coagulation
  • clotting cascade
  • deep vein thrombosis
  • hypertension
  • heart failure
  • COPD
  • asthma
  • pneumonias

Photo Credit: Getty Images/Science Photo Library RF

Complete the Knowledge Check by Day 7 of Week 3

To complete this Knowledge Check:

Module 2 Knowledge Check

What’s Coming Up in Week 4?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will examine the alterations in the cardiovascular and respiratory systems and the resultant disease processes through case study analysis. You will also consider patient characteristics, including racial and ethnic variables, which may impact altered physiology.

 

 

Week 4: Alterations in the Cardiovascular and Respiratory Systems

Cardiovascular and respiratory disorders can quickly become dangerous healthcare matters, and they routinely land among the leading causes of hospital admissions. Disorders in these areas are complicated by the fact that these two systems work so closely as contributors to overall health. APRNs working to form a similarly close partnership with patients must demonstrate not only support and compassion, but expertise to guide the understanding of diagnoses and treatment plans. This includes an understanding of patient medical backgrounds, relevant characteristics, and other variables that can be factors in their diagnoses and treatments.

This week, you examine alterations in the cardiovascular and respiratory systems and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

  • Analyze processes related to cardiovascular and respiratory disorders
  • Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
  • Analyze racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Module 2 Assignment: Case Study Analysis

An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact.

Photo Credit: yodiyim – stock.adobe.com

An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following

  • The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.
By Day 7 of Week 4

Submit your Case Study Analysis Assignment by Day 7 of Week 4

Reminder: The College 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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M2Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Module 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Module 2 Assignment

What’s Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 3, you will analyze processes related to gastrointestinal and hepatobiliary disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 5 Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In Week 5 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 3. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check since the resources cover the topics addressed. Plan your time accordingly.

Next Module

To go to the next Module:

Module 3

 

Week 5: Concepts of Gastrointestinal and Hepatobiliary Disorders

Patients of gastrointestinal and hepatobiliary disorders often face life-altering changes, including changes to diet, new treatment regimens, and more. For some disorders, treatments can include surgery.

Gastrointestinal conditions, such as ulcers, diverticulitis, and pancreatitis, often cause varying levels of pain and discomfort. Hepatobiliary conditions can also bring significant changes to patient routines and well-being.

This week, you examine fundamental concepts of gastrointestinal and hepatobiliary disorders. You explore common disorders in these categories, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the life span

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Gastrointestinal and Hepatobiliary Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • Ulcers
  • Hepatitis markers
  • After HP shots
  • Gastroesophageal Reflux Disease
  • Pancreatitis
  • Liver failure—acute and chronic
  • Gall bladder disease
  • Inflammatory bowel disease
  • Diverticulitis
  • Jaundice
  • Bilirubin
  • Gastrointestinal bleed – upper and lower
  • Hepatic encephalopathy
  • Intra-abdominal infections (e.g., appendicitis)
  • Renal blood flow
  • Glomerular filtration rate
  • Kidney stones
  • Infections – urinary tract infections, pyelonephritis
  • Acute kidney injury
  • Renal failure – acute and chronic

Photo Credit: Getty Images

Complete the Knowledge Check By Day 7 of Week 5

To complete this Knowledge Check:

Module 3 Knowledge Check

What’s Coming Up in Module 4?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 4, you will analyze processes related to endocrine disorders. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact physiological functioning and altered physiology.

Week 6 Knowledge Check: Endocrine Disorders

In the Week 6 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 4. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Also, during this week you will take your Midterm Exam. Please make sure to finalize and complete your Knowledge Check prior to completing your exam.

Next Module

 

Week 6: Concepts of Endocrine Disorders

Endocrine disorders are complex matters, and there is not always a one-size-fits-all treatment. Particularly in matters requiring the adjustment of hormone levels, treatment may require a custom approach tailored to individual patients. An understanding of these complications is essential to supporting these individual treatment plans.

