Posted: May 15th, 2023

Part 1: Pathophysiology G.J. is a 71-year-old overweight woman

Part 1: Pathophysiology (Divide the assigned seven paragraphs for part 1 into the nine questions solicited.) Case 1: Musculoskeletal Function

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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. 1. Briefly explain osteoarthritis a. Explain the differences with osteoarthritis. b. Briefly explain the risk factors presented on the case that contribute to the diagnosis of osteoarthritis.

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2. Briefly explain two differences between osteoarthritis and rheumatoid arthritis a. Include one clinical manifestation b. Include one major characteristic c. Include one joints usually affected and diagnostic methods.

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3. Briefly explain the different treatment alternatives available a. Including non-pharmacological and pharmacological appropriate for this patient and why. 4. How would you handle the patient concern about osteoporosis? a. Briefly explain the interventions and education regarding to osteoporosis case. Case 2: Neurological Function

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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. 5. Briefly explain two common risks factors for Alzheimer’s disease 6. Briefly explain two the similarities and two differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia. 7. Briefly explain explicit and implicit memory. 8. Briefly explain the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association

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9. Briefly explain what would be the best therapeutic approach on C.J. Part 2: Pathophysiology Topic: Pancreatic ductal adenocarcinoma 1. Describe the causes (One paragraph) 2. Describe two research on the disease (not older than 5 years) (One paragraph)

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a. Explain the findings 3. Describe the associated symptoms (One paragraph) 4. How is the disease treated? (One paragraph) a. How are symptoms relieved?

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5. Describe what is required to diagnose the condition (One paragraph) a. T3sts b. Symptoms c. signs

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6. Describe Data/statistics currently known concerning the disease a. Local (Miami) b.National c. Global

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Part 3: Nursing role transition to practice 1. Describe what business planning is (One paragraph) 2. Describe the relationship between business planning and system approach. (One paragraph) 3. Describe three characteristics of the process of Advanced Practice Nurse (APN) business planning from a system approach (One paragraph per characteristic: Total of three paragraphs)

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Parts 4 and 5 have the same questions. However, you must answer with references and different writing, always addressing them objectively, as if you were different students. Similar responses in wording or references will not be accepted. ___________________________ Part 1: Pathophysiology Case 1: Musculoskeletal Function

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1. Briefly explain osteoarthritis Osteoarthritis is a type of arthritis that occurs when the cartilage in the joints breaks down. This can cause pain, stiffness, and inflammation. Osteoarthritis is most common in the joints of the hands, knees, hips, and spine. a. Explain the differences with osteoarthritis. Osteoarthritis is different from rheumatoid arthritis in a few ways. Osteoarthritis is caused by wear and tear on the joints, while rheumatoid arthritis is an autoimmune disease. Rheumatoid arthritis causes inflammation in the joints, while osteoarthritis does not. Osteoarthritis is most common in older adults, while rheumatoid arthritis can occur at any age. b. Briefly explain the risk factors presented on the case that contribute to the diagnosis of osteoarthritis.

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The risk factors for osteoarthritis include: Age Obesity Injury to the joints Occupations that involve repetitive motion Genetics In the case of G.J., the risk factors for osteoarthritis include her age, obesity, and history of knee pain. 2. Briefly explain two differences between osteoarthritis and rheumatoid arthritis a. Include one clinical manifestation One clinical manifestation of osteoarthritis is joint pain that is worse with activity and improves with rest. Rheumatoid arthritis, on the other hand, can cause joint pain that is present even at rest.

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b. Include one major characteristic One major characteristic of osteoarthritis is the presence of osteophytes, which are bony growths that can form around the joints. Rheumatoid arthritis, on the other hand, does not cause osteophytes to form. c. Include one joints usually affected and diagnostic methods. Osteoarthritis most commonly affects the joints of the hands, knees, hips, and spine. Rheumatoid arthritis, on the other hand, can affect any joint in the body. The diagnosis of osteoarthritis is usually made based on the patient's history and physical examination. X-rays can be used to confirm the diagnosis and to assess the severity of the disease.

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3. Briefly explain the different treatment alternatives available There are a number of different treatment options available for osteoarthritis. These include: Pain medication Physical therapy Weight loss Joint injections Surgery The best treatment option for each individual will depend on the severity of their disease and their individual preferences. a. Including non-pharmacological and pharmacological appropriate for this patient and why. The non-pharmacological treatments for osteoarthritis, such as physical therapy and weight loss, are often the first line of treatment. These treatments can help to reduce pain and improve function. If these treatments are not effective, then pharmacological treatments, such as pain medication, may be used. The type of pain medication that is used will depend on the severity of the pain. In some cases, joint injections may be used to relieve pain and inflammation. If these treatments are not effective, then surgery may be necessary.

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In the case of G.J., the non-pharmacological treatments, such as physical therapy and weight loss, are the best option. She should also be encouraged to avoid activities that put stress on her knees. If these treatments are not effective, then she may need to consider pharmacological treatments, such as pain medication. 4. How would you handle the patient concern about osteoporosis? The patient's concern about osteoporosis is a valid one. Osteoporosis is a condition that causes bones to become weak and brittle. This can lead to fractures, even with minor injuries. The best way to handle the patient's concern is to educate her about osteoporosis. This includes discussing the risk factors for osteoporosis, the symptoms of osteoporosis, and the treatment options for osteoporosis. The patient should also be encouraged to make lifestyle changes that can help to prevent osteoporosis. These changes include: Getting enough calcium and vitamin D Exercising regularly Avoiding smoking and excessive alcohol consumption a. Briefly explain the interventions and education regarding to osteoporosis case. The interventions and education regarding to osteoporosis case include:

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Discussing the risk factors for osteoporosis Discussing the symptoms of osteoporosis Discussing the treatment options for osteoporosis Encouraging the patient to make lifestyle changes that can help to prevent osteoporosis Case 2: Neurological Function 5. Briefly explain two common risks factors for Alzheimer’s disease The two most common risk factors for Alzheimer’s disease are age and family history. The risk of developing Alzheimer’s disease increases with age. People over the age of 65 are more likely to develop Alzheimer’s disease than people under the age of 65

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