NURS 6501 Women’s and Men’s Health Infections and Hematologic Disorders

NURS 6501 Women’s and Men’s Health Infections and Hematologic Disorders

Sample Answer for NURS 6501 Women’s and Men’s Health Infections and Hematologic Disorders Included After Question

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: 

  • 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 

 

NURS 6501 Women’s and Men’s Health, Infections, and Hematologic Disorders
NURS 6501 Women’s and Men’s Health, Infections, and Hematologic Disorders

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)  

 

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

  •  Chapter 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review 
  • Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review 
  •  Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review 
  •  Chapter 27: Sexually Transmitted Infections, including Summary Review 
  •   Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review 
  • Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review 
  • Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review 

 

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481 

 

 

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview 

 

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3 

 

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true 

Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center. 

 

Document: NURS 6501 Final Exam Review (PDF document)  

 

Note: Use this document to help you as you review for your Final Exam in Week 11. 

 

 

Required Media (click to expand/reduce)  

 

Module 7 Overview with Dr. Tara Harris  

Dr. Tara Harris reviews the structure of Module 7 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m) 

 

Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia 

Note: The approximate length of the media program is 5 minutes. 

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children 

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 24, 26, 28, and 30 that relate to the reproductive and hematological systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/ 

 

A Sample Answer For the Assignment: NURS 6501 Women’s and Men’s Health Infections and Hematologic Disorders

Title: NURS 6501 Women’s and Men’s Health Infections and Hematologic Disorders

Question 1

Scenario 1: Polycystic Ovarian Syndrome (PCOS)

A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.

Question

1.     What is the pathogenesis of PCOS? 

Selected Answer: Polycystic Ovary Syndrome (PCOS) has an underlying genetic component that causes irregular ovulation, increased androgens, and ovaries with polycystic characteristics (McCance & Huether, 2019). Glucose intolerance and insulin resistance increase androgen secretion via the ovaries’ supportive structures and reduce sex-hormone-binding globulin (McCance & Huether, 2019). Elevated leptin levels act on the hypothalamus interfering with hormone production. Follicular growth and apoptosis alterations influence the absence of ovulation, creating inappropriate functioning of FSH and LH. Cortical thickening increases subcortical stroma, and hyperplasia occurs (McCance & Huether, 2019)

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to release eggs regularly.

other factors that may contribute to the development of PCOS include:

·         Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body’s primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise, and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.

·

·         Low-grade inflammation. This term describes white blood cells’ production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, leading to heart and blood vessel problems.

·

·         Excess androgen. The ovaries produce abnormally high androgen levels, resulting in hirsutism and acne. Early diagnosis of PCOS and treatment and weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

·

Complications of PCOS can include: Infertility, Gestational diabetes or pregnancy-induced high

NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders

blood pressure, miscarriage or premature birth, Nonalcoholic steatohepatitis, Metabolic syndrome including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease, Type 2 diabetes or prediabetes, Sleep apnea, Depression, anxiety and eating disorders, Abnormal uterine bleeding, and cancer of the uterine lining (endometrial cancer). It is important to note that these complications are more severe in overweight women.

Correct Answer:  

The pathogenesis of PCOS has been linked to altered luteinizing hormone (LH) action, insulin resistance, and a possible predisposition to hyperandrogenism. One theory maintains that underlying insulin resistance exacerbates hyperandrogenism by suppressing synthesis of sex hormone–binding globulin and increasing adrenal and ovarian synthesis of androgens, thereby increasing androgen levels. These androgens then lead to irregular menses and physical manifestations of hyperandrogenism. The hyperandrogenic state is a cardinal feature of PCOS but glucose intolerance/insulin resistance and hyperinsulinemia often run parallel to and markedly aggravate the hyperandrogenic state, thus contributing to the severity of signs and symptoms of PCOS.

Response Feedback: [None Given]

Question 2

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Scenario 1: Polycystic Ovarian Syndrome (PCOS)

A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.

Question

How does PCOS affect a woman’s fertility or infertility? 

Selected Answer: PCOS is the leading cause of infertility in women (McCance & Huether, 2019). Infertility results from alterations in androgen production, follicular disturbances, and an absence of ovulation. In other words, PCOS  negatively impacts fertility because women with the condition do not ovulate or release an egg each month due to an overproduction of estrogen by the ovaries.
Correct Answer:  

Ovulation problems are usually the primary cause of infertility in women with PCOS. Ovulation may not occur due to an increase in testosterone production or © 2020 Walden University 2 because follicles on the ovaries do not mature. Due to unbalanced hormones, ovulation and menstruation can be irregular. A hyperandrogenic state is a cardinal feature in the pathogenesis of PCOS. Excessive androgens affect follicular growth, and insulin affects follicular decline by suppressing apoptosis and enabling follicle to persist. There is dysfunction in ovarian follicle development. Inappropriate gonadotropin secretion triggers the beginning of a vicious cycle that perpetuates anovulation

Response Feedback: [None Given]

Question 3

4 out of 4 points

Scenario 2: Pelvic Inflammatory Disease (PID)

A 30-year-old female comes to the clinic with a complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 5 days. She denies nausea, vomiting, or difficulties with bowels. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID).