This week, you examine alterations in the endocrine system and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Optional Resources (click to expand/reduce)

Knowledge Check: Endocrine Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • Diabetes
  • Hyper- and hypothyroidism
  • Adrenal disorders
  • Parathyroidism (hyper and hypo)
  • Checks & balances / negative feedback
  • Syndrome of Inappropriate Antidiuretic Hormone
  • Pheochromocytosis
  • Diabetes insipidus
  • Diabetic ketoacidosis

Photo Credit: Getty Images/Science Photo Library RF

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm Exam.)

Complete the Knowledge Check By Day 5 of Week 6

To complete this Knowledge Check:

Module 4 Knowledge Check

Midterm Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm exam.)

Photo Credit: Getty Images

To prepare:

To help you review for your midterm exam, access the Midterm Exam Review document found in this week’s Learning Resources as well as any Knowledge Check feedback you might have received. (Note: You will also need to review all of your materials from each of these weeks to also help you better prepare for your midterm.)

By Day 7 of Week 6

Submit your Midterm Exam.

To complete your exam:

Midterm Exam

What’s Coming Up in Module 5?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 5, you will analyze processes related to neurological and musculoskeletal disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 7 Knowledge Check: Neurological and Musculoskeletal Disorders

In the Week 7 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 5. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module

 

 

Week 7: Concepts of Neurological and Musculoskeletal Disorders – Part 1

Anatomists often use the analogy of a house to explain the human body, with skeletal systems, respiratory systems, and circulatory systems represented as a home’s framing structure, ventilation, and piping, respectively. Such analogies further emphasize the point that relationships between systems can result in complications when issues arise in one system.

With hundreds of diseases that can impact the brain, spine, and nerves, neurological disorders represent a complicated array of issues that present significant health concerns. Disorders such as strokes and Parkinson’s disease not only affect the nervous system, however; they can have secondary impacts in other areas, especially the musculoskeletal system.

This week, you examine fundamental concepts of neurological disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Neurological and Musculoskeletal Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • Stroke
  • Multiple sclerosis
  • Transient Ischemic Attack
  • Myasthenia gravis
  • Headache
  • Seizure disorders
  • Head injury
  • Spinal cord injury
  • Inflammatory diseases of the musculoskeletal system
  • Osteoporosis
  • Osteopenia
  • Bursitis
  • Tendinitis
  • Gout
  • Lyme Disease
  • Spondylosis
  • Fractures
  • Parkinson’s
  • Alzheimer’s

Three basic bone-formations:

  • Osteoblasts
  • Osteocytes
  • Osteoclasts

Photo Credit: Getty Images/Science Photo Libra

Complete the Knowledge Check By Day 7 of Week 7

To complete this Knowledge Check:

Module 5 Knowledge Check

 

 

 

 

 

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time.

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives.

This week, you continue to examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  • Analyze processes related to neurological and musculoskeletal disorders
  • Identify racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here. 

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Module 5 Assignment: Case Study Analysis

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

Photo Credit: jijomathai – stock.adobe.com

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Day 7 of Week 8

Submit your Case Study Analysis Assignment by Day 7 of Week 8.

Reminder: The College 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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M5Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M5Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Module 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 8

To participate in this Assignment:

Module 5 Assignment

Week 9: Concepts of Psychological Disorders

Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.

Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.

This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  •  Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Psychological Disorders

In this exercise, you will complete a 10-20 question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • Generalized anxiety disorder
  • Depression
  • Bipolar disorders
  • Schizophrenia
  • Delirium and dementia
  • Obsessive compulsive disease

Photo Credit: agsandrew – stock.adobe.com

Complete the Knowledge Check By Day 7 of Week 9

To complete this Knowledge Check:

Module 6 Knowledge Check

What’s Coming Up in Module 7?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

 In Module 7, you will analyze processes related to women’s and men’s health, infections, and hematologic disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In the Week 10 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 7. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 10: Concepts of Women’s and Men’s Health, Infections, and Hematologic Disorders

Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.

