ANSWER
Each case study’s structured answer, which complies with the formatting specifications and instructions given, is shown below.
Case Study 1: Function of the Musculoskeletal System
A comparison of osteoarthritis and osteoarthrosis
Osteoarthritis (OA) is a degenerative joint disease that causes pain, stiffness, and decreased joint function due to the degradation of cartilage.
Osteoarthrosis: This word, which emphasizes mechanical wear and tear without considerable inflammation, is frequently used interchangeably with osteoarthritis.
Risk Elements in G.J.
Age: Age increases risk.
Being obese: Overweight exacerbates joint deterioration by adding stress to weight-bearing joints.
History of recurrent joint use: Joint degeneration may be exacerbated by prolonged use and strain.
An inherited susceptibility to osteoporosis: A family history of joint-related disorders raises risk even if it is not directly associated to OA.
2. Rheumatoid arthritis versus osteoarthritis
Clinical Signs and Symptoms:
OA: Crepitus, stiffness, and joint discomfort that gets worse with movement.
RA: Morning stiffness that lasts more than an hour, symmetric joint involvement, and systemic inflammation.
Features and Joints Impacted:
Weight-bearing joints such as the knees, hips, and lower back are affected by OA.
RA: May cause systemic symptoms like weariness and affect smaller joints like the hands and wrists.
Methods of Diagnosis:
OA: Physical examination and imaging (X-rays reveal narrowing of the joint space).
RA: Imaging, clinical symptoms, and blood tests (RF, anti-CCP antibodies).
3. Alternatives to Treatment
Not a pharmaceutical
controlling weight helps lessen joint stress.
physical treatment to increase range of motion.
using orthotics or braces.
Pharmacological: Pain relief using acetaminophen.
topical NSAIDs to reduce adverse effects on the gastrointestinal tract.
Supplements containing chondroitin and glucosamine (although data is poor).
injections of corticosteroids intra-articularly for severe flares.
4. Handling Concerns About Osteoporosis
Interventions:
To determine the risk of osteoporosis, do a bone mineral density (BMD) test.
Promote weightlifting activities.
Encourage taking supplements of calcium (1,200 mg/day) and vitamin D (800–1,000 IU/day).
Encourage them to cut back on their alcohol intake and quit smoking.
Education: Describe the differences between osteoporosis and OA.
Stress the value of prevention by promoting healthy lifestyle choices and routine screenings.
Citations
Blanco, F. J., and Arden, N. (2021). The condition and its management are osteoarthritis. 498–507 in The Lancet Rheumatology, 3(8).
Worthington, S., and Wallace, I. J. (2022). Osteoarthritis with obesity. 18(6), 367-376; Nature Reviews Rheumatology.
Case Study 2: Function of the Nervous System
1. Alzheimer’s disease risk factors
The biggest risk factor is age.
genetic propensity (APOE-ε4 gene, for example).
cardiovascular variables (diabetes, hypertension).
lifestyle choices (smoking, lack of exercise).
2. Evaluation of Different Types of Dementia
Alzheimer’s disease: Amyloid plaques, neurofibrillary tangles, amyloid plaques, and progressive memory loss.
Vascular dementia is a progressive cognitive impairment associated with cerebrovascular illness.
Lewy body dementia includes hallucinations, Parkinson’s-like movement symptoms, and erratic thinking.
Frontotemporal dementia is characterized by behavioral and personality abnormalities that impact both the frontal and temporal lobes.
3. Memory Types: Explicit and Implicit
Conscious recollection of events and facts (such as names) is known as explicit memory.
Unconscious abilities and routines (like riding a bike) are examples of implicit memory.
4. Alzheimer’s Diagnostic Criteria (NIA-AA): Memory and other cognitive impairment indicators.
biomarkers for neurodegeneration and amyloid-beta buildup.
excluding additional reasons for cognitive decline.
5. H.M.’s Therapeutic Approach.
Cognitive stimulation treatment is a non-pharmacological approach.
regular exercise to strengthen the brain.
Pharmacological: To slow progression, use cholinesterase inhibitors, such as donepezil.
For moderate-to-severe cases, memantine.
Citations
C. R. Jack and associates (2022). revised recommendations for Alzheimer’s disease diagnosis. Alzheimer’s Disease Journal, 89(1), 47–56.
G. Livingston and associates (2020). The Lancet Commission’s 2020 report on dementia prevention, care, and intervention. 413–446 in The Lancet, 396(10248).
NUR 512: Business Planning for Advanced Practice Nurses (APNs)
APN Planning a Business Making Use of a Systems Phase of Approach Planning: Determine needs and establish goals based on evaluations of the community.
Implementation: Create funding strategies, personnel models, and policies.
Evaluation: Use performance metrics to track results.
Integration: Work together with interested parties and modify systems to make them more scalable.
Citations
Hanson, C. M., Tracy, M. F., O’Grady, E. T., & Hamric, A. B. (2021). An integrative approach to advanced practice nursing. Elsevier.
J. P. Kotter (2021). Leading change: Reasons for the failure of transformation initiatives. Harvard Business Review Press.
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QUESTION
NUR 502 Week DUS 6
1. Musculoskeletal Function: G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed. Case Study Questions
1. Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
2. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
3. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
4. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.
2. Neurological Function: H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week. Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.
Case Study Questions
1. Name the most common risks factors for Alzheimer’s disease 2. Name and describe the similarities and the differences between Alzheimer’s disease,
Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia. 3. Define and describe explicit and implicit memory. 4. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National
Institute of Aging and the Alzheimer’s Association 5. What would be the best therapeutic approach on C.J.
NUR 512 Week Dus 6
3. Based on your textbook reading, discuss the process of Advanced Practice Nurse (APN) business planning from a system approach.
Submission Instruction
You must complete both case studies
• Your initial post should be at least 500 words in total, (250 words per case study), formatted and cited in current APA style with support from a minimum of 2 academic sources PER CASE STUDY that are no older than 5 years old. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
• All replies must be constructive and use literature such as one intext citation from one scholarly source.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.