Question:

1.     What is the pathophysiology of PID? 

Selected Answer: Pelvic inflammatory disease (PID) is a condition of inflammation related to infections and involves the uterus, fallopian tubes, ovaries, and the peritoneal cavity in severe cases. Infections combined with the normal vaginal microbiome’s failure allow the infecting microorganism to spread into the upper genital tract causing PID (McCance & Huether, 2019). Although often caused by gonorrhea or chlamydia, PID’s etiology can be caused by multiple bacteria when the pH of the vagina changes and alter the integrity of the mucus of the cervix (McCance & Huether, 2019). Altering the cervix’s integrity allows an inflammatory process to begin in the uterus and fallopian tubes with edema, obstruction, or necrosis. Gonorrhea pathogens secrete toxins increasing the inflammation and damage, and chlamydia replicates in the cells rupturing the cell membrane, with both pathogens capable of spreading into the abdominal cavity (McCance & Huether, 2019).
Correct Answer:  

Pelvic inflammatory disease (PID) is an infectious and inflammatory disorder of the upper female genital tract, including the uterus, fallopian tubes, and adjacent pelvic structures. Infection and inflammation may spread to the abdomen, including perihepatic structures. PID is initiated by infection that ascends from the vagina and cervix into the upper genital tract. Chlamydia trachomatis is the predominant sexually transmitted organism associated with PID. Of all acute PID cases, less than 50% test positive for the sexually transmitted organisms such as Chlamydia trachomatis and Neisseria gonorrhea. Other organisms implicated in the pathogenesis of PID include, Gardnerella vaginalis (which causes bacterial vaginosis (BV), Haemophilus influenzae, and anaerobes such as Peptococcus and Bacteroides species. Inflammatory responses in the fallopian tubes and uterus causes swelling and sometimes necrosis of the area. This inflammation leads to scarring of the fallopian tubes and causes infertility. N gonorrhoeae is no longer the primary organism associated with PID, but gonorrhea remains the second most frequently reported sexually transmitted disease, after chlamydial infection.

Response Feedback: [None Given]

Question 4

8 out of 8 points

Scenario 3: Syphilis

A 37-year-old male comes to the clinic with a complaint of a “sore on my penis” that has been there for 5 days. He says it burns and leaked a little fluid. He denies any other symptoms. Past medical history noncontributory.

SH: Bartender and he states he often “hooks up” with some of the patrons, both male and female after work. He does not always use condoms.

PE: WNL except for a lesion on the lateral side of the penis adjacent to the glans. The area is indurated with a small round raised lesion. The APRN orders laboratory tests, but feels the patient has syphilis.

Question:

1.     What are the 4 stages of syphilis 

Selected Answer: When syphilis goes untreated, it advances through four stages identified through clinical manifestations. The first stage is the primary stage and consists of bacterial pathogens replicating in the epithelium, producing chancre, and draining into lymph nodes, which stimulates the adaptive immune response (McCance & Huether, 2019). The secondary stage involves a systemic invasion of pathogens with the immune system fighting the infection and clearing the chancres. The latent phase follows the secondary stage. There are no clinical manifestations in this period, although the individual infected transmit the disease if sexually active. In the final phase, the tertiary period, the disease’s systemic manifestations are severe and lead to death. These manifestations include destructive lesions in the skin, bone, and soft tissue and cardiovascular complications such as aneurysm, heart valve malfunctions, and heart failure (McCance & Huether, 2019). Additionally, neurological lesions are possible.
Correct Answer:  

4-5 . What are the 4 stages of syphilis?

Answer: Syphilis is an infectious venereal disease caused by the spirochete Treponema pallidum. Syphilis is transmissible by sexual contact with infectious lesions, from mother to fetus in utero, via blood product transfusion, and occasionally through breaks in the skin that come into contact with infectious lesions. If untreated, it progresses through 4 stages: primary, secondary, latent, and tertiary.

Primary: A chancre, or hard lesion develops at the site of the treponemal entry after exposure. In acquired syphilis, T pallidum rapidly penetrates intact mucous membranes or microscopic dermal abrasions and, within a few hours, enters the lymphatics and blood to produce systemic infection. Incubation time from exposure to development of primary lesions, which occur at the primary site of inoculation, averages 3 weeks but can range from 10-90 days. Secondary syphilis develops about 4-10 weeks after the appearance of the primary lesion. During this stage, the spirochetes multiply and spread throughout the body.

Secondary syphilis lesions are quite variable in their manifestations. Systemic manifestations include malaise, fever, myalgias, arthralgias, lymphadenopathy, and  rash. Even if untreated, the immune system is usually able to suppress the infection and spontaneous resolution of skin lesions occurs.

Latent syphilis is a stage at which the features of secondary syphilis have resolved, though patients remain seroreactive. Some patients experience recurrence of the infectious skin lesions of secondary syphilis during this period. About one third of untreated latent syphilis patients go on to develop tertiary syphilis, whereas the rest remain asymptomatic.

Tertiary syphilis disease is rare. When it does occur, it mainly affects the cardiovascular system (80-85%) and the CNS (5-10%), developing over months to years and involving slow inflammatory damage to tissues. The 3 general categories of tertiary syphilis are gummatous syphilis (also called late benign), cardiovascular syphilis, and neurosyphilis.

Response Feedback: [None Given]