Understanding these differences in traits and their impact on pathophysiology can better equip acute care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.

This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives

Students will:

  • Analyze concepts and principles of pathophysiology across the life span
  • Analyze processes related to women’s and men’s health, infections, and hematologic disorders
  • Identify racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In this exercise, you will complete a 10-20-question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

  • Sexually transmitted diseases
  • Prostate
  • Epididymitis
  • Factors that affect fertility
  • Reproductive health
  • Alterations and fertility
  • Anemia
  • ITP and TTP
  • DIC
  • Thrombocytopeni

Photo Credit: Getty Images

Complete the Knowledge Check By Day 7 of Week 10

To complete this Knowledge Check:

Module 7 Knowledge Check

Module 7 Assignment: Case Study Analysis

 An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.

Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • The factors that affect fertility (STDs).
  • Why inflammatory markers rise in STD/PID.
  • Why prostatitis and infection happens. Also explain the causes of systemic reaction.
  • Why a patient would need a splenectomy after a diagnosis of ITP.
  • Anemia and the different kinds of anemia (i.e., micro and macrocytic).
Day 7 of Week 10

Submit your Case Study Analysis Assignment by Day 7 of Week 10

Reminder: The College 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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “M7Assgn+last name+first initial.(extension)” as the name.
  • Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Module 7  Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M7Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Module 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Module 7 Assignment

What’s Coming Up in Module 8?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.

Week 11 Knowledge Check: Pediatrics

In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 11 Final Exam: Pediatrics

In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Final Exam, since the resources cover the topics addressed. Plan

Group A Scenario:

A mother brings her 6-month-old daughter to the HCP for evaluation of possible colic. The mother says the baby has had many episodes of crying after eating and, despite having a good appetite, is not gaining weight. The mother says the baby’s belly “gets all swollen sometimes.” The mother says the baby tastes “salty” when the mother kisses the baby. Further workup reveals a diagnosis of cystic fibrosis. The mother relates that her 23-month-old son has had multiple episodes of “chest congestion” and was hospitalized once for pneumonia. The mother wants to know what cystic fibrosis is and she also wants to know if she should have any more children.

Response:

According to the Mayo Clinic, Cystic fibrosis (CF) is a genetic disorder that affects the lungs, digestive system, and other human body organs—characterized by sticky mucus, salty taste in the mouth, and sweat. The patients show symptoms like constant cough, thick mucus, wheezing, and intolerance to physical activities. In newborns, you can also notice foul-smelling, greasy stools, poor weight gain, and growth. These symptoms are due to the alteration of genetic material.

The role genetics in cystic fibrosis.

Cystic fibrosis can occur when a patient receives one copy of each gene from both parents, and when these genes do not function well, the mutation runs the risk of being present in their offspring. “It is an autosomal recessive disease meaning that both parents must be a carrier of one deleterious allele of the gene liable for this disorder. For these couples, the risk of having a CF child is, therefore, one-in-four at each pregnancy” (Férec & Scotet, 2020).  In group A case study, there is no disease history of the parent, but it mentioned that the 23-month-old son has had multiple chest congestion episodes and hospitalized for pneumonia. In the case study scenario, the child’s symptoms and the brother’s history shows that both parents must have a mutated gene responsible for cystic fibrosis. “A mutation is an inherited alteration of genetic material. Microscopically observable alterations of chromosome number or structure are examples of mutations”. (McCance & Huether,2019). The child presents with symptoms like; many episodes of crying after eating despite having a good appetite bu is not gaining weight, belly gets all swollen sometimes, and baby’s mouth tastes salty. People with cystic fibrosis have a higher than average salt level in their sweat because of the obstruction of the transport of negatively charged chloride ions that controls water in and out of the tissue.

