NURS 6501 A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers

NURS 6501 A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers

Case Study Analysis

The case study features a 65-year-old obese man with a crampy left lower quadrant, fever, discomfort, and constipation. The client has a history of diverticulitis, which might explain his present symptoms. He also admits to eating an imbalanced diet that is low in fiber and leading an unhealthy lifestyle with little physical activity. His father died of colon cancer as well. He decided to get a colonoscopy, which revealed that he had several polyps that tested positive for colon adenocarcinoma. The purpose of this discussion is to demonstrate the pathophysiology behind the patient’s symptoms as well as how genes and the immune system contribute to the onset of the illness.

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Patient Symptoms

The patient, who is also morbidly obese, complains of fever, constipation, and tightness in the left lower quadrant. He has a history of diverticulitis, which could have contributed to his symptoms along with his low fiber, poor diet, and sedentary lifestyle. According to studies, people with diverticulitis typically have tiny pouches that protrude from the lower digestive tract’s inner lining (Kayano et al., 2019). The normal outcome of rupturing one or more of these pouches is inflammation, which can occasionally result from infections and cause fever, lower abdominal pain, constipation, and nausea (Koo et al., 2020). Moreover, a high-fiber diet typically contributes to an increase in feces volume. As a result, the patient’s constipation gets worse while eating a low-fiber diet. The patient’s condition is further influenced by their unhealthy lifestyles, older age, and obesity.

Genetics

Colon cancer is frequently accompanied by certain complex health conditions linked to genetic alterations that promote the transformation of an aggressive adenocarcinoma from an adenoma. Colon cancer is among the most common hereditary cancer syndromes. According to studies, persons with familial adenomatous polyposis (FAP) often pass on mutations of the adenomatous polyposis gene (APG) at the early stages of the disease (Hassab et al., 2020). The KRAS proto-oncogenes and the tumor-suppressing genes Deleted in Colorectal Carcinoma (DCC) are additional genes connected to colon cancer development.

Immunosuppression

When an individual’s immune response is compromised, either temporarily or permanently, due to any type of immune system failure, among other health issues, the person is more susceptible to infections. This condition is known as immunosuppression (McKechnie et al., 2021). Immunosuppression has been linked to several causes, including medications like corticosteroids and chronic illnesses like diverticulitis. Moreover, researchers have shown that tumor cells regularly emit immunosuppressive substances that affect the patient’s immune system on a local and systemic level (Kearney et al., 2021). Adenosine, Interleukin-10 (IL-10), PGE2, and Transforming Growth Factor (TGF) are only a few of the immunosuppressive substances that tumor cells often generate. They are to blame for the immune cells’ compromised performance. Because of the patient’s body’s inability to defend itself against external dangers like germs, the likelihood of infection as well as other health problems increases.

Conclusion

The obese patient in the case study exhibits symptoms of colon cancer. Age, diverticulitis, and a family history of colon cancer may all have contributed to the patient’s disease. The development of colon cancer is often influenced by several genetic variables, including the proto-oncogenes APG and KRAS as well as the tumor-suppressing genes DCC. Studies have also shown that tumor cells can release immunosuppressive substances that raise the likelihood of infection in the patient. With this understanding, it is essential to treat the underlying causes of the patient’s ailment and encourage healthy habits for a better outcome.

References

Hassab, T., D’Adamo, C. R., Patel, S. D., Mavanur, A. A., Svoboda, S., & Wolf, J. H. (2020). Risk of Unexpected Colon Cancer after Operation for Suspected Diverticulitis. Journal of the American College of Surgeons, 231(4), e11-e12. DOI: 10.1016/j.jamcollsurg.2020.08.030

Kayano, H., Ueda, Y., Machida, T., Hiraiwa, S., Zakoji, H., Tajiri, T., … & Nomura, E. (2019). Colon cancer arising from colonic diverticulum: A case report. World Journal of Clinical Cases, 7(13), 1643. PMID: 31367623