The physiologic response to the stimulus

At the cellular level for patients with cystic fibrosis, there is an obstruction of the transport of negatively charged chloride ions that controls water in and out of the tissue needed for the formation of mucus. According to the article from Genetics Home Reference, the CFTR gene is a protein called the cystic fibrosis transmembrane conductance regulator. This protein acts as a channel across the membrane of cells that create mucus, sweat, saliva, tears, and digestive enzymes. The channel carries negatively charged particles called chloride ions into and out of cells. The transport of chloride ions facilitates control of water movement in the tissues, which is needed to make thin, freely flowing secretions. Mucus is a slippery secretion that lubricates and protects the airways’ lining, digestive system, reproductive system, and other organs and tissues. The CFTR protein also controls the function of different channels, such as those that movement of positively charged particles called sodium ions across cell membranes, which is for organs such as the lungs and pancreas. The mutations in the CFTR gene alters the making and formation of the chloride channel. All these changes prevent the medium from functioning well, impairs the movement of chloride ions and the movement of water into and out of cells. As a result, cells that line the pathways of the lungs, pancreas, and other organs produce thick and sticky secretions that obstruct the airways and glands, leading to the characteristic signs and symptoms of cystic fibrosis.

 The cell involved                

The epithelial cell is involved in this process; the CFTR gene mutation leads to the digestive and respiratory system dysfunction. “CF epithelial cells display abnormal ion transport responses when stimulated by cAMP-mediated agonists. cAMP-dependent signaling is intact in CF cells, and the characteristic cellular CF phenotype correlates with CFTR’s ability to undergo regulatory phosphorylation by protein kinases” (Cohn, 2005).

In males, abnormal intraluminal mucus causes congenital absence of vas deferens and male infertility. According to health prep, other characteristics like family history, chronic infection, Hemoptysis, and bronchiectasis are associated with widening and scarring of the lungs due to cystic fibrosis. This injury done to the bronchial tubes leads to symptoms like wheezing, persistent cough, breathing problems, chest pain, tiredness, and no weight gain.

 

Reference

Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing Ranks of Advanced Practice Clinicians – Implications for the Physician Workforce. New England Journal of Medicine, 378(25), 2358–2360. https://doi-org.ezp.waldenulibrary.org/10.1056/NEJMp1801869

Cohn JA. Reduced CFTR function and the pathobiology of idiopathic pancreatitis. J Clin Gastroenterol. 2005;39(4 Suppl 2):S70-S77. doi:10.1097/01.mcg.0000155522.89005.bf

Férec, C., & Scotet, V. (2020). Genetics of cystic fibrosis: Basics. Archives de Pédiatrie, 27(Supplement 1), S4–S7. https://doi-org.ezp.waldenulibrary.org/10.1016/S0929-693X(20)30043-9

Green, D. M., Collaco, J. M., McDougal, K. E., Naughton, K. M., Blackman, S. M., & Cutting, G. R. (2012). Heritability of Respiratory Infection with Pseudomonas aeruginosa in Cystic Fibrosis. The Journal of Pediatrics, 161(2), 290–295. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jpeds.2012.01.042

Genetic Home Reference. (2020, August 17) National Institute of Medicine: CFTR gene

cystic fibrosis transmembrane conductance regulator. Retrieved from: https://ghr.nlm.nih.gov/gene/CFTR

HealthPrep. (2020).  Causes, Risk Factors and Complications of Cystic Fibrosis. Retrieved from: https://healthprep.com/articles/conditions/causes-risks-complications-cystic-fibrosis/

Hedgecoe, A. M. (2003). Expansion and uncertainty: cystic fibrosis, classification and genetics. Sociology of Health & Illness, 25(1), 50–70. https://doi-org.ezp.waldenulibrary.org/10.1111/1467-9566.t01-2-00324

Mayo Clinic. (2020, March 14). Diseases and conditions: Cystic fibrosis. Retrieved from https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/symptoms-causes/syc-20353700.

McCance, K. L. & Huether  , S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.