Kearney, M. B., Williams, J. M., & Ebell, M. H. (2021). Colon Cancer and Diverticular Disease Association: a Case-Control Study. Journal of Gastrointestinal Cancer, 52(1), 120-124. https://doi.org/10.1007/s12029-019-00355-1

Koo, C. H., Chang, J. H., Syn, N. L., Wee, I. J., & Mathew, R. (2020). Systematic review and meta-analysis on colorectal cancer findings on colonic evaluation after CT-confirmed acute diverticulitis. Diseases of the Colon & Rectum, 63(5), 701-709. https://doi.org/10.1097/DCR.0000000000001664

McKechnie, T., Lee, Y., Kruse, C., Qiu, Y., Springer, J. E., Doumouras, A. G., … & Eskicioglu, C. (2021). Operative management of colonic diverticular disease in the setting of immunosuppression: A systematic review and meta-analysis. The American Journal of Surgery, 221(1), 72-85. https://doi.org/10.1016/j.amjsurg.2020.06.035

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In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factored in the diagnosis, and you explain the implications to patient health. This week we will have another case study to consider. You will review the below-listed case study and present your findings in a 1-2 page case study analysis. Be sure to review all of the requirements carefully for this assignment. If you have questions be sure to reach out.

Case Study:

A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101Ëš F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and a diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent a colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.

Be sure that your paper is no more than 1-2 content pages. You are to also include a title page, introduction, summary,  and reference page. No more than 1-2 content pages.

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.

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Criteria

Ratings

Pts

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.

30 to >27.0 pts Excellent 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.

27 to >24.0 pts Good The response describes the patient symptoms….. The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

24 to >22.0 pts Fair 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.

22 to >0 pts Poor 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.

30 pts

Identify the genes that may be associated with the development of the disease.

25 to >22.0 pts Excellent The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.

22 to >19.0 pts Good The response includes an accurate analysis of the genes that may be associated with the development of the disease.

19 to >17.0 pts Fair The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

17 to >0 pts Poor The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

25 pts

Explain the process of immunosuppression and the effect it has on body systems.

30 to >27.0 pts Excellent The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

27 to >24.0 pts Good The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

24 to >17.0 pts Fair The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

17 to >0 pts Poor The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

30 pts

Written Expression and Formatting – Paragraph

5 to >4.0 pts Excellent

4 to >3.0 pts Good

3 to >2.0 pts Fair

2 to >0 pts Poor

5 pts

Criteria	Ratings									Pts
Development and	Paragraphs and			Paragraphs and			Paragraphs and		Paragraphs and
Organization:	sentences follow			sentences follow			sentences follow		sentences follow
Paragraphs make	writing standards for			writing standards			writing standards		writing standards
clear points that	flow, continuity, and			for flow, continuity,			for flow, continuity,		for flow,
support well-	clarity….. A clear and			and clarity 80% of			and clarity 60%–		continuity, and
developed ideas,	comprehensive			the time. …			79% of the time. …		clarity < 60% of
flow logically, and	purpose statement,			Purpose,			Purpose,		the time…… No
demonstrate	introduction, and			introduction, and			introduction, and		purpose
continuity of ideas.	conclusion are			conclusion of the			conclusion of the		statement,
Sentences are	provided that			assignment are			assignment are		introduction, or
carefully focused—	delineate all required			stated, yet are brief			vague or off topic.		conclusion were
neither long and	criteria.			and not descriptive.					provided.
rambling nor short
and lacking
substance. A clear
and comprehensive
purpose statement
and introduction are
provided that
delineate all
required criteria.
Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation	5 to >4.0 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.	4 to >3.0 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.			3 to >2.0 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.			2 to >0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.		5 pts
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 to >4.0 pts Excellent Uses correct APA format with no errors.		4 to >3.0 pts Good Contains a few (1 or 2) APA format errors.			3 to >2.0 pts Fair Contains several (3 or 4) APA format errors.			2 to >0 pts Poor Contains many (≥ 5) APA format errors.	5 pts
Total Points: 100